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The Back Institute
The Back Institute is a specialist facility providing individuals with comprehensive rehabilitation solutions for back and neck pain. Wakefield Physiotherapy is situated with The Back Institute.
- Assessment Services
- Treatment Programmes
- Treatment Services
- Functional Assessment Services
- Facilities
- Staff Profiles
- Frequently asked questions
- Hours
- Location
- Books
- Newsletter
- Contact Us
- Links
The Back Institute is New Zealand's first licensed provider for the Canadian Back Institute.
This internationally recognized back management programme has over 25 years of clinical experience
in the assessment and management of spinal pain. At The Back Institute we are dedicated to
researching and developing new ways to resolve acute or chronic back and neck pain.
We
have a large clinical team comprising Orthopaedic Surgeons, Physiotherapists, Exercise Therapists
and a Clinical Psychologist and are able to offer a wide variety of assessments and treatment
procedures.
You are welcome to contact us if you would like more information about our services, or if you would like to make an appointment. Our services are available to the public and we are able to offer immediate treatment if required. If your injury is due to an accident we are able to initiate an ACC claim and commence treatment immediately. No referral is required but we welcome GP or specialist referrrals if available.
Assessment services
Your initial comprehensive orthopaedic assessment is from a physiotherapist who specialises in
spinal rehabilitation. The physiotherapist will be able to discuss in detail the source of the
injury and the most likely cause. Your initial assessment will also include exercises to help you to
control your symptoms.
An initial assessment is required before commencing your
rehabilitation programme.
Your physiotherapist is able to liaise with your GP regarding your progress and organize x-rays to be taken on site if required. Our clinic includes orthopaedic specialists and a clinical psychologist. If these services are required to assist in your recovery your physiotherapist can organize an internal referrral at the clinic.
Treatment Programmes
Treatment is based on each individual's specific problem. Generally patients are progressed through three stages. Stage one focuses on improved pain control.
Once this is addressed clients progress into the final two stages with a focus on improved flexibility and strengthening.
Time Frames
The time frames for programmes vary greatly. Most patients however are seen a minimum of treatments to ensure they can follow their rehab programme. More complex problems obviously take a number of weeks to progress through each stage.
Your tailored programme is individually designed depending on your circumstances.
You will take an active role in determining the content of your programme. A list of the services that will make up your programme is outlined below.
Treatment Services
Individual Physiotherapy Treatment
All patients are treated in private, fully equipped, indivdual treatment rooms.
Both mechanical and manipulative therapy techniques are performed to help restore spinal
function and relieve pain. Physiotherapists may use a number of modalities to assist in pain relief
including acupuncture, heat application or TENS therapy.
Initial treatment tends to
involve teaching clients independent pain control strategies and client education is an integral
aspect of rehabilitation at the clinic.
Individual Exercise Therapy
For a number of patients, exercise therapy is essential to restore normal functional capacity
following injury. Our exercise therapists have kinesiology degrees and specialize in returning
normal spinal strength and movement. Clients receive one on one treatment at our rehabilitation
gymnasium. The focus for rehabilitation
is on allowing a client to return to normal activities,
sport, or work.
Acitivity Based Programmes
We offer activity based programmes for complex mechanical back pain management and chronic back pain management. This form of intervention is suitable for an individual who requires an intensive time limited period of rehabilitation with a specific aim of a return of the individual to previous employment or gaining an improvement in functional capacity or to determine employment options.
Activity based programmes generally take 6 to 8 weeks. These clients are expected to attend a minimum of 3 appointments per week.
Gym Membership
Clients are able to utilize our fully equipped rehabilitation gym throughout their process of rehabilitation. There is no charge for this service. If you wish to join the gym to maintain your programme there are membership options available.
Back Classes
The clinic runs a series of exercise and education classes. Each class stream involves a progressive exercise base and an education component addressing issues such as technique, return to work issues, and home exercise progressions.
