From the number of people reading it, Wouter Ramboer’s last post on noijam had people thinking. It kept Wouter thinking too…
The recent blog Hit me with music kept me thinking. Something as simple as music can have a big impact on behaviour and emotions – it can alter our very experience of a situation. So how does the entire context in which we propose to test exercise regime A vs exercise regime B affect the outcome?
When we read papers about chronic pain, we see that no ‘intervention’ is superior to the other – or the differences are rather small and non significant. It seems that no matter what specific exercise is put into the regime the results are more or less the same – short term outcomes of slight improvement. Long term improvements? Not really, and often drop-outs along the way.
Perhaps we should we take it from another perspective? When researchers/physios test their exercises on the painful population, they impose their strict regimes and protocols – intensity, duration, timeframes, and so on. I understand that this is necessary and important from a research perspective, but, what if we considered what patients want, what their goals are, and let them control the regime in some part? What do they like – the same ‘core’ exercises over and over again in a clinical environment? Or fun, novel activities at home, or in the park, with their favourite music playing? What about meaningful movements building on what *they* need in daily life, be it work related or for their hobbies?
Is there too much of the therapist; too much “I” and too much “me” in the research regimes?
Wouter Ramboer, PT, Belgium.