Mobilising the Military
Today I took a trip to Hampshire to demonstrate the Mobiliser bed to some military medical personnel.
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. They have just bought a batch for use in some of their intensive rehabilitation centres and with any luck, all military medical rehabilitation departments will soon be able to order Mobilisers.
My job today was to demonstrate the use of the Mobiliser to the staff who will be responsible for introducing it to their practices, along with David Newbound. 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.
The Mobiliser
As I said in my last post, Victory has started using the therapy room within The Back Shop on New Cavendish Street, just off Harley Street.
The Back Shop has recently been taken over by Back in Action, who also sell ergonomically-designed furniture and back care products. My favourite of their products is the Mobiliser. Back in 2004, when I was in the Army and based at Northwood HQ in Hertfordshire, several of my patients independently came to tell me that they'd found a shop called Back in Action, in Amersham, and that they had a machine called the Mobiliser which I ought to have a look at.
Initially I was sceptical but after the third such patient arrived, I decided to go and see what the fuss was about.
The Mobiliser is a 7-foot mat with knobbly rollers. You lie on your back on the mat, and the rollers work their way up and down your whole body, lifting each vertebra in turn when it gets to the spine, causing a combination of flexion, extension and shearing force and glide, as well as massaging the muscles and heating the torso. It feels great when you're on it, but when you're convincing the powers-that-be to buy new kit for the physio department, that's rarely enough of an argument!
Luckily I had a fantastic Commanding Officer at the time, who was prepared to take a chance and spend the required £3,500 - as long as I could prove that the Mobiliser worked.
So I did exactly that. I looked at the manufacturers' claims - that the Mobiliser improved flexibility and pain - and set up a small study to show whether using it regularly, caused those effects in my patients. Twelve of my patients signed up to take part, and the results were impressive, with a mean increase in low back extension of 32% and mean reduction in pain of 44% over four weeks.
Since then, I've continued to use the Mobiliser in my practice, and think it is a brilliant adjunct to physiotherapy for the majority of back pain patients. Some of my patients hire them for use at home, and use the Mobiliser on a daily basis. Others come into the shop and use the Mobiliser before their treatment session, which is great because the Mobiliser provides a general warm-up for the spinal joints, and I can then focus my treatment on the remaining restrictions, which are likely to be the real cause of the problem. That's not to say that it's the answer for everyone - but for most people, it's a great bit of kit.
If you're interested in discussing using or hiring the 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.
Blog for Victory
Hi, I'm Nell Mead. I'm a former Army physiotherapist and I specialise in sports medicine and back pain. This is my blog, where I write about issues that are on my mind. Some of these are about issues that are specific to particular injuries or medical conditions but I will also be updating you on events occurring inside Victory and in the wider world of medical rehabilitation. I also publish guest posts by Victory's other therapists whenever I can persuade them to sit still for long enough to write something!
When we're not writing, we're offering appointments at The Foundry in Liverpool Street. We'd love to see your comments on our posts - and we'd love to meet you even more, so do pop by and meet the team.