What was the issue you were addressing or working on?
Patients with neurological conditions told us that existing commercial exercise programmes were not suitable for them. These patients were coming to see the physiotherapy team as they had no options to self manage.
The project was set up with the primary aim of ensuring that all patients with neurological conditions had access to appropriate exercise opportunities in the community and were supported to access these. The secondary driver was to help them to achieve the best possible wellbeing, mobility and function by using exercise as an opportunity for health improvement.
What you did?
Key partners are NHS Shetland, Shetland Islands Council and Shetland Recreational Trust (SRT), (manage leisure facilities on the islands). Initial start up funding was provided through the Neurological Services Improvement Programme, which provided for a neuro physiotherapist for a year to start up the project, create documentation, provide clinical assessments and run classes. This money also allowed for specialist training for 2 of SRT exercise tutors. The Change Fund has lengthened the programme by 9 months to allow it to be mainstreamed into SRT.
The first phase of the project was delivered in the NHS physio department. Pre-work included devising pathways, assessment tools and supporting information for the projects such as exercise diaries and assessing all participants.
All eligible patients that were known to the service were invited to take part. Evidence based programmes were divided, one for the range of impairments usually associated with Multiple Sclerosis and one for the range usually associated with Parkinson’s.
7 classes a week, one hour in duration, were delivered by 2 physiotherapists, with 8 participants in each class.
The second phase of the project is to transfer the project to the Shetland Recreational Trust for ongoing management
What were the outcomes - benefits or otherwise?
3 aspects of the class were audited. Objective clinical measures of balance and mobility, a patient reported mobility measures and a patient satisfaction questionnaire.
- In the exercise group with impairments associated with MS 90% of the group made a clinically significant improvement in one or more objective measures
- In the exercise group with impairments associated with Parkinson’s 40% of the group made a clinically significant improvement in one or more objective measures.The improvement in the MS group exceeded expectation and and we plan to continue this group unchanged. The Parkinson’s disease programme and results will be reviewed with regard to expected outcomes and programme efficacy. The patients satisfaction survey revealed that all respondents enjoyed exercising as part of a group, with 86% noticing and improvements in day to day function as a result of the class and 92% feeling that exercises in the classes were just right for them.
Contacts - to find out more
Kerry Russell, Assistant Director of Clinical Services, NHS Shetland, Kerry.firstname.lastname@example.org 01595 74 3632