Psychology Services
Back pain is a complex problem. Any individual who has sustained a back injury is susceptible to developing problems associated with ongoing pain. The effect of mood, behaviour, sleep etc, can not be underestimated. We are fortunate to have qualified psychologists who specialize in teaching cognitive skills to help with these problems. Psychology sessions are generally conducted over an hour session.
Orthopaedic Surgery
Chris Hoffman and Peter Welsh operate out of Wakefield Hospital. Surgery for back injuries is fortunately not a common occurrence. However, it can provide significant benefit to a specific patient group. About 5% of our patients require surgery as part of their rehabilitation. Options regarding spinal surgery should be discussed in detail with our orthopaedic surgeons.
Facilities
Our facilities include individual private treatment rooms, a fully equipped gym with a qualified exercise kinesiologist. The gym includes a Pilates Reformer, a treadmill, Vectra strengthening equipment, swiss balls and an exercycle. Changing and shower facilities are available.
Functional abilities assessment services
The Back Institute offers more complex assessment services for individual clients. To manage
back pain effectively clients must be able to return to work effectively and safely. Determining
appropriate restriction or timeframes can be difficult and time consuming. We are able to offer
assessment services that
give objective detailed information on an individual client's current
abilities and progressions required in return to work planning. Information obtained from these
reports are confidential and are available to case managers, or employers with employee
permission.
Functional Abilities Evaluation (FAE)
This form of assessment is ideal for clients who are no longer employed due to their injury and
have no particular job to return to following rehabilitation.
The associated report
gives details on the physical capacity of the individual and provides guidelines on any restrictions
when considering vocational options.
This form of assessment can also be used in
conjunction with a rehabilitation programme to show objective measurable changes in the timeframe
of the programme.
A Functional Capacity Evaluation includes a 40 minute assessment with a
physiotherapist and a 3 hour assessment with an exercise therapist on Day 1. There is a 20 minute
follow up appointment on the next working day.
Vocational Abilities Assessment (VAA)
The VAA is ideal for clients off work due to injury who want to return to a specific job. The assessment provides an objective indication of the client's ability to return to the job and indicates physical barriers to returning to work.
In addition, a client's functional level is tested in relation to the specifics of the job
description to provide an objective match of the client's current
level of ability compared to
the necessary level of physical ability to perform a specific job. The VAA can also provide
information on availability of modified
duties and the ability of the client to perform
modified duties.
A Vocational Abilities Assessment consists of a 60 minute assessment with a physiotherapist and a 3 hour assessment by the exercise therapist on day 1.
On day 2 there is a 2 hour physiotherapy review and another 3 hour assessment with the exercise therapist.
Research
The Back Institute is part of international research associated with CBI Clinics in Canada. Our
database of clinical outcomes are incorporated with
all CBI clinics around the world. This
allows us to ensure our client management is based on the latest research, ensuring best practice
and best outcomes. For
information on CBI research visit CBI Health
Team Members
We have an enthusiastic team of clinicians who aim to provide a comprehensive service. All are fully qualified and registered in their profession and many have obtained or are obtaining further post graduate qualifications. We hold regular inservices and team meetings where we discuss specific cases and new research regarding managing back and neck pain.
Physiotherapist/Regional Manager
Chris Gregg (Dip Phys, Post Grad. Dip Manip Th.,MNZSP)
Professional memberships: NZ
registered Physiotherapist, MNZSP. MNZPPA Chris Gregg has over 13 years experience in providing
rehabilitation services within the public and private health sector. He completed post-graduate
training in 1996 in Perth, Australia specialising in manipulative therapy and functional
rehabilitation. He has a specialist interest in protocol based functional rehabilitation and is
Regional Manager of The Back Institute.
Regional Administrator
Sandy Stewart (RG ON)
Sandy is a registered nurse and the clinics administrator. Sandy
manages our rehabilitation and activity based programmes.
