Unit D519 Design, agree and adapt a physical
activity programme with adults with low
back pain
Mapping Version
Element 1 – D519.1 - Design and agree a physical activity programme with
patients/clients with low back pain
What you must do
Mapped Against
1. establish an effective working relationship with patients/clients and
appropriate health care professionals
2.
collect, record and interpret information about your patients/clients
with low back pain using safe and appropriate methods
3.
risk assess the client according to current guidelines within your
scope of practice
4.
follow the correct procedures and protocols for working with health
care professionals, including those for confidentiality and consent
5.
establish and agree the patient/client’s readiness to participate
6.
plan and agree goals that are appropriate to your clients and their
current level of ability
7.
plan and prepare objectives, activities and delivery methods that
are appropriate to your client’s goals and condition
8.
design and agree a programme adapted to your patient/clients
using relevant principles of training
What you must cover
Mapped Against
Information
personal goals
2 referral form
3 informed consent to transfer medical information/participate
1
4 medical history and medication
functional capacity
6 current and previous physical activity history and preferences
7 social and psychological considerations
5
methods
1. reports
2. interview
3. questionnaires
4. observations
5. functional and psychological assessments
6. risk assessment
Unit D519
Mapping Version
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Element 2 – D519.2 - Deliver, review and adapt a physical activity programme
with patients/clients with low back pain
What you must do
Mapped Against
1.
assess progress, monitor and manage risk to patient/clients
throughout the programme
2.
respond appropriately to medical complications and emergency
situations
3.
deliver planned activities to patient/clients with low back pain,
adapting activities according to individual needs and abilities in
accordance with current evidence based guidance
4.
communicate and consult with patient/clients on issues to do with
their physical activity programme and progress
5.
provide appropriate attention to patient/clients with common comorbidities
6.
support patient/clients in a way which will promote sustained
change in physical activity levels
7.
enable patient/clients in self-management
8.
monitor patient/clients progress against agreed goals, adapt the
programme accordingly and where appropriate, refer on to other
health or exercise settings
9.
provide ongoing reports to communicate outcomes to the
appropriate health care professional.
What you must know and understand
Mapped Against
K1 Government policy and published national guidelines for low
back pain and its management.
K2 Awareness of national agencies, organisations and literature
relating to low back pain management
K3 Relevant medico-legal requirements.
K4 How to interact appropriately with general practitioners, other
health care professionals and personnel involved in the
process of low back pain management.
K5 Ensure patient/client information and consent, meeting
recommended guidelines (e.g. NQAF, 2001), is received prior
to advising, prescribing or instructing exercise.
K6 The protocol to follow when dealing with patients/clients who
have been transferred from a range of health settings and
those who self-refer.
K7 Understand the importance of an agreed link with a named
health care professional from the secondary and/or primary
care setting.
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K8 Barriers to communication with referred patients/clients and
the communication skills needed to overcome these.
K9 How to identify when to refer to other physical activity or
health care professionals patient/clients whose requirements
fall outside your scope of practice and limits of competence
K10 Ethical considerations involved in low back pain management,
including respecting inter-professional boundaries and
patient/client confidentiality.
K11 Methods of information collection and interpretation,
appropriate storage of confidential records and management
processes encountered in running low back pain management
exercise sessions.
K12 Current relevant structures of the National Health Service, the
names and functions of different relevant medical
organisations and service providers.
K13 Epidemiology, causes, consequences and classification of low
back pain.
K14 Risk factors for low back pain onset and chronicity
K15 How physical activity/inactivity may influence risk factors.
K16 Relevant anatomy and physiology of body systems that could
contribute to low back pain, eg musculo-skeletal, neurological.
K17 Relevant psycho-social aspects that could contribute to low back
pain eg fear avoidance behaviour, catastrophising and expectations
K18 Assessment of modifiable risk factors:

Medical, e.g. medications

Functional e.g. gait, balance and
movement
K19 Occupational health eg work place ergonomics Understanding of
interaction between exercise and co-interventions for low back
pain management e.g.:

pain management course

cognitive behavioural therapy

complementary therapies
K20 The range of associated co-morbidities/medications and their
exercise considerations.
K21 Evaluate and monitor an individual’s status associated with
low back pain using tools validated in a variety of settings eg
function, pain and psycho-social
K22 Beneficial effects of physical activity/exercises on the
prevention and management of low back pain.
K23 Contra-indications to exercise and red flags to intervention
which need to be taken into account for the patient/client with
low back pain
K24 Psychosocial considerations (Yellow Flags) which need to be
taken into account for the patient/client with low back pain
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K25 Initial assessment including appropriate assessment of
exercise/physical activity level.
K26 Monitoring procedures prior to each exercise/physical activity
session.
K27 How to set up and manage a safe physical activity
environment relevant for a patient/client with a low back pain.
K28 Both group and individual exercise programming principles for
patient/client with low back pain, following recommended
guidelines.
K29 Monitoring intensity methods including pain as an intensity
moderator.
K30 How to determine and adapt appropriate progressive physical
activity programmes appropriate to low back pain
management using results from the physical / exercise
assessments, medical information, national evidence-based
guidelines, consultation and patient/client aims.
K31 The motivational processes, models and techniques involved
in behavioural change for the referred patient/client to
encourage adherence to long term beneficial lifestyle
changes.
K32 Mental health and mental health promotion in a population
with low back pain.
K33 How to communicate and consult effectively with the referred
patient/client about their programme and progress.
K34 How to respond safely and appropriately to medical
complications, e.g. postural hypotension, hypoglycaemic
event, sudden increase in back pain
K35 How to respond safely and appropriately to emergencies e.g. a fall
K36 The management, evaluation and reporting of information, in
verbal and written formats.
K37 How to use and adapt a system for monitoring and recording
the patient/clients progress and updating their physical activity
programme.
K38 How to evaluate the effectiveness of a low back pain referral
programme
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