Assessment-Treatment-Prevention
Cumulative/Degenerative Disorders of Chronic Pain

(Regional Application of the Duffy-Rath System©)

Brief Description of the Course:

The Duffy-Rath System© (DRS) is a unique approach to the assessment, treatment and prevention of musculoskeletal disorders (MSD) and disability. Developed in 1984 by Wayne and Jean (Duffy) Rath, the system is currently utilized at outpatient clinics and industrial sites across the United States and internationally. This workshop provides the clinician with a system to improve their effectiveness and efficiency in assessment and treatment of activity-related chronic musculoskeletal pain disorders and disability; all treatment strategies are oriented towards recovery of activity tolerance and long-term self-efficacy (i.e. secondary and tertiary prevention).

This workshop has an online and a live component. The online component must be completed before attending the live workshop; this involves having to successfully complete an ‘open-book’ test. The live workshop is a 1-day format with a focus to treatment strategies, procedures and problem-solving techniques specific to the most common chronic musculoskeletal pain disorders than can lead to disability. The focus is to low back and cervico-brachial pain disorders.

Pre-requisite to Registering for this Workshop: Evidence of successful completion of the online course entitled; “Introduction to the Duffy-Rath System©: Linking treatment and prevention for musculoskeletal self-efficacy” is required to register for this workshop.

Workshop Goal: Promote a systematic, prevention-oriented and non-operative approach to the assessment, treatment and prevention of activity-related chronic musculoskeletal pain disorders and disability that is effective, efficient, accountable and long-term focused.

Workshop Instructional Objectives – upon completion of this activity, participants will be able to:

1. Identify relevant epidemiology for chronic musculoskeletal pain and disability.
2. Identify the patient intrinsic risk factors for chronic pain and disability that need to be recognized during the course of evaluation and treatment.
3. Identify the care-giver risk factors that can facilitate chronic pain and disability during the course of evaluation and treatment.
4. Identify a strategic plan for implementation of the Duffy-Rath Function Treatment Strategy for legally involved and not legally involved chronic musculoskeletal disorders.
5. Identify the most common cautions and contraindications related to chronic musculoskeletal pain disorders and methods for rapid identification.
6. Identify the role of objective assessment of function, surgery and alternative methods of healthcare in the treatment and prevention of chronic musculoskeletal pain disorders and disability.

Workshop Schedule:

Topic

Description
Online Registration and Orientation Participants register online and are directed to an orientation section that identifies the goals and objectives for the course, and the structure and process for completing the online component. The participant is then directed to the start of the course
Introduction Identify the role, experience and findings with application of the Duffy-Rath System© to chronic musculoskeletal pain disorders and disability; identify focus to low back and cervico-brachial MSDs. Provide definitions for patient populations relevant to the topic. Review appropriate treatment strategies for these disorders.
Epidemiology Scope of the problem, regional probabilities and risk factors for developing chronic pain and/or disability. Thorough review of “Yellow Flags”.
Iatrogenesis & Quaternary Prevention Define iatrogenesis and quaternary prevention, review recent evidence for this growing problem and provide solutions.
Chronic Pain Mechanisms & Manifestations Identify the differences in chronic pain mechanisms versus acute pain; distinguish nociception, pain, suffering and pain behavior.  and describes the differences
Mechanical verses Non-mechanical Chronic Pain Describe differences between those patients with chronic pain who are rapidly verses gradually resolvable, and the most relevant factors that can limit potential for recovery.  This includes self-report tools, history-taking and examination findings and correlation of multiple sources of data.
Legally-involved Non-mechanical Pain Review relevant factors that require control when the patient has a made a claim and/or hired an attorney to seek reward. Emphasis placed upon review of the new conceptual model proposed by the 2008 Neck Pain Task Force.
Role of Alternative Treatment The role of meditation and mindfulness training with chronic pain, kinesiophobia, catastrophizing and ineffective coping strategies.
Objectifying Function and Ability Review to measure or estimate physical demands and develop goals and treatment strategies to meet those demands safely and acceptably; i.e. objectifying demand and ability.
Problem-solving Techniques Identify methods for problem solving failure to recover and/or flare-ups and match to appropriate tactics to overcome these obstacles. 
Test Open-book test; 20 true or false questions – 100% passage required, multiple opportunities (i.e. as many as needed) provided.
Study Time 4 – 8 hours is expected to complete the online section of the course

 


Live Portion of Course (>50 PowerPoint Slides and 13 pages of evidence support)
Time Regristration Brief Description
8:30 Regristration Participants sign-in again (required for course certificate).
9:30 The Assessment Process Provide a system for the interpretation of self-reported pain and function ratings along with specific questionnaires related to risk factors for chronic pain and disability. This leads to identification of three general sub-groups: 1) mechanical chronic pain, 2) non-mechanical chronic pain without legal involvement and 3) non-mechanical chronic pain with legal involvement.
10:45 BREAK
Assessment Process Continued Connect these sub-groups to the most appropriate choices of DRS treatment strategies.
11:30 Obstacles to Recovery Identify the most common obstacles to patient recovery and connect to tactics to overcome these barriers.
12:30 Lunch
1:00 Case Studies Mechanical chronic pain examples; participants need to identify strategy and tactics that facilitate and acceptable level of recovery.
1:45 Case Studies Non-mechanical chronic pain with no legal involvement examples; participants need to identify strategy and tactics that facilitate and acceptable level of recovery.
2:45 Case Studies Non-mechanical chronic pain with legal involvement examples; participants need to identify strategy and tactics that facilitate and acceptable level of recovery.
3:45 BREAK
3:45 Objective assessment of function Methods to objective physical performance and function before, during and after treatment of chronic musculoskeletal pain disorders.
4:30 Cautions & Contra-indications Review the most common cautions and contraindication encountered with chronic musculoskeletal patients; distinction between yellow and red flags.
4:45 Summary, Critiques & Certificates Summarize the online and live components; provide direction for further information and training.Certificates awarded after critique is submitted.
5:00 Conclusion
8 hours – 1 hour 7.0 Contact Hours (Total 11 hours)