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THE CANADIAN BACK INSTITUTE PROGRAM -DOES IT WORK IN NZ?



Abstract

To determine if patients referred to a back clinic in NZ would respond to a structured program based on the Canadian Back Institute (CBI) system and match results obtained by the system in Canada.

All patients referred to the Wakefield Back Institute over one year were assessed using the CBI system. The program employs a structured history and physical exam to identify a pattern of pain. The identified syndrome then forms the basis for initial treatment and achieving the anticipated outcome confirms the original pattern. Patients undergo a 3-stage exercise program. A Spinal Status assessment and a satisfaction survey were completed on discharge. These were compared with the CBI National Outcomes (CBINO) data for 2001.

The clinic was referred 532 patients of whom 508 could be classified in to one of the recognised patterns of mechanical pain for the lumbar or cervical region. The distribution of pain patterns and patient’s demographics were similar to the CBINO data. Thus far, 162 patients have completed their program. Positive pain management (pain gone or markedly decreased) was reported in 85% of the lumbar group (93% in Canada) and 92% of the cervical group (same as Canada). Better pain control (lumbar 86%, cervical 93%) and longer pain-free episodes (lumbar 64%, cervical 75%) were reported. Patient Satisfaction was high (4.57 on a 1–5 scale).

The CBI program has been adapted and applied in a New Zealand environment and early results suggest outcomes similar to those reported in Canada can be obtained here.

Correspondence should be addressed to the editorial secretary: Associate Professor Jean-Claude Theis, Department of Orthopaedic Surgery, Dunedin Hospital, Private Bag 1921, Dunedin, New Zealand.