Chronic low back pain in the defence forces; effective treatment, evidence based outcomes and research proposal
Chronic Low Back Pain (CLBP) is a major health and socio-economic problem in our society today. There is a high prevalence of Low Back Injuries within the Defence Forces particularly due to the unique environment and duties performed, often in very challenging circumstances. CLBP is extremely costly in terms of medical expenses, absenteeism and disability and constitutes the second most common symptom presenting to general practice and is the leading source of musculoskeletal health system expenditure. In Australia, annual LBP expenditure exceeded $9.2 billion in 2004 (Walker 2004).
Exercise is one of the few clearly effective treatments for CLBP and the two highest levels of evidence for treatment, levels I and II, strongly support physiotherapy supervised exercise programmes (NH&MRC 2007). Despite evidence to validate exercises, uncertainty still surrounds whether any specific type of exercise is more effective than another.
In March 2003, a rehabilitation area was established within the Navy Indoor Sports Centre (NISC) at HMAS Kuttabul, Fleet Base East, Sydney. The aim of this programme was to facilitate Defence members’ rehabilitation and consequent return to sea-going status and operational readiness in a more expedient manner. This area was purpose designed and fitted with Clinical Pilates equipment and the programme has produced some excellent outcomes since
inception. Significantly, results include the reversion of at least four members from medical discharge and subsequent return to sea going status.
Pilot studies conducted in 2004 and 2005 produced some excellent outcomes and a research project is now being formulated to commence in 2008. The aimof this research is to investigate the effect of Clinical Pilates treatment on pain and function for patients(Defence personnel) with Chronic Low Back Pain.
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