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ROM Dance Used in Canadian Chronic Pain "I was looking for a gentle exercise program that would be safe for just about everybody with chronic pain...There [were] participants who had stopped all exercise before trying the ROM Dance...[this] new approach...worked for them." A recent study examined the effect of a low-cost, community-based, nurse-delivered, group psychoeducation program entitled the Chronic Pain Self-Management Program (CPSMP). One of the primary techniques taught in the CPSMP is the ROM Dance Range of Motion Exercise and Relaxation Program. Participants in this standardized program attend 2-hour long sessions for 6 consecutive weeks. These focus on discussion and group problem solving and encourage individual participation and experimentation with various cognitive/behavioral self-management techniques. At the 3-month follow-up, participants in the CPSMP reported less dependency on others, reduced severity of the pain problem on their lives, had higher levels of self-efficacy and resourcefulness, reported greater involvement in valued adult role activities and had greater life satisfaction compared to the control group who did not receive the program. In addition there were strong positive trends to improvement in measures of pain quality and disability compared to the controls. Treatment subjects also had reduced bodily pain (a measure of intensity and interference), improved physical role functioning, and increased vitality when compared to controls. In addition, there were positive trends to improvement in general mental health and in social functioning. The study design was a randomized controlled trial with 110 patients suffering from a chronic non-malignant pain problem that was idiopathic in nature. All had experienced the pain for more than 3 months. 57 of these were assigned to the treatment and 53 to the control group. The content and materials of the CPSMP were modified from the successful Arthritis Self-Management Program (ASMP). They were adapted to be more directly applicable to those with various idiopathic chronic pains. Program materials given to each participant included a 150-page workbook, relaxation tape, and a variety of pamphlets. Chapter 6 of the workbook includes 16 pages on the ROM Dance Program. Sandra LeFort, Ph.D, MN, RN, School of Nursing, Memorial University of Newfoundland, added the ROM Dance to the ASMP program. She states that, "I was looking for a gentle exercise program that would be safe for just about everybody with chronic pain." She also wanted to include a program that would involve the participants in at least a few minutes of physical activity each session. The ROM Dance met these criteria. LeFort explains that, "the ROM Dance is introduced as a flexibility program that can be used as a warm-up or cool-down for those who have a walking program. It is also suggested that the participants do the ROM Dance even on days when they can't get out and walk or do other aerobic activity." As a part of the CPSMP Program, participants contract each week for an activity. LeFort reported that, "some people will contract to do the ROM Dance 3 or 4 times in a particular week. There have been participants who had stopped all exercise before trying the ROM Dance. They thought that there was nothing they could do, but the new approach of the ROM Dance worked for them. It emphasized slow, controlled movement rather than ideas like 'working through the pain.' They seemed much more willing to try it because they were encouraged to do only what felt right for them." The CPSMP provides a low-cost, accessible intervention that helps people manage the difficult problem of chronic pain. Because it has a standard protocol, this intervention has the potential to be reliably delivered at a low cost in varied urban and rural community settings. Therefore, it can be more widely accessible to a greater number of people suffering from chronic pain than is currently the case with more specialized pain clinic services. The original study results are published in the journal Pain, Vol. 74, 1998, pp 297-306. For more information, contact Dr. Sandra Lefort at slefort@morgan.ucs.mun.ca. Dr. Lefort is also writing another paper about the CPSMP that will include more details about the information and materials included in the program. A follow-up study of the CPSMP is being conducted. It replicates the first study but has 286 participants.
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