DBC stands for DOCUMENTATION BASED CARE is the
internationally recognized, musculoskeletal treatment program getting
unprecedented results for patients around the world.
has recently been published in the top spine specialty medical journals
for its proven results through the toughest scientific criteria
(randomized controlled trials)
Is DBC scientifically proven?
At DBC, we pride ourselves on conforming to the
medical principles of Evidence Based Medicine thus the name DBC
(Documentation Based Care). Evidence Based Medicine assures each DBC
patient that any treatment they receive has been scientifically proven
as well as clinically reliable to work for them.
This is in stark
contrast with many rehabilitation centers that may formulate their own
program along with claims that contradict the scientific literature and
Though DBC is a leader in spine technology, DBC works in
cooperation with leaders around the world and embraces the reality that
DBC will continue to evolve and improve over time.
DBC’s dedication to
Evidence Based Medicine principles assures each DBC patient they will
receive and continue to have the full benefit of scientific advancements
in spine care.
How long is the DBC Program?
The DBC program varies in duration depending on
the needs of the patient. Factors influencing the duration are the
return of segmental neuromuscular control, mobility, muscular endurance
and the adaptation rates of the segmental and supporting tissues.
Why is the DBC protocol advised 2 times per week?
When the DBC protocol was developed, DBC conducted
iterative, comparative studies evaluating the effectiveness of
different frequencies of treatments and their effects on adaptation and
The DBC protocol is 2 times per week because clinical trials
showed this frequency maximized tissue adaptation while minimizing risk
of over-stimulation and increased pain.
Unlike therapy for other joints
that can be protected from use during the recovery phase of the
adaptation process, the spine must continue its function between
treatments, effectively reducing the recovery time between treatments.
The DBC studies indicated that this frequency was optimal since it
achieved the maximum adaptation rates as 3 times per week while the more
frequent visits increased risk threefold and increased cost by 50%
without additional benefit.
DBC provides care that is based on outcomes for the
long-term benefit of our patient.
The DBC program has received
widespread support among the health care providers and insurers, as they
become more informed and discriminating in the services they prescribe
We should be careful to clarify that the results found
with DBC should not be misrepresented to suggest that performing other,
or less effective, programs twice per week over similar periods would be
any more productive than they already are, or are not.
On the contrary,
it identifies the glaring deficiencies of programs developed without
Is this work hardening?
No. Work hardening uses the theory of
"task-specific reconditioning" which is specific to the patients job
task, but does not address the specific area of injury, nor the
adaptation needed to return the patient to job specific tasks.
hardening theory hopes, that by progressively increasing exposure of the
whole body chain to simulated work situations, the body will somehow
adapt to the increasing demands of performing simulated job tasks.
is usually done in a controlled environment where patients are taught to
concentrate on proper ergonomics and invoke conscious compensation
mechanisms to "adapt" to, or rehearse, simulated job-task Requirements.
DBC is spine-specific adaptive therapy, which
objectively documents specific deficiencies and develops an individual
program to correct each deficiency before involving the whole body
DBC develops each component to be properly prepared for standard
and more importantly non-standard tasks to decrease the risk of injury
when proper ergonomics are not possible or neglected.
DBC’s goal is to
protect the patient from re-injury both on and off the job so the
patient does not need additional care.
Work hardening or work conditioning may be useful if
limited to its proper application -- for use after DBC has returned the
spine to a dynamically functioning level.
However, it should not
inappropriately be used to recondition the spine. DBC clinicians work
with patients to address specific work related tasks during the DBC
In situations where total body reconditioning may be necessary,
appropriate programs are also used to recondition the other body areas
during and after DBC.
Is this normal Therapy?
No. Traditional pain relieving therapies (heat
packs, massage, modalities, etc.) are used to treat symptoms of acute
injury (first-time or fresh injuries) or improve blood circulation after
The DBC protocol is researched and proven to address the
individual’s specific debilitation and resolve the deficiencies that can
keep back/neck patients from getting better or cause recurrence.
Adaptive Response Therapy works to recover full function which allows
DBC graduates to remain healthy through normal activity (similar to
normal non-injured people in most cases) and reduce future risk of
injury or reinjury. DBC incorporates unique, patented and FDA listed,
testing and training devices specifically designed to initiate, sustain
and control adaptation through careful doses of load and motion while
isolating the target areas of the spine.
Other programs that typically
perform subjective evaluations or total torso tests may not identify the
DBC’s ability to isolate the spine in testing and
cause specific adaptive responses in the spine during treatment is so
unique it was awarded patents in the US as well as many other countries
around the world.
Does this take the place of surgery?
No. When surgery is clearly indicated, research
supports that spine surgery is the best course of treatment with proven
The challenge is that most spine patients do not have
clear surgical indications.
In the past, conservative rehabilitation was used in
an attempt to screen out patients who did not need surgery.
