Transcription
documentation based carefor back andneck patients
PAINFear of pain andavoidance behavior.Impairment inendurance,mobility, strengthand coordination.DISUSEDECONDITIONINGwhy DBC?Today we are seeing a revolution in thetreatment strategies of spine disorders. Anactive approach is now widely recommended,whereas bed rest was the treatmentmethod of choice for lower back pain onlya decade ago.DBC International has been a leadingdeveloper of methods and technology forthe assessment and active treatment of backand neck problems since the late 1980s.The mission of DBC is to create evidencebased treatment concepts for experts andspecialists in spine care, with the goal ofbeing the leading pioneer of moderntechnology and treatment protocols for theactive treatment of back and neck disorders.Recent research results show that DBC hasachieved that status, one which it sustainsand improves on a continuous basis.A Complete Concept for DocumentationBased Back and Neck CareDocumented treatment protocolsValidated testing and follow-up protocolsPatented technology and high-techmeasurement systemsComputerized patient managementQuality assurance systemProven business concept andinternationally recognized trademarkContinuous scientific research to maintaincompetitivenessDiminished use of the spine;less opportunity to calibrate the painsensation against the pain experience.Decreased fearof pain andavoidancebehavior.REDUCTIONOF PAINACTIVATIONIncreased use ofthe spine leads tomuscle hypertrophyand improvedcoordination; greateropportunity tocalibrate the painsensation against thepain experience.RECONDITIONINGImproved endurance,mobility, coordination,strength and postural control.DBC BenefitsDoctorsPatientsThe ultimate goal of DBC is to improve thewell-being and quality of life of the patient byreducing pain and improving function, as wellas maintaining the result by activating the patientto take care of him/herself after treatment.Thishas been verified by independent studies andrepeatedly in DBC’s follow-up documentation.83 %Decrease of painHospitals and Rehabilitation CentersA DBC center is set up as a turnkey operationincluding up-to-date technology, the field'slatest medical know-how, as well qualitymanagement support. Ongoing research anddevelopment and feedback from these unitsguarantee DBC's continuing success as aninternational leader in active back and neckcare.25 %17 %No changeRef: Spine 24:1034-1042, 199975 %Increase in strengthand mobilityNo changeRef: Journal of Spinal Disorders 9:306-312, 1996The tests and measurements at DBC arevalidated and reliable, providing a good pictureof the patient's problem. DBC treatmentprograms are safe and efficacious, basedon the individual needs of the patients. Beinga member in the DBC doctor networkprovides access to the latest informationconcerning back and neck research.PhysiotherapistsDBC makes the latest tools and knowhow available to the care providers, enablingpatients to be treated effectively whileincreasing their chances of sustaining theclinical results long after treatment. Ongoingtraining and support maintain the knowledgebase of DBC treatment providers in therapidly changing world of physiotherapy.Payers and the CommunityOutpatient treatment of back and necktrouble is inexpensive compared to the costsof absenteeism from work, losses in productivity and, in particular, the costs of earlyretirement. DBC helps to reduce theseand other costs. Both follow-up results atDBC and independent reports show thatDBC treatment can reduce absenteeism.
