Lower back injury is one of the more common injuries occurring at work. Low back pain will affect 8 of every 10 people at some point in their lives. Since we spend much of that life in the workplace, it is frequently deemed a work-related injury. Weather it be from an accident or repetitive stress disorder, spinal rehabilitation is often part of the process for that person getting well and getting back to full and productive employment. However, sometimes traditional physical therapy in the clinic is not a reasonable option. Especially in our present Covid-19 environment. Some examples include:
1. Employee wishes to limit exposure to Covid-19 from going into a therapy clinic.
2. Employee is a traveling worker, i.e., truck driver, route driver, sales and is constantly away.
3. Employee works a shift concurrent with the therapy clinic hours and having to clock out creates financial hardship.
4. Employee lives remotely and would have to travel extensively to attend regular physical therapy.
With these scenarios in mind, we have another option for rehabilitation of these patients. MRS. Health provides the first isolated lumbar extension strengthening machine directly connected to the web by propriety software called EVE. This treatment is easily individualized with high quality results due to its automated protocol planning, feedback based adaptive loading and pain monitoring throughout the established program. With this device the pelvis is locked into place, thus preventing firing of the glutes and hamstrings to isolate the lumbar extensors during exercise. The device provided in the Jonesboro, AR area through a joint venture with Cynergy Rehab Group and MRS Health.
The minimum 90-day treatment is paid for by Workers Compensation only. Device is delivered to the patient’s home the patient is instructed in use by a health coach. Additional exercises are instructed to be done before exercises on the device and selected exercises for cool down afterward. While using the machine, the patient gets instant feedback as to their performance through the monitor on the machine which guides them to proper speed and range of motion. Performance scores and feedback are provided to the patient immediately after completion of each set, and feedback is obtained from the patient as to the difficulty of the exercises. The patient exercises 7 days per week. The health coach provides a telehealth call every week to assess how the patient is doing and monitors their progress over the web. This is possible because the EVE software reports the patient’s gains in Range of Motion, Endurance and Strength each time the patient uses the device, via mobile data direct to the web. The client is advanced under the Health Coaches supervision based on compliance and successful completion of exercises and improved scores.
The patient requires recertification by the physician every 4 weeks. This is done via a 4-week progress note that goes to the physician and includes documentation of Compliance, of gains (Strength, Endurance, Range of motion) and of subjective complaints including Function Based reports. This data allows the physician, case managers and adjusters to easily track the patient’s progress through the program.
This program could be conducted on its own or in conjunction with traditional physical therapy. Perhaps the patient has a physical therapy evaluation, and it is determined his case is more appropriate for a supervised telehealth program. Advantages of the program include:
1. Daily monitoring of progress and Compliance
2. Easy and consistent weekly and monthly progress notes with consistent measurable parameters.
3. Customized and isolated strengthening of the lumbar spine extensors.
4. Instant feedback to the patient resulting in competitiveness, motivation and knowledge of improvement.
5. Improved compliance as the patient knows participation is monitored (“did you do your home program????)
In summary, this program may not be right for EVERY patient, but it is right for SOME. After working out on the machine I see the advantage of the device itself. But the program as a whole is even better. It provides an option for the injured worker with low back pain who might get left behind or put in financial hardship with traditional therapy. And as therapist we all know that home programs are CRITICAL to recovery and we all know they are frequently, or even usually neglected by the patient once they get away from us. The MRS Telehealth back program offers an excellent solution for that client.
If you have a client or are interested in knowing more about this program, please contact me and I’ll be happy to answer any questions.
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