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January/February 2003

By Sarah Schmelling

Here’s an embarrassing story. About a month after I started working at Rehab Management, I woke up one morning with intense lower pack pain. After deducing that the likely culprit was my office chair, I tried to fix it. I rolled up a sweater in a ball and leaned on it in a sad attempt at ergonomic bliss. I borrowed an attachable pillow from a coworker and adjusted it for days to no avail. At home, I did the exercises I had been taught when suffering from sciatica several years earlier, but it would help only until the next day. Defeated, and reticent to ask for a new chair, I then tried something I should have done in the first place: I felt underneath the seat for a lever. I adjusted it, and within minutes my pain disappeared.

This just goes to show how often the small, obvious thing can make a huge difference. Not just for minor ailments like the one I had, but for much more intense conditions, be they physical, social, or psychological. This may not seem like news in the rehab community, but it is definitely something to keep in mind.

Two articles in this issue attest to the virtues of not overlooking the obvious. Physical therapist Sherry Brourman (“Walking Off the Pain”) suffered from severe lower back and leg pain several years ago. After physicians recommended that she undergo spinal surgery, she wondered if it might help to correct her gait or, more specifically, what she calls a “primary movement pattern.” Derived from “part physical therapy background, part survival,” she says, she formulated her own gait correction regimen, and was able to completely eliminate her pain. Now she is an avid proponent of gait correction and an author of a book on her method, Walk Yourself Well (Hyperion, 1998). Her story shows how even a professional PT took a while to consider a seemingly small part of her routine—walking—as a possible cure.

Researchers Barbara Crane, MA, PT, ATP, and Douglas Hobson, PhD, in another article (“No Room for Discomfort”), look into a similarly obvious-sounding topic, the importance of comfort in wheelchair seating. Surprisingly, they report that comfort is often ranked highest on the list of important criteria by wheelchair users in reports and surveys, but very little research on the subject has been conducted. By turning their focus on comfort, these authors and their colleagues will pave the way for even more extensive research that could lead to more comfortable seating in future wheelchairs.

As for dilemmas that are a bit more difficult to resolve, this issue also contains the debut of the column “HIPAA Smarts,” in which experts will do their best to help you make sense of the new government requirements.

If only all complications could be overcome by just pulling a lever.

—Sarah Schmelling
cwolski@medpubs.com

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