Assessment-Treatment-Prevention
Low Back Pain Disorders & Disability

(Regional Application of the Duffy-Rath System©)

Brief Description of the Course:

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 back pain diagnoses and relevant classification systems.

Pre-requisite: 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 prevent of activity-related low back 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 low back pain disorders including; natural history, risk factors for onset and disability and apply to a treatment plan focused to musculoskeletal self-efficacy.
2. Identify anatomy, biomechanics and pathological processes relevant to clinical management of the activity-related low back pain disorders – including accuracies of diagnostic imaging.
3. Identify the distinguishing clinical characteristics, appropriate treatment strategies and key therapeutic procedures for 5 lower back pain disorders: lumbar derangement syndrome, activity-related SI joint disorders, lumbo-sacral nerve root entrapment and adherence disorders lumbar spinal stenosis with neurogenic claudication, lower back soft-tissue disorders.
4. Able to perform basic manual therapy procedures appropriate to the 5 low back pain disorders.
5. Identify the most common cautions and contraindications related to low back 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 low back 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: Low Back Pain Incidence, prevalence, risk factors (onset, occupational reporting and disability distinguished), natural history, socioeconomic impacts and the growing issue of iatrogenic disability.
Anatomy & Biomechanics Review of relevant lower back anatomy, biomechanical and physiological responses to movement and loading under normal and pathological conditions.
Diagnostic Imaging Review of the diagnostic accuracy of x-rays, CT scans and MRI relevant to LBP disorders.
Degenerative Spondylosis Review of the process and stages of degenerative spondylosis, including: changes in the intervertebral disc, zygapophyseal joints, neural arch, canal and foramen.
Non-specific Low Back Pain Review and identification of this large group of patients and evidence-based sub-groups.
Intervertebral Disc Disorders  Review and identification of contained verses non-contained activity-related disc disorders.
Nerve Root Disorders Review and identification of nerve root entrapment and adherence of intervertebral discal origin.
Lumbar Spinal Stenosis Review and identification of neurogenic claudication; central and lateral.
Other Activity-related Lumbar Pathologies  This section review and identification of muscle/tendon, ligament, zygapophyseal and S-I joint disorders.
Role of Injections and Surgery Review of efficacy for select groups of patients; i.e. specific clinical diagnoses verses degenerative spondylosis.
Role of Alternative Treatment Review of evidence-basis for alternative methods including; meditation and mindfulness training, acupuncture, Yoga and others.
Objectifying Low Back Function and Ability Role of physical abilities testing, functional capacity evaluations and functional demand evaluation in treatment and prevention of LBP disorders and disability.
Self-efficacy & Long-term Planning The role of self-efficacy in long-term management, preserving physical ability and preventing disability.
Basic Low Back History & Exam Outline of the basic history and examination utilized in the Duffy-Rath System©.
Test Open-book test; 50 multiple choice 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).
9:00 Introduction Review of online material, identification of the sub-groups of NSLBP and specific low back pathologies to be addressed in the workshop.
9:30 Lumbar Derangement Syndrome  Review distinguishing clinical characteristics and sub-groups of the lumbar derangement syndrome.Palpation and landmark identification for manual techniques and diagnosis of the level of derangement.Review evidence required to establish that reduction has been achieved.
10:45 BREAK  15 minutes
11:00 Lumbar Derangement Syndrome Continued Practice 4 groups of manual and therapeutic techniques to achieve reduction: extension, extension-rotation, rotation/lateral flexion and flexion.Discuss strategies to maintain and stabilize reduction, recover full function and prevent recurrence.
12:30 Lunch  30 minutes
1:00 Low Back Soft-tissue Disorders Identify distinguishing clinical characteristics of muscular and ligament disorders.Practice manual techniques for ligament (supra/infraspinous and SIJ), muscular (extensor and gluteal/posterior hip) and bursa (gluteal and ischial).
1:45 Nerve Root Entrapment and Adherence  Identify and discuss distinguishing clinical characteristics of a stable nerve root entrapment and adherence of discal origin; i.e. ready for remodeling.
2:30 Lumbar Spinal Stenosis Identify distinguishing clinical characteristics of lumbar spinal stenosis and practice manual (flexion-based) techniques.
3:15 Role of Injections & Surgery Discussion of the role of lumbar injections and surgery in treatment of disc and degenerative low back disorders.
3:45 BREAK  15 minutes
3:45 SIJ Disorders Identify distinguishing clinical characteristics of SIJ disorders and practice evidence-based provocative examination procedures. Practice SIJ manual techniques and discuss therapeutic strategies.
4:30 Cautions & Contra-indications Review and discuss the most commonly encountered cautions and contraindications.
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)