The role of occupational therapy in back school.

As 'Back Schools' are finding growing acceptance and recognition as a treatment for patients with back pain, occupational therapists are increasingly becoming involved in programming them. Traditionally such schools have been conceived and implemented by physicians and physical therapists. However as the Back School concept is analyzed, need for direct application of the skills and philosophies of the occupational therapy profession is quite evident. The core of the Back School program emphasizes that patients control back pain ultimately through the appropriate selection of and approach to their daily activities. Traditionally occupational therapists use directed performance in activities of daily living as ways to maximize patients' function. However, before hurling occupational therapists into the Back School setting one must ask "How much understanding of the biomechanics of the spine does the occupational therapist have?" A real "backbone" of understanding is essential in order for one to teach correct posture and body mechanics to persons who need to engage in all sorts of activities of daily living. An example of the occupational therapist role in two back school formats offered by the North Texas Back Institute is described. Results of follow-up surveys of back school 'graduates' from both programs are briefly reviewed.