Physio findings: Teamwork and Action Health aids cancer patients’ hearts

Day centres can help people with mild-to-moderate disabilities to continue living at home. But not all promote the physical and social activities that improve health and wellbeing.

 

Michael Hurley of St George’s university of London and colleagues found that an innovative six-month project at a Leonard Cheshire day centre brought improvements for both users and staff.

 

To tackle concerns about people with complex needs spending most of their time sitting, a community rehabilitation team from St George’s NHS trust worked with staff at the centre to implement a programme called Access to Wellbeing. They aimed to create ‘an active, individualised and purposeful environment’.

 

The team – a senior physio, occupational therapist and rehab assistant – interviewed service users and assessed the buildings and work practices. They then wrote a report detailing what could be changed.

 

‘Staff would often do things for the users as they were unsure of service users’ abilities, felt unable to say no, and worried that encouraging greater independence might cause injury,’ say Professor Hurley and colleagues.

 

The team had discussions with management and staff, who saw the point of helping users to become independent instead of overprotecting them. The team then worked with staff to put the changes into practice. Some were as simple as buying walking frames and adapted kitchen equipment. The staff played their part by encouraging people to use them.

 

A room was set up as a rehabilitation space with exercise equipment. Activities that users had asked for were instigated, and staff helped users take an increasingly active role. Goal-setting workshops and activity plans kept up the momentum.

 

‘The atmosphere at the day centre was transformed,’ say the authors. A year later, they found the low-cost programme had become part of everyday life at the centre.

 

‘The programme increased service users’ physical health and wellbeing, and satisfaction with the service, and improved staff motivation and job satisfaction,’ they conclude. ‘A committed team working together was the most important factor determining successful implementation.’  Hurley M et al. Increasing the health, activity and participation levels of people attending day centres, International Journal of Therapy and Rehabilitation 2014.  

Regular physical activity has been proved helpful to people who have had cancer, especially breast or colorectal cancer. And cardiovascular disease is, apart from cancer itself, the leading cause of illness and death they are likely to face. Yet exercise isn’t routinely included in cancer treatment or rehabilitation programmes. 

 

CSP member Louise Tipson and colleagues at the Action Heart Centre in Dudley’s Russell Hall hospital are tackling this unmet need. Patients can be referred to Action Health, a service provided at the centre by cardiovascular and cancer teams. 

 

‘The reduction of cardiovascular disease risk should be a priority for the long-term care of cancer survivors,’ say the team.

 

Starting with a one-to-one consultation, staff help patients take control of their situation and decide what form of exercise to do and where. Local ‘exercise stations’ include the centre itself, leisure centres, outdoor gyms or walking groups, as well as independent exercise. 

 

Each patient is offered a 12-week programme, supported by centre staff, and a personal activity plan to continue afterwards.

 

Early figures show that a majority of referred patients have taken up the offer and most of these completed their programme, with more than half of those who stuck to it achieving activity levels recommended by the Department of Health. 

 

‘The Action Health experience suggests that a physical activity service for cancer patients can be hosted successfully within a cardiovascular rehabilitation setting,’ say the team, who presented their findings to the British association for cardiovascular prevention and rehabilitation 2014 conference.

 

A short course of manual lymphatic drainage eased pain and swelling for patients with chronic venous insufficiency, and improved their quality of life. Crisóstomo RS et al. Archives of Physical Medicine and Rehabilitation 2014.  

 

Sudden death from heart arrhythmia (SAD) in people aged 14 to 35 is most likely to happen when they are resting or sleeping, and epilepsy is a risk factor, research for Cardiac Risk in the Young has found. Emotional stress or strenuous activity such as sports were linked with 16 per cent of SADs, with boys under 18 most at risk.Mellor G et al. Circulation: Arrhythmia & Electrophysiology 2014.  

 

Some reports have suggested a higher death rate among people with stroke admitted to hospital at weekends. Researchers using data on 56,666 patients have found no significant extra risk if specialist doctors didn’t attend every day, but a higher death rate if the ward had fewer nurses at weekends.Bray BD et al. PLOS Medicine 2014.   

 

People with Parkinson’s who learned the Chinese traditional exercise system t’ai chi, in three one-hour lessons a week for 12 weeks, improved their balance and were less than half as likely as others to fall during the following six months. Gao Q et al. Clinical Rehabilitation 2014.