About Michiel Trouw
Michiel Trouw is a physiotherapist, extended scope therapist, and manual therapist with 15 years of pain treatment experience in the head, neck, and face region. He is also a CRAFTA instructor (Cranio Facial Therapy Academy). In his clinic in Hengelo, Michiel often sees patients with headaches, dizziness, as well as neck, jaw and spine problems. The majority of patients coming to his clinic have had pain for a long time.
Innovation in physiotherapy
In our interview, Michiel shared his professional journey and how he turned his passion for helping pain patients into his career. "I liked to work with the moving disabilities and problems of the body. My main focus was on people incapacitated by pain due to severe dysfunction. As a young physiotherapist, I made it my goal to help that group."
Reducept offers a non-invasive, digital therapeutic solution to help patients suffering from chronic pain. The patient gains control over their pain behaviour while simultaneously reducing the level of pain perceived. Michiel explains how he came across Reducept and why he chose to work with it:
"When I had just finished manual therapy, I saw a presentation about the relationships between the jaw, the neck and headaches. It was an eye-opener for me. I looked at that group of pain patients from a different perspective; many things came together. I also followed a lot of international education in England and Australia. Through these congresses and courses, I learnt a lot about the cortex and neuroimmune system, the different levels of pain receptors and how much patients' beliefs played a role in their pain experience. This knowledge was formative for me as a manual therapist working on joints and muscles. It refocused me strongly towards guiding patients, explaining their situation and making them self-aware and in control of their bodies. This was my first connection with Reducept."
Challenge 1: It takes a lot of effort to explain how pain works.
Chronic pain is incredibly complex. It requires a lot of effort from a professional to explain pain to patients from a biological and physiological perspective. Considering the individual aspect of physiotherapy, delivering pain education can be less effective than desired if using traditional methods, such as lectures and books. It's time-consuming for professionals, and as for patients, the information can be hard to connect to and process.
Solution 1: Digital therapy enables effortless pain education.
Michiel has always been intrigued by innovations in treatment. He shared, "I was never only fixated on the traditional therapy concepts from the literature. I heard something about Virtual Reality (VR) glasses and the possibility of explaining pain to patients in VR. I was maybe the third or fourth therapist in the Netherlands who asked for guidance from Reducept.
When I saw the program for the first time, I was enthusiastic because I'm used to explaining pain concepts to patients using books to read at home and whiteboards to draw pictures. But the VR experience was completely different. It was much more profound and able to change the perspectives of patients. I saw fantastic things happening when I tried the VR glasses."
Adjusting to the VR experience is a smooth transition from traditional methods familiar to patients. Michiel states: "It was much easier for patients to adapt to this visual routine than reading papers and having to make the connections yourself."
Challenge 2: It can be unclear how to treat patients with long-term pain without tissue damage.
Sometimes patients come for physiotherapy with long-term pain but no physiological indication. Michiel once received a patient with seven years of abdominal pain with no tissue damage. The patient was referred to him by a hospital that could not find a suitable treatment for such pain.
Solution 2: Immersive pain education allows patients to become self-sufficient in pain management.
Enrolling this patient into the Reducept therapy helped reduce their pain rating from 8 to 2 out of 10. "This was a major change that got me thinking: I want to do more with this. And now it's part of the clinic's program".
Michiel explains: "For me, the type of pain is not the deciding factor for the use of VR. Rather, it is about long-term pain or an inability to find a particular tissue responsible for the problem. So I always perform a thorough physical examination on my long-term pain patients. If I find the tissue responsible, I talk to the patient, and we do two or three treatments to see if I can reduce the pain. But there is a group of people who don't have many tissue problems yet still experience pain. I think for this group, Reducept is an effective tool. It provides the pain management education that is recommended and gives them more self-sufficiency in controlling their pain."
Challenge 3: It is necessary to track patients' progress with at-home exercises.
If a physiotherapist prescribes at-home exercises, what is the best way to ensure that the patient follows the training routine and makes progress?
Solution 3: Monitoring patients' at-home progress with the Professional Dashboard.
A thorough introduction and explanation will significantly increase a patient's motivation to follow the program. With the Reducept digital therapy, professionals can use the Reducept online dashboard to let patients practise at home while the therapist monitors their progress remotely. Patients can train with the Reducept VR app if they have a VR headset or log in to a mobile app and train on the go.
Michiel explains how he sets up a new patient: "When a patient first comes to me, I make room for a conversation about their pain background and medical journey, then I perform a thorough physical examination and decide on the treatment. If the patient agrees to my proposal to try the VR therapy, we do a 30-minute session in the clinic together. They put the glasses on and get introduced to the program. Then we discuss their VR experience and check whether they are comfortable with the method. If the patient is happy, I make it accessible for them at home to use on their mobile. Sometimes they buy an affordable pair of glasses (editor note - VR headsets for phones) to train with the mobile app. In the Reducept professional dashboard, I can observe what's happening, how often they play the game, and what their pain scores are."
Are you also a healthcare professional who would like to bring innovation into your work? Get in touch with us to learn how to integrate digital therapy into your practice.
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