PRE PLACEMENT INFORMATION

Version 3

Last updated 17/03/2010

Update planned 07/03/2011

Aims and Objectives of your GGBPS Placement

Your specific aims and objectives will depend on your particular course and level at time of Greater Glasgow Back Pain Service (GGBPS) placement. However the following are core objectives of your time with GGBPS. It is likely you will want to discuss and set additional aims with your clinical supervisor.

Aims:

To increase the student’s confidence in their personal skill, knowledge and understanding of the overall management of a patient presenting with low back pain (LBP).

To present the current evidence base for the management of patients presenting with LBP.

To outline “best practice” in the physiotherapy management of patients presenting with LBP.

Objectives:

By the end of the placement you will be able to:

Identify the current guidelines and their relevance to the physiotherapy management of patients with LBP

Identify “red flags” in a patient presentation and discuss the implications for management in patients with LBP

Recognize “yellow flags” and discuss their significance in the management of patients with LBP

Define pain mechanisms that are relevant in patients with LBP and relate this to patient management.

Select the appropriate questioning technique to obtain the maximum, relevant information from a patient during an assessment.

Background information to Greater Glasgow Back Pain Service
The GGBPS aims to provide the highest standards of care to the healthcare users of Greater Glasgow. The service is evidence based, and systematically evaluated and developed to ensure this. Patient centred, we will respect the individuality of all patients and their carers. Using a bio psychosocial model of back pain, self-management and the principles of rehabilitation are central to the service approach; the aim is to develop the GGBPS as a centre of excellence for the management of patients with low back pain.

The GGBPS is led by a lead Physiotherapist overseeing service organisation and the management of all patients with LBP within Greater Glasgow. Permanent funding was granted for 10 WTE Clinical Physiotherapy Specialists, including the Lead Clinician, 2.8 WTE Psychologists to allow appropriate service development and 1.2 WTE administrative and clerical support to provide service support for GGBPS. This is a physiotherapy-led and delivered service. It extends beyond the scope of the initial service by integrating the physiotherapy management of patients with both acute and non-acute LBP. Furthermore as a city-wide service the Clinical Physiotherapy Specialists cross Primary Care and Acute boundaries. This provides individual patients with equity of access to appropriate resources dependent on their individual need, rather than location. The GGBPS was launched on 9th September 2002.

Relevant Guidelines

As a service, the GGBPS incorporates all the relevant guidelines to ensure the delivery of a clinically effective service. The use of guidelines for LBP patients assists in the improvement of clinical assessment, promotes appropriate investigation and referral for physical therapy or to other disciplines as required and, helps in the prevention of chronic LBP and disability. The service is based on the Royal Collage of General Practitioners Guidelines for the management of LBP (Hutchison et al (1997)).

Essential reading

Greater Glasgow Back Pain Service Pathway Document 2.1 (2010). Found on GGBPS web-site at

Greenhalgh, S & Selfe, J (2006) Red Flags: A guide to identifying serious pathology of the spine. Churchill Livingstone, Elsevier.

Ferguson F, et al. (2007) Cauda Equina Syndrome: The development of a citywide physiotherapy pathway of care. International Journal of Therapy and Rehabilitation Vol. 14 (1) pp24-29

Kendall, N. Linton, S. Main, C. (1997) Guide to Assessing Psychosocial Yellow Flags in Acute Back Pain: Risk Factors for Long-Term Disability and Work Loss. Accident Rehabilitation & Compensation Insurance Corporation of New Zealand and the National Health Committee. Wellington, New Zealand

NHS Quality Improvement Scotland, National Physiotherapy Low Back Pain Audit

Further suggested reading

Aina A, May S, Clare H (2004) The Centralisation phenomenon of spinal symptoms – a systematic review. Manual Therapy Vol. 9 pp134-143

Bigos S J et al. (2009) High quality controlled trails on preventing episodes of back problems: systematic literature review in working-age adults. The Spine Journal 9 pp147-168

