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|October 21, 2002|
The Rediff Special/Shobha Warrier
The colonel in the Indian Army is a committed and able officer, but has not been able to take up any challenging posting in difficult terrain. Reason: a persistent pain in the neck. "I have been suffering from a bad attack of spondylitis for the past few years," the dejected colonel said as he stood up stiffly. "It has affected my career very badly." It was evident from the officer's expression that he was in great pain, though bearing it stoically.
"Only those who suffer from back and neck pain will understand what a stumbling block it is in our personal and professional lives," said Sarada, an executive who has to regularly travel all around the world, but suffers from nagging back and neck pain.
Studies reveal that globally four out of five people suffer from back and neck pain sometime in their lives, and these ailments are the single largest contributors to employee absenteeism in the corporate world.
Back and neck pains arise if the discs, muscles, ligaments, and joints in the spine are not working properly. The pain is often exacerbated by lifting heavy loads. Such spines can be described as 'out of order' and need treatment to get them working properly again. Not surprisingly, people who are physically fit generally experience less back pain, and when they do, they recover faster.
Another study has found that back pain can develop on account of work pressures, criticism, and stress. In an experiment carried out at the Ohio State University in the United States, differences were revealed in how students used their body muscles when lifting loads in normal conditions and under stress, all of which contribute to back pain.
In India too, back pain is rampant, especially in urban areas and among those leading what are called corporate lifestyles. Recognising this fact, Apollo Hospitals has brought to this country a new method of treatment, called the 'Documentation-Based Care' therapy, which was developed by Dr Simo Taimela of the University of Kuopio's department of physiology, Finland, after more than 20 years of research.
It all started when Dr Taimela was doing physiology research at the university. "There were a few equipments intended for physical training, and we found that some patients responded very well to certain types of training. That was how the research programmes that included both physical and educational or vocational components started. We tried to figure out how well patients would respond to them," he told rediff.com
The research was followed by the publication of a large number of studies in various international medical journals. Finally, Dr Taimela and his team could develop a revolutionary treatment for spine-related problems called Documentation-Based Care therapy. "So you can say DBC is a concept borne out of over two decades of research and is now present in over 80 locations all over the world," he said.
Dr Taimela and his team designed the first training programme in the early 1990s, and the first version was ready by 1993, which, he said, has been refined further as "it is a continuous development process".
DBC is a spine-specific therapy that documents specific deficiencies in the system, and develops individual programmes to correct each deficiency before involving the whole body chain. The therapy treats each individual separately. On admission, all details about the patient and his/her history are recorded and programmes are designed exclusively for that patient. The patient is profiled and levels of pain and impairment as well as occupational, physical, and psychological details are found and listed, followed by physical assessment. Based on this information, the computer creates a programme for each patient.
The DBC back and neck treatment programmes consist of modular elements of physical exercises that are progressive and specific, and they are combined with functional exercises and relaxation training.
"The spine-specific exercises are aimed at the improvement of motor control and endurance of back and neck muscles under the guidance of a therapist who will apply behavioural modification as an adjunct to physical training. The exercises aim at improving lumbar stability and co-ordination," Dr Taimela explained.
DBC differs from physiotherapy in the sense that it complements the former. While traditional physiotherapy aims at pain relief by taking symptoms away through passive modalities like massage and heat packs, DBC aims at building up the structure or rebuilding the muscles and muscular strength and improving co-ordination, which may have deteriorated because of the prolonged symptom.
"This is the fundamental difference between physiotherapy and DBC. In short, we are trying to rebuild a function that has been lost for some time," Dr Taimela said. "Our intention is to re-educate patients how to use their muscles. It is usually found that muscles become weak and movements become less accurate when not in use. Our primary intention is to teach what sort of postures to keep and what sort of movements to use."
The first group of patients was treated with DBC therapy in Sweden. Nearly a decade later, more than 15,000 patients have been treated. The average success rate is 80-85 per cent, according to Dr Taimela. Moreover, there is no difference in the way people from different races respond to the treatment.
The main reason for back and neck pain among modern working people, Dr Taimela said, is their sedentary lifestyle. The treatment's duration depends on the severity of pain and muscle impairment. A typical module is for six weeks, but those with severe pain may need up to 12 weeks or more, followed by three months of a home programme.
The treatment in India costs Rs 9,000 to Rs 12,000. Though only Chennai has this facility now, the Apollo Hospitals Group plans to launch DBC centres at its Delhi and Hyderabad facilities too, before moving on to other key metros in the third phase.
Apollo Hospitals can be contacted at +91 44 829 5753 and firstname.lastname@example.org
Image: Rahil Shaikh
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