Unfortunately, the science and technology did not exist for spine
rehabilitation to be effective, so they did the best they could.
know that these rehabilitation programs lacked the scientific or medical
evidence--the consensus of high-quality studies conclude that
traditional rehabilitation is no more effective than placebo for spine
Since traditional rehabilitation was not an effective way to
separate appropriate surgical candidates from inappropriate ones,
surgery had been limited to being the treatment of last resort--when the
condition had gotten so unbearable the patient had little to lose.
process resulted in the traditional surgical outcomes where 50 percent
got better, and 50 percent became worse after the surgery.
know friends who lost this coin toss and may have even opted for
Many unfairly blame surgeons or rehabilitation
providers for these poor outcomes when in fact; the technology was just
not available to do better, until now.
DBC is now being used by leading physicians from
family practice through pain management and surgeons as a evaluation
tool to separate conservative (non-surgical) candidates from surgical
ones and as the exclusive rehabilitation program to restore lost
function once the surgeon has repaired the mechanical problem which may
have initiated the debilitation or have been the result of debilitation
that had not been addressed properly.
With this new effective screening
method, leading surgeons are now achieving unprecedented positive
outcomes of 80 to 90 percent for their non-surgical and surgical
With DBC as the new screening method, solution-oriented
physicians can now consider surgery as a more predictable and effective
course of treatment, patients can now be more confident of both their
conservative and surgical options, and payers can be assured of cost
effective quality care without fear of going down the never-ending cycle
of ineffective and expensive treatment.
Consider which generation of
health care technology will be available to you when selecting your
health care professionals or network.
DBC facilities have a list of
physicians and insurance providers in each area known for their advanced
outcomes (see the link to Locations or email us at
Why is the DBC protocol unique?
The DBC protocol is based on scientific research
and developed to produce reliable patient outcomes.
The dosage of
therapy applied in each session, the distinct phases and the designed
progression within each phase of the DBC protocol are based on
physiological and neurological adaptation rates.
copyrighted content of each session, the frequency (2x per week) and the
length of the protocol has been developed only after extensive
scientific research on adaptation and iterative trials with safety and
patient results as the measurement of success.
DBC determines a patient’s individual program based on
what has proven to work for patients of similar situation and
Each of the DBC clinics (over 100 and growing) updates
the database of over 10,000 patients and over 6000 normal subjects. DBC
continually analyzes this database to identify patterns and continually
improve the DBC protocol and its outcome.
DBC is advanced science applied by specialized
clinicians. Each DBC Certified Clinician must be certified through an
intensive course in spinal function, pathology and adaptive response
DBC is the international standard - the clinically
tested, medically proven and published, scientific program for the
specific evaluation and functional restoration of back and neck
Will this help Degenerative Disc Disease?
Many symptoms of functional debilitation mimic
that of Degenerative Disc Disease. The challenge is determining the
difference. Physicians find DBC very useful to help separate patients
who only have debilitation from being categorized into the vague and
perceptively more serious category of "Degenerative Disc Disease".
Leading physicians who use DBC find that over 85 percent of those who
have previously been, or about to be, labeled with Degenerative Disc
Disease are helped through DBC, or merely had back pain symptoms also
associated with Degenterative Disc Disease.
Even most with actual
Degenerative Disc Disease improve function, reduce pain and reduce its
DBC objectively quantifies spinal function and adaptation rates
to identify positive response which would indicate debilitation versus
This is not to say that failure in other programs
not proven to be effective, should be used as an indicator of the
severity of a specific patient.
On the contrary, the predictible lack of
outcomes of providers are too often blamed on the severity of the
disease or willingness of the patient.
What is included in the DBC testing?
Testing is DBC’s means of evaluating and
quantifying the function of the spine.
It documents pain levels and
patterns, psychosocial variables related to pain such as depression, and
musculoskeletal patterns of posture and balance resulting from the
pain/injury, segmental instability and paraspinal endurance.
testing sets the baseline for documenting improvement and the initial
levels of the protocol.
The mid-term test reveals the function after
segmental neuromuscular deficiencies have been corrected.
information, the sustained dosage of activity needed to accomplish
program targets can be determined.
What is the DBC home program?
The DBC home program is a natural continuation of
the DBC protocol designed to maintain the clinical benefits provided by
the DBC clinical program with the addition of more complex activities
designed to reduce risk of future injuries.
DBC’s clinical program also
includes a daily home program that makes the transition to a home
program and healthy lifestyle change very natural.
Who oversees the program?
DBC will ensure that all clinicians treating DBC
patients to be DBC Certified Clinicians by successfully completing the
DBC sub-specialty course or training in spinal anatomy, biomechanics,
pathology, rehabilitation and the DBC protocol.
What are the contraindications?
DBC has clear, scientifically evidenced
contra-indications. Please contact your local DBC facility or referring
DBC physician for more details.
How does a patient get into the DBC?
The DBC treatment program is mainly available
through a prescription from a physician.
Certified DBC Clinicians in
each DBC clinic are available to work with treating physicians to
discuss indications, contraindications, expected outcomes as well as
develop treatment strategies, plans and targets.