Bogduk N. (2009) On the definitions and physiology of back pain, referred pain and radicular pain. Pain Vol. 147 pp17-19

Burton, A. K.; Waddell, G.; Tillotson, K. M.; Summerton, N. (2000). Information and advice to patients with back pain does have a positive effect: an RCT of an educational booklet in primary care. Journal of Bone & Joint Surgery - British Vol. 82-B Supplement I:38-39,

Ferreira Manuela L, et al. (2002) Does spinal manipulative therapy help people with chronic low back pain? Australian Journal of Physiotherapy Vol. 48 pp277-284

Frost, H, Lamb SE, Doll HA, Carver, PT,and Stewart-Brown S. (2004)
Randomised controlled trial of physiotherapy compared with advice for low back painBMJ, Vol. 329 pp. 708-712.

Hutchinson, A, Waddell G, Feder G, et al. Clinical Guidelines for the Management of Acute Low Back Pain. London: Royal College of General Practitioners; 1996

Long, A Donelson, R, Fung, T. (2004) Does it Matter Which Exercise?: A Randomized Control Trial of Exercise for Low Back Pain. Spine Vol. 29(23) pp2593-2602

MoseleyG. L. (2003) A pain neuromatrix approach to patients with chronic pain Manual Therapy Vol. 8(3) pp.130–140

Back Pain Education for Scotland site: (you may require an ATHENS password for access to this site)

Student co-ordinator: Fraser Ferguson

Contact:

How to find your clinical site

Being a student with GGBPS will often involve spending time with differentmembers of the specialist team. Details on how to find these clinical sites are below. Normally you will have one clinical base and trips elsewhere will be discussed in advance.

It is important that you contact your clinical supervisor, at least 2 weeks before your placement starts to clarify your base, starting times etc. Staff move around and move on, so specific contact details are not given. However, you will be provided with these before your placement starts.

Back Pain Service Clinics:

Information regarding location of the clinics is given below. Information regarding travel to and from the clinics including advice on timetables and routes can be obtained from the Traveline Scotland site:

Castlemilk H.C. Physiotherapy Department

Castlemilk Health Centre.

71 Dougrie Drive

G45 9AW

Tel. 531 8560

Limited parking facilities at the Health Centre.

Clarkston H.C.Physiotherapy Department

Clarkston Clinic

56 Busby Road

G76 7AA

Tel. 300 1214

Train Service: to Clarkston Train Station

Parking: Parking at the Clinic is limited, particularly first thing in the morning.

Alternatively parking is available at the Train Station opposite the Clinic.

Clydebank H.C.:Physiotherapy Department

Clydebank Health Centre.

Kilbowie Road

G81 2TQ

Tel. 531 6324 / 6329

Parking: Available at the H.C.

Train Service: to Singer or Clydebank

DrumchapelH.C.:Physiotherapy Department

Drumchapel Health Centre

80/90 Kinfauns Drive

G15 7TS

Tel. 211 6147

Bus Service: There is a bus stop outside the Health Centre on Kinfauns Drive.

Train Service: to Drumchapel Train Station

Parking: Limited parking by the Health Centre.

Easterhouse H.C. Physiotherapy Department

Easterhouse Health Centre.

9 Auchinlea Road

G34 9HQ

Tel. 531 8140

Train Services: to Easterhouse Train Station

Parking: Parking is available at the Health Centre.

GartnavelGeneralPhysiotherapy Department

Gartnavel General Hospital

1053 Great Western Road

G12 0YN.

Tel. 211 3021

Bus Service: Bus route to Great Western Road.

Train Service: to Hyndland Train Station

Parking: Limited to 4 hours within the grounds. Heavy fines apply where this is breached.

Govanhill H.C.Physiotherapy Department

Govanhill Health Centre.

