Pain: vulnerable populations (FS-21)

Focused symposium
Monday 13 May 2019, 10:45-12:15
Room B

Walton LM1Raigangar V2Schbley B3, Islam N4, Zaaeed N5
1University of Sharjah, Physiotherapy, Sharjah, United Arab Emirates, 2University of Sharjah, Sharjah, United Arab Emirates, 3Washburn University, Social Work, Topeka, United States, 4Bangladeshi Health Professions Institute, Affiliated with Center for Rehabilitation of the Paralyzed, Savaar, Bangladesh, 5Syracuse University, Department of Public Health, Food Studies, & Nutrition, United States

Learning objective 1: Define and identify toxic stress and traumatic life events for vulnerable populations and identify self- limitations and internal bias affecting pain management outcomes.
Learning objective 2: Discuss the relationship between toxic stress, traumatic life events and health outcomes related to pain management for the physiotherapist.
Learning objective 3: Develop skills to participate in an inter-professional health care team for comprehensive assessment and community intervention programs related to pain management for vulnerable populations with past trauma.
Description: Physiotherapists are committed to reducing chronic pain conditions and promoting health and wellness for patients and communities, regionally and internationally. Vulnerable communities experience toxic stress, traumatic life events, and violence embedded within the structure of society which may negatively affect pain outcomes and pain management in rehabilitation. The effect of trauma and violence begins early in the neurologic system during the prenatal period, with genetic and epigenetic alteration in development during the critical fetal developmental phases. This presentation will explore the prevalence, incidence rates, and cumulative incidence of toxic stress, structural violence and trauma as it relates to vulnerable patient population health outcomes and pain management, health-related quality of life, neurologic, genetic, epigenetic, and immune system implications for chronic pain and disease. The speakers will discuss a comprehensive, inter-professional, collaborative, community-based model with emphasis on sustainability of global programs and special comparisons between four diverse global populations: Middle East, North America, Southeast Asia, and Africa.
Implications / Conclusions: There is a great need to incorporate a model of physiotherapy pain management which considers the impact of toxic stress and trauma on vulnerable patient populations. This symposium session will bring together four disciplines from across the globe to discuss the impact of a growing population in need of addressing the psychosocial components of a comprehensive pain management program from a physiotherapy perspective. 
Key-words: 1. pain management 2. toxic stress and trauma 3. vulnerable populations
Funding acknowledgements: None.
Relevance to physical therapy globally: Increasing numbers of people are undergoing toxic stress from wars, violence, and poverty. This trauma has been shown to be linked to long term health outcomes for vulnerable populations. The World Health Sustainable Health Development Goals 2030 reduction of negative health outcomes for vulnerable populations. Physiotherapy pain management programs, with consideration of trauma and toxic stress impact, may provide more comprehensive, targeted solutions for rehabilitation in these vulnerable populations.
Target audience: Physiotherapists and other rehabilitation professionals interested in work with vulnerable populations, trauma and pain management