The RTAA® for the spine and its field of application - interview with Bernd Steinhoff

Interview with Bernd Steinhoff - The RTAA® for the spine and its areas of application.

Bernd Steinhoff developed the RTAA® for the spine together with Matthias Keller, Georg Supp, Wolfgang Schoch and Eduard Kurz. In this interview he explains the thoughts behind the Return to Activity Algorithm® and how and when it is implemented.

OSINSTITUT: Bernd, you were part of the team who developed the RTAA® for the spine. What was the intention and the considerations behind it?

Bernd Steinhoff: After the RTAA® for the lower and upper extremities, the spine was the logical next step. Basically, the idea is to develop a structured procedure for rehabilitation with which measurable goals can be set and achieved - this time for back patients. Of course, the RTAA® does not only concern the spine, but the entire torso. 

OSINSTITUT: Which challenges did you have to overcome in developing the RTAA® for the spine?

Bernd Steinhoff: The side-to-side comparison, which seems to be missing at first glance, certainly cost us a lot of brainpower and time. We had to think about where to get standard values or the values we orientate ourselves by. If we refer to the trunk, we either have to orient ourselves to the overall situation or retain the possibility of a right-left comparison by selecting the tests. Many spinal problems also cause discomfort on a particular side, for example radiating pain. We have therefore included some jump tests in the RTAA® for the spine. A second option is to take totals. This works very well for teams, for example. We test the whole team before the season and then have reference values when rehab becomes necessary.

OSINSTITUT: You have always talked about standard values. Are there values in the literature that can be used, especially when I work with patients as a therapist and have no reference value? 

Bernd Steinhoff: Unfortunately, not yet to a satisfactory extent. We have started to collect data at the OSINSTITUT. But it is a lengthy process before this data can be published - the population has to be right, the test has to be standardised and the data obtained has to be analysed properly afterwards. Therefore, there is still no scientifically reliable "standard data". At some point, however, we will have sufficient data and then present them. With the RTAA® for the lower extremity, by the way, we are already quite a bit further along.

OSINSTITUT:Which tests are used for the RTAA® spine and why were these tests chosen?

Bernd Steinhoff: We have different "drawers" as tests. Firstly, provocation tests, with which we want to provoke the individual segments of the spine in different directions of movement. These are extension, flexion, rotation and, of course, impacts. Here we want to see how the respective segments and the surrounding musculature react to an appropriate load. These tests cannot always be documented in terms of deterioration or improvement. We have therefore chosen the decision question "Pain: yes or no" and the development of pain for assessment. This is especially about radiating, long-lasting pain.

The second drawer is measurable tests. For example, we have integrated various plank tests, such as frontplank or sideplank tests based on the Bunkey test. We have included two jump tests, the front-hop test and the square-hop test. With these last two test forms, a left-right comparison is then possible and measured values can be created.

Seminar notice

The Module Rehab contains all contents around the RTAA®.

Module Rehab // 27th - 29th October 2022

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