233 Calder Street

G42 7DR

Tel. 531 8339

Bus Service: to Govanhill

Train Service: to Polloksheilds East/ Polloksheilds West/ Queen’s Park train stations

There is parking available at the Health Centre.

Kirkintilloch H.C.Physiotherapy Department

Townhead Clinic

Lenzie Road

Kirkintilloch

G66 3BQ

Tel. 304 7424

Bus Service: Various

Train Service: to Lenzie Train Station

Parking: Parking is available at the clinic

MaryhillH.C.Physiotherapy Department

Maryhill Health Centre.

41 Shawpark Street

G20 9DR

Tel. 531 8730

Bus Service: Bus service to Maryhill Road

Train Service: to Maryhill train station.

Parking: Parking is available at the Clinic.

MilngavieH.C.Physiotherapy Department

Milngavie Clinic

1, North Campbell Avenue

G62 7AA

Tel. 232 4808

Bus Service: East Dunbartonshire Ring ‘n’ Ride service, Bus No.600

Train Service: From Queen Street Station to Milngavie

Parking: Limited parking at the Clinic

Pollok H.C.Physiotherapy Department

Pollok Health Centre.

21 Cowglen Road

G53 6EQ

Tel. 531 6878

Parking: Is available at the Health Centre.

Royal Infirmary Physiotherapy Department

Glasgow Royal Infirmary

Queen Elizabeth Building

16 Alexandra Parade

G31 2ER

Tel. 211 4778

The Physiotherapy department is located on the ground floor of the “new building” from the Alexandra Parade entrance

Bus Services: to Alexandra Parade.

Train Services: to Alexandra Parade.

Parking is extremely limited around GRI. Charges apply.

Rutherglen H.C.Physiotherapy Department

Rutherglen Primary Care Centre

130 Stonelaw Road

G73 2PQ.

Tel. 531 4155

Bus Service: Regularly from Glasgow City Centre and East Kilbride

Train Service: to Rutherglen train station

Parking: There is parking available at the clinic.

ShettlestonH.C.Physiotherapy Department

Shettleston Health Centre.

420 Old Shettleston Road

G32 7JZ

Tel. 531 6217

Train Service: to Shettleston train station

Parking: Parking is limited at the Health Centre.

Southern GeneralPhysiotherapy Department

Southern General Hospital

1345 Govan Road

G51 4TF

Tel. 201 1498

Bus Service: to the Southern General

Underground: to Govan followed by 20 minute walk.

Parking: Limited to 4 hours within the grounds. Heavy fines apply where this is breached. There is street parking available outside the grounds but owners leave their car at their own risk.

Springburn H.C.Physiotherapy Department

Springburn Health Centre.

200 Springburn Way

G21 1TR

Tel. 531 6753

Bus Service: to Springburn.

Train Service: to Springburn train station

Parking: Parking is available at the clinic

StobhillHospital Physiotherapy Department

Stobhill General Hospital

133 Balornock Road

G21 3UW

Tel. 201 3587

Bus Service: Various

Parking is normally available with in the grounds.

Victoria Infirmary: Physiotherapy Department

New Victoria Hospital

Grange Rd

G42 9LF

Tel: 347 8685

Train Service: to Mount Florida train station

Parking: Limited to 4 hours within the grounds. Heavy fines apply where this is breached.

Western Infirmary Physiotherapy Department

Western Infirmary

Dumbarton Road

G11 6NT

Tel. 211 2445

Bus Service: Bus stops on Dumbarton Road and Byres Road

Underground: Hillhead or Kelvinhall

Parking: Limited to 4 hours within the grounds. Heavy fines apply where this is breached.

Woodside H.C. Physiotherapy Department

Woodside Health Centre.

Barr Street

G20 7LR

Tel. 531 9243

Underground: St. George's Cross

Bus: Maryhill Rd.

Parking: Parking is limited at the Clinic.

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GGBPS Pre Placement Package. Version 3 SM/FF March 2010. Review 2011