The DBC treatment concept comprises methods and devices used in the various phases of patient assessment, treatment and outcome monitoring. In acute back, neck or shoulder pain it is important to address the cause and ameliorate the distress of musculoskeletal pain by appropriate medication. The length of the pain episode may be reduced and the risk of chronicity reduced if the patient stays active, keeps spirits high and avoids fixing thoughts on pain.
STAYING ACTIVE TO COMBAT MUSCULOSKELETAL CONDITIONS AND ACUTE LOW BACK PAIN
Staying active to the extent possible is important in all musculoskeletal conditions. For instance, in acute low back pain it has been shown that ``…it is reasonable to advise people with acute low back pain and sciatica to stay active``. This recommendation is based on a systematic review of randomised clinical trials in which advice to stay active was compared with advice to rest in bed. The recommendation is based on the potentially harmful effects of bed rest. (Hilde et al. 2001.)
If the treatment of acute pain is not successful, a chronic condition can gradually develop as recurrent pain can induce behavioural, postural and functional changes that increase the likelihood of further pain episodes. While acute pain often has specific causes, chronic pain is a multidimensional problem. Often there are no clear correlations between pain and specific diagnostic findings.
TREATING CHRONIC MUSCULOSKELETAL PAIN, ADDRESSING DEFICITS IN MUSCULOSKELETAL SYSTEM
In medicine, the usual approach is to diagnose what the exact causes of a condition are. Then these causes are rectified by means of surgery or other forms of treatment targeting these specific causes. In chronic musculoskeletal pain, the exact physical causes are in most cases not identifiable, and that is why surgery or other specialised treatments often do not produce lasting results.
Chronic musculoskeletal pain involves subtle changes that have taken place in the affected tissues and the central nervous system. These are not identifiable by current clinical methods. Moreover there are changes in behaviour, such as tendency to avoid exertion. In consequence, the musculoskeletal system may develop deficits in control and reflex patterns, thus becoming increasingly susceptible to further problems.
Features of DBC Treatment System
The DBC treatment system is available for licensing. The DBC treatment system is available for clinics specialising in the treatment of musculoskeletal conditions. In addition to the ready-made treatment devices and protocols for using them, DBC International provides DBC clinics with training, manuals, support services as well as management and marketing tools. At the root of DBC treatment protocols is the DBC treatment concept. Its aim is to reduce musculoskeletal pain by restoring the normal function of the afflicted musculoskeletal system.
- Treatment programmes start with a careful, multidimensional initial assessment of each patient.
- On the basis of the initial assessment, an individual treatment plan is designed for each patient. The treatment programmes include not only exercise treatment but involve also cognitive and behavioural factors.
- Treatment takes advantage of special features of DBC equipment. DBC treatment protocols are available for back, neck and shoulder conditions.
- The treatment methods developed by DBC International are effective, because they rely on methods that have been tested in medical research and clinical practice.
DBC Treatment Concept
The DBC treatment concept is well suited for all care-giving settings in which treatment and rehabilitation of severe musculoskeletal problems is given a special emphasis. Reflecting the versatility of the DBC system, potential customers of DBC International include
- Hospital outpatient rehabilitation units
- Rehabilitation units
- Physiotherapy centres
- Occupational health care units
- Research centres
The DBC treatment concept consists of four phases: baseline assessment, design of individual treatment programmes, monitoring of outcomes and maintenance of results. There are specific protocols and devices available for all of the phases that are carried out in the clinic. Initial or baseline assessment forms the basis of treatments given at DBC clinics. The assessment focuses on factors that have been proven to be of relevance in rehabilitation and recovery.
The initial assessment is based on a structured interview with the patient and results obtained with specific measurements. The assessment is repeated later during the programme in order to gain insight on the progress of recovery. At the end of the programme an outcome assessment is carried out.
Baseline Assessment
- Forms the basis of individualised treatment plans
- Produces information on range-of-motion and muscle activity
- Questionnaires used in the interview provide information on cognitive and behavioural factors that have a bearing on recovery
- DBC software essential in the design of individualised treatment programmes
Progress Assessment
- Yields feedback on the progress of recovery
- Measurable improvements are usually gained and motivate patients to continue rehabilitation efforts
- Information on fatigue, postural control, physical function and pain
- DBC software essential
Outcome Assessment
- Shows the results of rehabilitation treatment for each patient
- DBC software also produces aggregated reports on patient outcomes for quality assurance purposes of the clinic management
- All patient information is treated as highly confidential and is carefully protected
