THE SPANISH BACK SCHOOL (EEDE)
Background.
Healthy posture ("postural hygiene")
consists of adopting postures and making movements or efforts
so that there is the least possible load on the spine and
back muscles. Thanks to it, healthy individuals have less
risk of suffering back pains and back patients improve their
mobility and autonomy.
The Back School is a program in Health Education aimed at
the general public and preferentially to patients with back
pain or to groups most likely to suffer it. In the school,
the rules of healthy posture and knowledge about the back
and its functioning are presented in much greater depth than
in a public campaign for prevention. Additionally, the appropriate
attitude to adopt in the event of pain is taught in order
to reduce the risk that it last longer and to be able to maintain
as active a lifestyle as possible.
The Back School is effective in reducing the risk of suffering
back pains and in shortening their length as well as in improving
the recovery and the autonomy of those who already suffer
pain. Its goal is to teach patients to practice and apply
this knowledge in their daily lives, so that the teaching
methodology and the media used are as important as its content.
In practice, certain problems exist that reduce the effectiveness
of Back Schools. Some schools are excessively theoretical
and are not truly applicable for many groups of people. They
tend to be organized by one doctor or a group of doctors who
use only the limited means at their disposal and are not coordinated
with other Schools. That, furthermore, makes it more difficult
to bring its contents up to date with the scientific evidence
available, and the contents and teaching system vary from
one school to another.
This is very serious, because it is harmful to communicate
obsolete information. In fact, studies have shown that providing
inappropriate information, as for example, recommending bed
rest as a treatment or encouraging an obsessive attitude towards
the "protection" of the back, can cause greater
disability than the back pain itself.
Additionally, such schools tend to lack a systematic evaluation
of what and how much the students have learned and cannot
measure the real impact of the knowledge and skills acquired
on their daily lives, so that the degree of their effectiveness
is often not known and is predictably uneven.
Objective.
To set up a network of Back Schools that:
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Work together in a coordinated fashion;
use homogeneous teaching contents and materials and bring
them up to date constantly on the basis of the most reliable
scientific evidence.
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Use the most modern means of communicating
these contents in the most effective fashion.
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Evaluate their results systematically
in order to improve them continually.
Description.
The Foundation brings together and summarizes
the available scientific information on the efficacy of each
one of the contents presented at The Back School, on the schemes
or systems that provide the clearest and most useful information
in the shortest amount of time possible, and on the teaching
methods which achieve the highest levels of comprehension
and practical application among students. Thus, the Kovacs
Foundation defines and is constantly bringing up to date the
contents and teaching systems of The Spanish Back School.
A typical teaching program at the School is divided into
several phases:
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Basic concepts about the structure and functioning of
the spinal column.
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Rules of healthy posture.
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Criteria for performing exercises centered on the back
and abdominal muscles.
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Attitude to maintain in the event of pain.
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Confirmation that the students have understood the concepts
explained and apply them correctly.
The school is usually organized into three 45-minute classes
in theory and practice, with a maximum of 10 students. Courses
are also custom-designed for specific groups, such as workers
or senior citizens, in which the contents and organization
may vary. Thus, for example, special classes designed for
specific workers are given at the workplace.
The Kovacs Foundation established The Spanish Back School
in 1996. Today, the School includes centers in Alicante, Asturias,
the Balearic Islands, Barcelona, Granada, Madrid, Murcia and
Zaragoza.
The means and criteria by which this expansion has been made
are:
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To invite the leading medical rehabilitation centers
of each region, in order to reach the most beneficiaries
as possible and to encourage the medical community to
get together and work as a team. In this sense, the Foundation
considers its Back School an open forum to which it contributes
its scientific work and its organizational capacity, so
that all specialized Centers that meet the criteria for
quality and commitment are welcome. The Foundation defines
and brings up to date the teaching methods based on quality
scientific evidence and these Centers apply them.
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To integrate the School into the Kovacs Back Units,
which constitute the center the Foundation's health care,
since all of the procedures scientifically proven effective
for the prevention or treatment of back ailments are applied
in them. Thus, all of the Kovacs Back Units, whether they
are located in Foundation clinics or in associated clinics,
contain a Back School.
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To try to reach the broadest segment of the general public,
but to give priority to those groups with the greatest
risk of back pain, or those in whom it could have greater
consequences, as in the elderly, adolescents, or specific
groups of workers. With this aim, the School has begun
supervising the work of gymnasiums
and muscle recovery centers in the health care setting.
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Along with the Kovacs Foundation, the following
have participated in this project.
Sports and rehabilitation centers in the different regions
in which the School has been established.
Status.
Between January 1, and May 31, 2004, the Spanish Back School
has trained a total of 3,124 people. The students themselves,
through their companies or their mutual work accident insurance,
financed the training.
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