Sri Lanka

Update from the Field

January 31, 2007

Michael Lear

Many in the US are familiar with the effectiveness of therapeutic bodywork, movement education, acupuncture, yoga and massage in treating pain, relieving stress and addressing other psychological and physical trauma. However, these techniques that are so common here, have not widely reached abroad to countries like Sri Lanka, Pakistan and Indonesia, recently devastated by natural disasters and in need of effective affordable health care options.

While most relief organizations recognize the need for immediate medical care, many have not yet taken advantage of the long term benefits that cost effective holistic protocols can provide to those suffering from Post Traumatic Stress, chronic pain and neuromuscular disorders. Through Team Whole Health, Real Medicine can now provide both clinical support and instruction in progressive, complementary holistic healing techniques to physical therapy networks in these devastated countries.

Unique to these education programs are the benefits that continue after the trainings. Once taught, therapists can train others, including lay caregivers, long after the initial costs are absorbed. Further leveraging the donor contributions and reducing the cost benefit per patient are the ongoing enhanced treatments patients receive.

Our pilot initiative to introduce progressive healing therapies into physical therapy networks in Sri Lanka to aid in the treatment of Post Traumatic Stress, Chronic Pain and neuromuscular disorders took place at Navajeevana Rehabilitation Center in Tangalle, in February and March of 2006. Navajeevana, a community based rehabilitation center in its 19th year, is the only non-governmental organization with a comprehensive cross-disability rehabilitation program ranging from physical and mental rehabilitation to economic and educational rehabilitation and empowerment.

In addition to Navajeevana founder Kumarini Wickramsuryia and her staff, members of the UK based physical therapy group Motivation.org.UK, who have been assisting with rehabilitation services in Sri Lanka, were in attendance.  (A pdf of the Navajeevana Project Summary is available for download at the bottom of this page.)

Our preliminary goal was to train physical therapists who do not have access to innovative healing protocols and who are often inundated by the extensive needs of their poor surrounding communities. Well received and successfully applied, The Trager® Approach (see below) quickly proved to be an effective adjunct therapy, enhancing the efficacy of treatment protocols for post traumatic stress related low back and neck pain from last year’s tsunami, Cerebral Palsy, Hemipalegia and other injury related issues. Therapists traveled from as far north as the Tamil Tiger dominated region of Jaffna to attend.

The success of the pilot program has since resulted in requests for additional trainings as well as the development of a training program for the blind as part of Navajeevana’s Community Vocational Training Program. Studies on the efficacy of Trager® to treat acute psycho-physical trauma associated with mine accidents have also been considered.

Our preliminary goal for 2007 in Sri Lanka is to commence in January and provide 3 month-long trainings at Navajeevana Rehabilitation Center for their therapists, other regional personnel and lay caregivers.

An Introduction of The Trager® Approach for Physical Therapists

This Four-Week Program is designed to impart the fundamental and most adaptive and effective principles principles of The Trager® Approach to enhance their mobilization and treatment protocols for chronic muscle pain, spasms, Post Traumatic Stress related pain, Cerebral Palsy and other neuromuscular disorders as well as educate therapists in self-care. The two-day Introductory Workshop satisfies the Category A Continuing Education Unit requirements for the US based National Certification Board of Therapeutic Massage and Bodywork. 12-16 CEU’s are awarded by the United States Trager ® Association to workshop participants.

Note: The program schedule may be modified to integrate with the existing staff schedules and clinic operations.

 

The Trager® Approach

Developed over 70 years ago by Dr. Milton Trager for the treatment of polio and sciatica, The Trager® Approach remains an innovative approach to movement education and self care which facilitates lasting neuromuscular change without setting up burnout or injury for the therapist. The Trager® Approach utilizes gentle touch and rhythmic movements to cultivate a state of deep relaxation to release muscle holding patterns residing in the unconscious mind that often manifest as functional limitation, or pain. The rhythmic movements also introduce a new feeling state from which the patient can recall and experience the associated muscular changes. The effects of this work are cumulative and, through a series of sessions over time, can lead to increased self reliance which may reduce the frequency of visits and free up valuable resources at rehabilitation centers. * For more information on the complete Trager® Professional Training please visit: http://www.trager-us.org

Program Four-Week Protocol:

Week 1:

  • Provide technical papers to staff for review of concepts and theory.
  • Offer Trager® sessions to each staff member for experiential knowledge of technique
  • Educate therapists in self care
  • Hold clinical and peer sessions* for observation and discussion of technique adaptations
  • Two day introductory workshop (16 hrs.) on the first weekend

Note: * Permission is obtained from receiver to allow others to observe.

Week 2

  • Continue with staff sessions* as their schedules allow
  • Work 1 day clinic/week, more if requested (Therapists may select and schedule which of their cases/patients they wish to see addressed with Trager®.)
  • ½ day clinic review session for workshop participants 3-4hrs/week (typically Friday)

Week 3

  • Continue with staff sessions* as their schedules allow
  • Work 1 day clinic/week, more if requested (Therapists may select and schedule which of their cases/patients they wish to see addressed with Trager®.)
  • ½ day clinic review session for workshop participants 3-4hrs/week (typically Friday)
  • Third weekend – two day workshop (16 hrs.) – focus on review of technique, applications based on clinical needs, and how to teach self care movements

Week 4

  • Continue with staff sessions* as their schedules allow
  • Work 1 day clinic/week, more if requested (Therapists may select and schedule which of their cases/patients they wish to see addressed with Trager®.)
  • ½ day clinic review session for workshop participants 3-4hrs/week (typically Friday)

Please contact Michael Lear at michael@realmedicinefoundation.org with any questions. For program cost information/funding requirements please see cost summary in the Physical Therapy Enhancement Training Budget Summary available for download below. 

 

Related Files:

Navajeevana Project Summary (.8 MB pdf)

Physical Therapy Enhancement Training Budget Summary (.1 MB pdf)

Country Page: Sri Lanka Initiative Page: Physical Therapy Enhancement Training