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In Canada, A Pain Self-management Program with Tai Chi Ingredient Snowballing

In Canada, A Pain Self-management Program with Tai Chi Ingredient Snowballing


In 2005, in Kingston City of Ontario, Canada, family physician Dr. Ruth Dubin, discouraged by the lack of improvement in the lives of her patients suffering from chronic non-cancer pain, spearheaded a multidisciplinary team that included physicians, pain specialists, a nurse, physiotherapists, an occupational therapist, a psychologist, an exercise physiologist, and fitness trainers from the Kingston Family YMCA.


The team developed a 12-week exercise and education program, Y-PEP, based on the chronic pain self-management program by Dr Sandra LeFort at Memorial University of Newfoundland in St Johnís. Y-PEP sessions include concepts, such as pacing, problem solving, and setting goals, and gently graded exercises, such as Tai Chi, Yoga, and pool therapy.


Since then, this low-cost community-based program has "really snowballed", says Dr Dubin. Word of Y-Pep's positive results has spread and Dr. Dubin and her research partner, Cheryl King-Van Vlack, a rehabilitation professor at Queen's, are now in high demand at pain conferences.


In the March 2009 issue of Canadian Family Physicians, Dr. Dubin talked about this program: "Those who completed the program had reductions in their depression scores, which correlated with reductions in the degree to which their pain interfered with their lives and increases in their functioning."


"As well, qualitative interviews revealed themes of hope, social support, and coping skills that were associated with decreased depression, a shift to an internal locus of control, and increased assertiveness when communicating about pain. Participants indicated that these factors assisted with their pain management and enhanced their participation in meaningful occupations."


After Y-PEP participation, two of Dr. Dubin's chronic pain patients returned to work after many years of complete disability.


Dr Ruth Dubin invites you to contact her to find out how you can start a Y-Pep program and bring it to your own community. You can email her at


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