Why Regular Exercise Is GoodPromotes a feeling of well-being whilereducing depression and anxietyReleases natural chemicals known toreduce painImproves coordination and control ofmovementBuilds fit muscles and stronger bones andevidence leadingto real-life resultsligamentsMakes one generally fitDBC Works in Real LifeThe efficacy of DBC has been proven incontrolled studies with well-definedThe DBC measurement and treatment con-unit as a quality control measure.The methoddiagnostic criteria, as well as standardizedcept is based on the principles of modernis developed further based on what is learnedtreatment methods provided by well-trainedevidence-base and quality management.from the results. Highly convincing clinicalprofessionals.Evidence-based medicine promotesresults have been achieved, with responseImpressive results have also beenthe integration of both valid clinical andrates exceeding 80% in pain reduction andachieved in real-life conditions throughoutresearch-derived knowledge. The bestfunctional gain.the international chain of DBC centers, whereevidence is moderated by individual patientWhy Inactivity Is Badcircumstances in order to apply the bestBones, muscles and ligaments weakenavailable treatment.soonerToday's back and neck specialists areThe spine stiffens and loses control andtreatment providers and patient circumstancesvary more than in controlled trials. DBC'squality management system includescontinuous training and monitoring of theresults of each unit in the system.widely aware of the harmful effects causedcoordinationby bed rest and inactivity. Active approachesOverall physical fitness deteriorateshave rapidly become the norm in spine care,Sufferers become more prone toremain active after DBC treatment benefitand DBC treatment responds directly to thatdepression and sensitive to painfrom years of sustained clinical results.growing demand.Resuming normal activity and dailyScientific Evidence for DBCroutines becomes more difficultDBC leads a network of scientific researchersin different countries. DBC's measurementsand treatments have been developed andtested in numerous independent studies. TheDBC treatment is based on guided exercisesand activating the patient to reduce – oreliminate – these and the other effects ofinactivity.results have been published in severalThere should be a fundamentalof Physical Medicine and Rehabilitation, Journalchange in management strateg yClinical Evidence for DBC%100755025medical journals including Spine, Archivesof Spinal Disorders and Pathophysiology.In the majority of cases, patients whoof chronic low back pain directedtowards early active rehabilitationand return to work. It should bebased on physical, psychologicalThousands of patients have already beenand social needs of the individualtreated with the active DBC method. DBCpatient.International collects the results from eachClinical Standards Advisory Group Committee, 1994006121824Follow-up (months)Cumulative Proportion without Persistent LBPCumulative Proportion not AbsentBy continuing an active lifestyle with regular exercise afterthe treatment, the DBC results last for years. This holds true interms of keeping people at work and free of chronic pain.
Ergonomics and Psychologicaland Workplace InterventionPsychological and workplaceinterventions can be added to theprogram as supplementary modulesintegratedtreatmentconceptbased on individual needs.Relaxation andFunctional ExercisesRelaxation between exercises andadequate resting periods are used toThe DBC concept consists of severalrelieve muscle tension.The programelements designed to support the criticalalso integrates functional exercisesfactors of patient success. Protected,to improve overall function in dailyproprietary DBC know-how is integratedactivities.into all of the treatment concepts. These areapplied in a universal yet localized fashionIndividual Guidance, Cognitiveand Behavioral Supportby all DBC centers, producing consistentlygood results.The support and guidance of ourThe modular structure of the treatmentexperienced physiotherapists isconcepts enables entirely individual treatmentconsidered an essential factor inprograms to be built. Applying the treatmentachieving the outstanding resultsin small groups, however, has proved effectivecharacteristic to DBC treatment.since group members provide motivationand support to one another.Follow-upAssessmentDBC produces follow-up reportsEach patient’s treatment is individu-based on valid outcomes presentedFor the main treatment component,Severity sion)Specific Loadingof SpineReumaattinenselkävaivaHealthLocus ofControlDepressionAerobic CapacityOutcome: Duration of the Treatment ProgramTechnologyDBC continuously develops theStress Managementexercises.This special equipment makesprecise and targeted loading ivaBehavioral PatternMobilityDBC equipment is used to guide thepatients through planned, controlledNeed for WorkplaceErgonomicsQuestionnairePain Regularityin a clear and transparent manner.Optional surementsDevice ExercisesQuestionnaire VASevaluation using validated questionnaires and tests.for patients, doctors and employersStandard Evaluationsally planned, based on a thoroughFear of Painprogram's technology and overallconcept. New innovations ensure thatOutcome: Need for SpecialProgram Componentseach center operates with the mosteffective methods available today.
