Have questions or need more information? Contact us and we will respond as soon as possible. admin@backpaindiy.com Contact Us Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form. NAME YOUR CONFIRM YOUR NAME *YOUR EMAIL *CONFIRM EMAIL *MESSAGESubmit To support the Back Pain DIY project. Please make a donation Donate Seven-Day Progress Form Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.YOUR NAME *EMAIL *Confirm Email *Baseline (for comparison prior doing the exercises)- Pain Level (no pain to worst pain) *--- Select Choice ---no painmildmoderatesevereworst painBaseline (for comparison prior doing the exercises)- Pain location *--- Select Choice ---Centre of the lower backCentre of the lower back radiating to the buttock (left or right)Centre of the lower back radiating to the knee (left or right)Other locationDAY 1 : Pain Level (no pain to worst pain) *--- Select Choice ---No painMildModerateSevereWorst painDAY 1 : Pain location *--- Select Choice ---Centre of the lower backCentre of the lower back radiating to the buttock (left or right)Centre of the lower back radiating to the knee (left or right)Other locationDAY 1 : In total how many times did you perform? (morning, noon, afternoon or night) *--- Select Choice ---OnceTwiceThree timesFour timesDAY 1 : How many set did you do each time? (1 set means = ExA Cross-leg and ExB Semi push-up) *--- Select Choice ---1 set each time2 sets each time3 sets each timeDAY 2 : Pain Level *--- Select Choice ---No painMildModerateSevereWorst painDAY 2 : Pain location *--- Select Choice ---Centre of the lower backCentre of the lower back radiating to the buttock (left or right)Centre of the lower back radiating to the knee (left or right)Other locationDAY 2 : In total how many times did you perform? (morning, noon, afternoon or night) *--- Select Choice ---OnceTwiceThree timesFour timesDAY 2 : How many set did you do each time? (1 set means = ExA Crosse-leg and ExB Semi push-up) *--- Select Choice ---1 set each time2 sets each time3 sets each timeDAY 3 : Pain Level *--- Select Choice ---No painMildModerateSevereWorst painDAY 3 : Pain location *--- Select Choice ---Centre of the lower backCentre of the lower back radiating to the buttock (left or right)Centre of the lower back radiating to the knee (left or right)Other locationDAY 3 : In total how many times did you perform? (morning, noon, afternoon or night) *--- Select Choice ---OnceTwiceThree timesFour timesDAY 3 : How many set did you do each time? (1 set means = ExA Cross-leg and ExB Semi push-up) *--- Select Choice ---1 set each time2 sets each time3 sets each timeDAY 4 : Pain Level *--- Select Choice ---No painMildModerateSevereWorst painDAY 4 : Pain location *--- Select Choice ---Centre of the lower backCentre of the lower back radiating to the buttock (left or right)Centre of the lower back radiating to the knee (left or right)Other locationDAY 4 : In total how many times did you perform? (morning, noon, afternoon or night) *--- Select Choice ---OnceTwiceThree timesFour timesDAY 4 : How many set did you do each time? (1 set means = ExA Cross-leg and ExB Semi push-up) *--- Select Choice ---1 set each time2 sets each time3 sets each timeDAY 5 : Pain Level *--- Select Choice ---No painMildModerateSevereWorst painDAY 5 : Pain location *--- Select Choice ---Centre of the lower backCentre of the lower back radiating to the buttock (left or right)Centre of the lower back radiating to the knee (left or right)Other locationDAY 5 : In total how many times did you perform? (morning, noon, afternoon or night) *--- Select Choice ---OnceTwiceThree timesFour timesDAY 5 : How many set did you do each time? (1 set means = ExA Cross-leg and ExB Semi push-up) *--- Select Choice ---1 set each time2 sets each time3 sets each timeDAY 6: Pain Level *--- Select Choice ---No painMildModerateSevereWorst painDAY 6 : Pain location *--- Select Choice ---Centre of the lower backCentre of the lower back radiating to the buttock (left or right)Centre of the lower back radiating to the knee (left or right)Other locationDAY 6 : In total how many times did you perform? (morning, noon, afternoon or night) *--- Select Choice ---OnceTwiceThree timesFour times means did perform? DAY 6 : How many set did you do each time? (1 set means = ExA Cross-leg and ExB Semi push-up) *--- Select Choice ---1 set each time2 sets each time3 sets each timeDAY 7 : Pain Level--- Select Choice ---No painMildModerateSevereWorst painDAY 7 : Pain location--- Select Choice ---Centre of the lower backCentre of the lower back radiating to the buttock (left or right)Centre of the lower back radiating to the knee (left or right)Other locationDAY 7 : In total how many times did you perform? (morning, noon, afternoon or night)--- Select Choice ---OnceTwiceThree timesFour timesDAY 7 : How many set did you do each time? (1 set means = ExA Cross-leg and ExB Semi push-up)--- Select Choice ---1 set each time2 sets each time3 sets each timeAny comments:Enter any comment regarding the experience of performing these exercises.Submit Form
