Week 2- Categorization

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The theme for this week was categorization, whether it was sorting studies or scans.

Through the beginning part of the week I spent my time perusing a new avenue of research that I mentioned in my blog last week- this included putting the 188 studies on the World Health Organization (WHO) site under different current theoretical models to see if we can further confirm the need for fascia exploration and the addition of sub categories to update the categorization of lower back pain.

We decided to use 6 current theoretical models:

1.) Peripheral nociceptive generator –based.
– Anything that acts on mediating pain caused by the nervous system.

2.) Movement-based/ Treatment-based.
– Source of pain associated with types of movement and mechanical loading.

3.) Psychosocial.
– Any study associated with psychology, the mind, or social stresses such as finance, relationships, jobs etc.

4.) Neurophysiological.
– Any study that is looks at mechanisms of pain/evaluating source of pain by neurological testing.

5.) Biopsychosocial.
– Any study that involves a combination of the movement/treatment based category and psychosocial category.

6.) Spinal Control.
– Exercise where the source of pain is neuromuscular, not just neurological.

Categorizing the different studies was quite a difficult job at times as I sometimes found that the study may fit two particular categories, in which case, I put them in both. I am yet to discuss my results with Kyra, this will be a job for first thing Monday morning- I can already see an interesting pattern forming, and I plan to discuss this on my blog next week after more detailed analysis.

Looking through these different studies in detail throughout the sorting process enabled me to learn about new techniques/modalities and grow as a student sports therapist. In order to gain an understanding of each study I had to research words I was not familiar with. For example – Electroencephalography, SPECT-CT imagery and Centralization Phenomenon.

In the latter part of the week I spent my time starting to analyse the scans from the database as planned- to see if we can correlate the perceived ‘organised’ and ‘unorganised’ fascia with the level of pain the participant reported. It was really interesting to analyse the different echogenicity for separate structures, notice how different the scans were for each individual, and how the left and right side can differ so greatly on the same participant. In order to provide consistency I used the written criteria for ‘organised’ and ‘unorganised’ fascia for the survey done last week.

I have attached an example image of an ultrasound scan of Thoracolumbar Fascia so you can have a go at pointing out the Thoracolumbar Fascia. It is fascinating how scans that have the same measured echogenicity and thickness, can differ in their appearance to the human eye in their layout… how would you describe the layout of the fascia in the image?

I am still in the process of analysing all the scans, when I have finished me and Kyra plan to analyse the results.

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