MDNews - Minnesota

(SMART) goals to identify the physical activities they want restored. The Keele STarT Back Screening Tool helps providers assess the presence and severity of psychosocial barriers to recovery, and if necessary, patients can choose to conjointly enroll in support groups led by PDR's licensed social worker. Occupational therapists assess whole body function and how pain affects daily activities. Physical therapists delve into spinal function and measure back strength and ranges of motion. MedX equipment isolates neck and back muscles while providing integral support so patients can improve their mobility and enhance muscular endurance without further injury. The Functional Approach SMART goal setting not only helps inform the rehabilitation plan, it also shapes the interactions between providers and patients. Setting clear, aspirational goals helps patients concentrate on positivity rather than their pain and tracks their progress towards functional goals. In fact, PDR implemented a Focus on Function campaign, removing the word "pain" from day-to-day patient interactions. "It seems counterintuitive not to talk about pain at all, but the results are amaz- ing," Missling says. "If our first question to patients is about how their pain is today, they'll think about pain more and feel it more profoundly. Instead, our therapists focus on functional goals." Jason Schultz, OTR, occupational thera- pist at PDR Clinics, adds that the method is not designed to make patients ignore the pain; it simply helps them reframe their understanding of relief. "We don't ignore their pain, but we try to frame the conversation around how it pre- vents them from participating in activities they love," he says. "Then, we can measure the progress they make towards their goals. Instead of 'How is your pain today?' the question becomes, 'Are you able to do more; can you tolerate things better?'" The Mind Matters To people living in a culture that emphasizes instantaneous results, chronic pain creates cognitive dissonance. For pain that cannot be eradicated, patients must understand the importance of realistic expectations. "When we begin therapy, we thoroughly discuss physical and emotional pain cycles and how we are going to address these obstacles together," says Nikki Weiers, DPT, physical therapist at PDR Clinics. "This requires patients to think differently about pain. They often say their goal is to be pain-free, but that's unrealistic. Nobody's pain-free. We equip patients with the tools "People can function without being restricted by chronic back pain. We build relationships with our patients and give them the tools and know- how that can change their lives and allow them to return confidently to their normal activities." — Jason Schultz, OTR, occupational therapist at Physicians' Diagnostics & Rehabilitation Clinics they need to manage pain and successfully achieve their functional goals." During treatment, therapists assess functional improvements and incorporate activities as patients become able to handle them. Graded pacing also helps extend the body's tolerance for moderately longer or more intense exercise, while keeping pain within controllable limits. As the patient pro- gresses, they can see empirical improvements in both function and capability, putting them in a positive mindset that promotes success. Outcome Measures PDR's own patient survey results demon- strate the success of the functional approach. When asked to rate "total recovery in their condition," the average response was 75 percent recovery. But more importantly, once patients complete their rehabilitation, they no longer need PDR's services. "Patients want a return to normalcy," Weiers says. "We give patients what they need to manage exacerbations. Instead of remaining in the healthcare system forever, they lead long, happy, functional lives." For more information about PDR Clinics, visit pdrclinics.com. ■ M D N E W S . CO M ■ MD NEWS Minnesota | 2 3

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