Orthopaedic Consultants:
Chris Hoffman (MB ChB, FRACS, Dip Clin Epi) Spinal Surgeon
Chris Hoffman is a fellowship
trained spinal and orthopaedic surgeon who completed his post- graduate fellowship training in
Toronto, Canada. He has a specialist interest in evidence based rehabilitation programmes and
surgical intervention for back complaints.
Peter Welsh (MB ChB, FRCSC, FACS, Dip ABOS) Surgeon
Peter Welsh has spent 20 years
practicing orthopaedics in Canada. He was Chief of staff at the Orthopaedic and Arthritic Hospital
and Associate Professor of surgery at the University of Toronto. He now runs a busy orthopaedic
practice from The Back Institute at the Wakefield Hospital site.
Physiotherapists:
Linda Lee (BPhty., MNZSP)
Professional memberships: NZ registered Physiotherapist,
MNZSP.
Linda is a physiotherapist at The Back Institute. She graduated from Otago in 1995, and
has over 6 years experience. Linda has worked in New Zealand and spent two and a half years in the
UK in both the public and private sector.
Linda has a special interest in working with muscle
balance clients and joined our team in December 2001.
Michelle Crawford(BPhEd, B Phys. MNZSP)
Michelle has a degree in both physical education and
physiotherapy from Otago. She is the physiotherapist for the Capital Shakers Netball team and has
significant experience in musculo skeletal rehabilitation.
Derek Young ( BPhys., PGDip Manip Th. MNZSP)
Derek has obtained a post graduate diploma in
manipulative therapy from the Auckland Institute of Technology. Derek has just returned from working
overseas for 2 years in which he had the opportunity to work at the Commonwealth games in
Manchester. Derek has an interest in motor control and functional strengthening strategies.
Kinesiologist
Katie Low (BSc Kin)
Katie completed her degree in 2001 and spent time in Victoria working
within the Canadian Back Institute. Katie specialises in developing individual rehabilitation
programmes with a focus on functional strengthening. Katie has completed training in Canada to
perform functional and vocational ability assessments and is responsible for coordinating our
functional and vocational capacity tests.
Frequently Asked Questions
What is The Back Institute?
The Back Institute is New Zealand's first licensed provider for the Canadian Back Institute. This internationally recognized back management programme has over 25 years of clinical experience in the assessment and management of spinal pain. Our clinic is a franchise of the Canadian Back Institute and CBI Health. CBI Health is committed to researching and developing new ways to resolve back and neck pain. Our clinic uses a number of procedures to assess, diagnose and treat back and neck pain that has come about from this ongoing development.
Who works at the clinic?
Our team consists of Orthopaedic Surgeons, Physiotherapists, Kinesiologists, Clinical Psychologists and an administration team. We have three clinics in the Wellington region - Newtown, Lower Hutt and Mana.
What happens during my first assessment?
Your initial assessment is always with a registered physiotherapist. Our Physiotherapists have had specialist training in assessing back and neck problems. Most assessments take up to 40 minutes. Your Physio will spend some time asking detailed questions about your back injury. You will then have a spinal examination in which you will be asked to perform gentle movements to determine the pattern of your back pain.
What sort of treatment will I have?
Initially, our main focus is determining the exercises and positions that you need to practice in your day to help relieve your own pain. Client education is a big focus of your initial treatment as it is the foundation for successful treatment. As you respond to exercises your physio may add treatment modalities such as manual therapy, manipulation and acupuncture. This is to help give you more relief from pain and improve movement in your back if required. Your physio will discuss any options regarding treatment and you will play a big part in determining your programme and the treatment required.
When do I get into the gym?
All patients are encouraged to complete 3 stages of treatment. The initial stage is aimed at improving your pain level and your own control of symptoms.
As your pain settles the focus is on restoring your spinal mobility and strength.
These are the final two stages of your treatment and are probably the most important.
There is good evidence to support strengthening programmes as a preventative measure for recurrent back problems.
