Mobilising the Military

Posted by Nell Mead at 18:58 on 17 May 2011

Today I took a trip to RRU Aldershot.  This is the flagship of the military Regional Rehabilitation Unit network and only opened six months ago, so I was intrigued to see it; but I was also there to do some work.

As I've previously mentioned, in 2004 I designed and carried out the first piece of formal research on the Mobiliser bed, a passive spinal mobilisation device created by engineer David Newbound, the owner of the Back in Action chain of ergonomic furniture shops.  My pilot study bore out the manufacturers' claims that the Mobiliser could help to improve range of movement in the spine, improve thoracic expansion and reduce pain levels in patients with back pain - and I've been using the Mobiliser ever since.

Finally, it looks as though I am winning in my battle to have the Mobiliser recognised by the military as a therapeutic tool, an adjunct to physiotherapy.  The RAF have just bought a batch for use in their RRUs - where more seriously injured servicemen go for periods of intensive rehabilitation - and it is anticipated that the Mobilisers will be awarded NATO Stock Numbers or NSNs very soon, meaning that all military medical rehabilitation departments will be able to order Mobilisers.

My job today was to demonstrate the use of the Mobiliser to the RRU staff who will be responsible for introducing it to their practices, along with David Newbound and senior MOD physiotherapist Dr Cathy Daborn.  I also explained my theories as to how it acts on spinal mechanics and helps to restore normal motion.

Essentially, the spine is able to perform large global movements such as bending and stretching, leaning forwards, backwards and sideways.  But it does this with the help of a lot of very small accessory movements between the vertebrae, which slide and tilt and twist on each other infinitesimally in order to produce the obvious, big movements.  Stiffness occurs when the accessory movements - the slide and the tilt and the twist - are reduced, by disc dehydration, joint disruption such as injury or by muscle spasm.

I believe that the Mobiliser - with its regular, fairly gentle but relentless repeated movements - calms  muscle spasm and then (using the gravity-induced backward shear I discussed in the last post) passively pulls the joints apart to restore the sliding accessory movement.  Over time, with the muscle spasm reduced and joint mobility restored, pain is reduced and function improved.

What the Mobiliser doesn't do - and this is why, particularly when there are rotational components to a spinal problem, you still need a therapist to mobilise the spine with hands or feet - is to restore the twisting accessory movements.  After all, it's a machine, and not capable of intelligent touch or clinical reasoning.  But it is a very useful adjunct to manual therapy and exercise therapy, and I believe is a valuable tool in the treatment of chronic spinal stiffness.

If you're interested in discussing using or hiring a Mobiliser, the best option would be to contact Back in Action, or pop into one of their shops to try it for yourself.

And if you'd like to read my original research, please e-mail me for a copy.