Individual back exercises may aim to reducepain, strengthen muscle groups, and improveproventechnologyconceptsmovement or posture. They are often prescribedas a second stage of management after painrelief. An active rehabilitation program usesexercises, but its main emphasis is on restoringfull function.Clinical Standards Advisory Group Comittee, 1994Other Treatment Devices andEquipmentEMG Measurement SystemDBC has developed innovative technologyfor the assessment and treatment of back andneck disorders since the late 1980s.The latesttechnology is now applicable for use in themost demanding hospital and rehabilitationsettings.Active Back Care DevicesLTE Lumbar Thoracic ExtensionDBC's patented hip-lock systemsafely targets the desired musclegroups of the lower back whilesimultaneously guiding thecorrect movement pattern.SBA Shoulder Blade AdductionThe hip-lock system safely targets the desiredActive Neck Care DevicesCEE Cervicothoracic Elliptic Extensionmuscle groups used when flexing the trunkA breakthrough in cervical motion, CEEadduction of the shoulder blades to improvewhile simultaneously guiding the correctsafely guides the cervical spine through anthe function of the stabilizing structures ofmovement pattern.elliptical movement pattern while targetingthe upper thoracic area.LTF Lumbar Thoracic FlexionThe unique SBA device facilitates thethe muscle groups involved.LTR Lumbar Thoracic RotationThe EMG (electromyography)measurement system is used toobjectively evaluate muscle fatigueof the lower back based onchanges in frequency content inmuscle activity.The testing is donewith a validated evaluationprotocol.In addition to specifictreatment and measurementdevices, DBC clinics also featurecomplementary devices andequipment such as leg presses,stationary bikes, steppers,relaxation pillows, and balancetraining devices – all designed tomake the customer’s start withDBC as easy and effective aspossible.C3R Cervical 3D RotationMLU Multipurpose Low-Friction UnitC3R safely targets the muscle groups involvedA multipurpose device incorporated into thein cervical rotation while incorporating three-concept, MLU allows for a wide array ofdimensional movement patterns to correctlyexercises important in the rehabilitation ofuser-friendly software for clinicalLumbar Thoracic Lateral Flexionguide the cervical spine through flexion,neck patients.work and business analysis, as wellThe desired muscle groups used in laterallateral flexion and rotation simultaneously,as corporate identity materials arebending of the trunk are effectively isolatedreplicating real-life movements.provided to the clinics to round-The muscle groups involved in trunk rotationare effectively isolated while correctly guidingthe desired movement pattern.Trademark PackageA complementary package ofdetailed manuals, efficient andwhile simultaneously guiding the correctout the support needed to ensuremovement pattern.clinical and operational success.evidenceclinical based onand reseexperiencearchdo cu mefo r ba ck nt at io n ba sed ca rne ck pa an dtie nt sassessmprogra ent-based treamtmentfollow-u mes andps
neck disorders.The most compelling findingsand innovations are transformed into conceptlevel applications.Quality Assurance SystemDBC's unique quality assurance system beginsbusiness conceptand global supportwith customer satisfaction surveys, which arecollected from each patient. In addition tosatisfaction surveys, the medical data of eachindividual patient is collected into a centralizeddatabase.Further analysis of the continuouslyClinic Services and PersonnelThe business concept's feasibility andgrowing data and patient outcomes is also aThe DBC Active Spine Care concept isperformance have been tested and furtherkey element in developing the concept anddesigned for the conservative treatment ofdeveloped in various centers and markettreatment protocols. DBC has experience inprolonged, recurrent and chronic back andconditions.treating tens of thousands of chronic andneck problems as part of the total servicesoffered by the center.The treatment programsDBC provides a range of importantbusiness benefits.recurrent back and neck