Do I need to see a kinesiologist?
Your strengthening programme may be carried out by your physiotherapist. However, we also have Kinesiologists, who specialise in stregthening programmes. If you are referred to see them you will be given an initial 40 minute assessment and an individual strengthening programme will be designed for you to use at home or in the gym.
How much exercise do I need to do?
Exercise therapy packages vary according to your needs and a number of patients have a home exercise programme and see the Kinesiologist every now and then to update the exercises and check your progress. Some patients require extensive and intensive strengthening programmes. Those patients are encouraged to join the gym and have regular one on one personal training sessions.
Alternatively, we run strengthening classes which you are welcome to attend.
When can I see an orthopaedic surgeon?
Everyone who suffers a back injury has concerns that their injury may be significant and feel that they should see a specialist. Fortunately, back and neck pain usually resolves completely over time with correct treatment. The number of people requiring a specialists opinion, scanning, or surgery is very small.
Over the past 2 years only 15% of our patients needed to see a specialist and only 1% required
surgery.
We are however fortunate to have orthopaedic specialists working at the clinic.
Your physiotherapist is trained to determine if you require an immediate specialist opinion
and we will be able to organise an urgent referral for you. As a team
we have weekly inservice
meetings and conduct reviews to update everyone on our current patient load.
Who needs to see the clinical psychologist?
All pain experienced by an individual has a psychological component. How you perceive pain and react to it is an individual experience. People who suffer back pain are particularly vulnerable to developing "abnormal" pain behaviour that can have a significant impact on the individual's lifestyle.
Your physiotherapist is trained to identify clients at risk of developing psychosocial problems associated with back pain. Some of our patients are referred to see our clinical psychologist for an assessment. Behavioural problems such as anxiety, sleep disorders or depression are a natural problem associated with back pain and can be helped with appropriate treatment from a clinical psychologist.
If you want to see a clincial psychologist or have concerns regarding the impact of your back pain on your behaviour/mood, please discuss this with your physiotherapist.
How long will I need treatment?
This is a hard question to answer exactly. We prefer our patients to progress through the three stages of rehab, pain control, improved mobility and finally restored spinal strength. For some this process takes a number of days, and others however with more significant or recurent symptoms the programmes can take longer. Most programmes are completed within 6 weeks. We do however have patients who have regular reveiws or join our gym to maintain their fitness levels.
What if I don't get better?
If you are not responding to treatment at the clinic after 3 weeks you should discuss your concerns with your physiotherapist. Our basic rule of thumb is, if you have mechanical back pain you should be able to get some relief within 3 weeks with mechanical (exercise) based treatment. If you are not getting better after 3 weeks of treatment most patients will be referred to see our spinal specialist as soon as possible.
Newsletter
Copies of our newsletter are available by emailing info@tbihealth.co.nz
Books
The Back Doctor - Hamilton Hall
Location and Opening Hours
Newtown
Wakefield Hospital
Level Four
99 Rintoul Street
P.O.Box 16 116
Newtown
Wellington 6021
Monday to Thursday - 8.00am to 7.00pm
Friday 8.00am to 6.00pm
Lower Hutt
ANZ Business Centre
Level One
21 - 23 Andrews Ave
P O Box 31608
Lower Hutt 5010
Monday to Friday 8.00am - 5.00pm
Mana
Level One
107 Mana Esplanade
P O Box 57213
Porirua 5026
Monday to Thursday 8.00am - 7.00pm
Friday 8.00am - 5.00pm
Auckland
626 Great South Road
PO Box 17148
Greenlane
Auckland 1546
Contact Us:
Newtown
Phone (04) 381 8690
Fax (04) 381 8126
Lower Hutt
Phone (04) 5702639
Fax (04)570 2741
Mana
Phone (04) 233 0754
Fax (04) 233 0783
Auckland
Phone (09) 525 6340
Fax (09) 525 6341
Email: info@tbihealth.co.nz
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