patients around theworld – giving new clinics the importantadvantage of starting with evidence-basedconsist of initial assessments and questionnaires, modular active treatments withProven productsprotocols.exercises, behavioral support to activate theExperience with compensation systemsOngoing Supportpatient, and ongoing programs after thetailored specifically for DBC taking intoEach country has its own DBC countryguided treatment.account the evidence-baseorganization, the principal task of which isAn internationally recognized trademarkto support the operating DBC clinics andcare. A DBC unit is typically managed by theDesigned clinic interiorto coordinate national activities andassigned physiotherapist together with theDesigned corporate identitydevelopment. Ongoing support is providedresponsible doctor. All personnel receiveAdministrative toolsto help clinic physiotherapists and doctorsspecial training for running the DBC center.Pricing and budgeting guidelineswith treatment-related, medical, administra-Marketing guidelines and toolstive and other facilitative support.Specially trained therapists provide allBusiness ConceptA DBC center is implemented as a turnkeyLicensing StructureWorldwide Network of DBCoperation, in terms of treatment technologyAll units belonging to the network haveDBC has gained experience in back and neckand methods as well as business standards.access to the latest developments in back anddisorders from five continents of the world.neck care. The licensing system also providesThe DBC international network of clinics isfor each unit to be supported by help-deskgrowing rapidly. With evidence-basedguidance, quality assurance, continuousresearch, documentation-based treatmenteducation and a number of other supportprotocols and sophisticated technology, DBCmeasures.has become the leading provider of integratedThere should be a fundamental shiftin physical therapy aims and facilitiesto provide active rehabilitation pro-DBC has an international partner networkspine treatment concepts for professional use.grams and patient education on pre-of research organizations and collaboratingFor more information about DBC anduniversities which continuously seek optimalDocumentation Based Care, please contactcare solutions for specific types of back andthe DBC organization in your country orneck disorders.The most compelling findingsDBC International.vention and personal responsibilityfor continued management.Clinical Standards Advisory Group Committee, 1994
DBC AmericaDBC LuxembourgDBC SwedenDBC Switzerland3725 CockrellForth Worth, TX 76110USATel. 1 817 921 9981Fax 1 817 921 1407Mondorf le domaineThermal, BP 52L-5601 Mondorf-les-BainsLuxembourgTel. 352 66 12 12 603Fax 352 66 12 12 620Håkan Kihlström ABHattmakargatan 580311 GävleSwedenTel. 46 26 106 007Fax 46 26 106 431Fitness Connection AGSchulweg 98610 UsterSwitzerlandTel. 41 1 940 6354Fax 41 1 940 8827DBC BelgiumEmail: m.heinricy@mondorf.luEmail: info@dbcsweden.seOrtho-Spine bvbaKortrijksesteenweg 1065B-9051 GentTel. 32 9 221 46 22Fax 32 9 220 29 68DBC FinlandSuomen Aktiivikuntoutus KyMarttilantie 5360100 Seinäjoki, FinlandTel. 358 6 414 1723Fax 358 6 414 C UKDBC NetherlandsBackhand B.V.Gaffelhoek 317546 MT EnschedeThe NetherlandsTel. 31 53 478 0064Fax 31 53 478 0065Email: backhand@wxs.nlDBC Nor wayAktive Rehab Norge ASJohan Berentsensvej 63N-5161 LaksevågNorwayTel. 47 55 34 90 32Fax 47 55 34 90 31DBC SingaporeTeBex Medica SingaporePte Ltd.Camden Medical Centre1 Orchard Boulevard#09-05Singapore 249615Tel. 65 835 2896Fax 65 835 2897Email: tebexmedica@pacific.net.sgDBC International Ltd.PO Box 125, 01511 Vantaa, FinlandTel. 358 9 870 0640Fax 358 9 870 06450Email: dbc@dbc.fiFiona LongBupa House15-19 Bloomsbury WayLondon WC1A 2BAUnited KingdomTel 44 171 656 2504Fax. 44 171 656 2703Email: longf@bupa.com
The ultimate goal of DBC is to improve the well-being and quality of life of the patient by reducing pain and improving function, as well as maintaining the result by activating the patient to take care of him/herself after treatment.This has been verified by independent studies and repeatedly in DBC's follow-up documentation.
