Rehabilitation

The effectiveness of circuit training on physical ability in palliative care.

Exercise and physical activity is increasingly being encouraged with palliative care patients due to emerging evidence suggesting the physical and psychosocial benefits to patients. This small, local audit analyses the changes in physical outcome measures of a group of patients undertaking a weekly circuit exercise group.

Managing complexity in a rare condition: A single case report of novel forearm tendon transfers for Inclusion Body Myositis

Inclusion body myositis (IBM) is an acquired, inflammatory myopathy presenting in the over 50´s. Characterised with progressive muscle weakness and atrophy in the quadriceps and long finger flexors. Currently, this complex health problem, that has a prevalence of 5-10 per million, does not have an effective treatment or cure, therefore forearm tendon transfers provide a viable option to address finger weakness in suitable patients. The marked finger flexor weakness poses a significant limitation to patients´ quality of life and functional abilities.

This case demonstrates how physiotherapists can be pivotal in managing complex and challenging conditions through multi-disciplinary team (MDT) working, demonstrating how our roles evolve in response to complex cases.

Move, Groove Improve Quality Improvement Project

The purpose of this project was to reduce the effects of deconditioning and promote functional independence on an elderly care ward, with the ethos inspired by the End Pj Paralysis campaign. The first aim was for over 55% of patients to be sitting out daily for lunch on the ward. The aim was also for over 20% of patients to be wearing their own clothes daily on the ward. Secondary aims including improving patient experience, increasing staff knowledge on deconditioning and maintaining and reducing length of stay.

Contributing to service development and enhancing patient care through the establishment of a balance class

The requirement for a balance exercise class was identified whilst working in a musculoskeletal clinic that receives many referrals for patients who attend with balance deficit. We needed a class that would allow patients to improve upon confidence, mobility, functional balance and lower limb strength whilst being fun and augmenting individual Physiotherapy care. This class would also free up the popular assistant rehabilitation clinics.

Getting the Know-How: The Feasibility of Delivering a Digital Self-Management Programme for Axial Spondyloarthritis

Despite recommendations by the National Institute for Health and Care Excellence in the management of Axial Spondyloarthritis (AS), adherence to exercise and self-management education is reported to be variable. The Axial Spondyloarthritis Know-How (ASK) self-management programme offers service-users a single attendance exercise and education workshop supported by a self-management digital toolkit. The digital toolkit consists of a short educational film and self-assessment tool prior to attendance and an interactive self-management handbook to support health behaviour change following attendance. The feasibility of delivering a digital self-management programme for adults with AS was explored prior to implementation.

On Your Marks - Are PDRU Patients Meeting Government Exercise Guidelines?

The primary aim of the project was to review current practice and establish if our client group were meeting government exercise guidelines whilst attending the Physically Disabled Rehabilitation Unit (PDRU). In addition data was collected in relation to compliance rate of 1Repetition Maximum, exercise completion and recording of BORG RPE scores to determine intensity of treatment.

Supported Exercise programme for Adults with Congenital Heart disease (SEACHange)

Congenital heart disease is a lifelong condition. Many patients will require repeated open heart surgeries during their lifetime and others may go on to develop heart failure, arrhythmia or other problems associated with acquired heart disease. The benefits of regular exercise are well known. The overall aim of this pilot study is to determine the feasibility of introducing a supported exercise programme in to clinical practice to support physical and psychological well being in adults with congenital heart disease living in Scotland.

Priming elderly patients for surgery - the development of a pre-operative service for frail elderly patients

The Peri-operative Review Informing Management of the Elderly (PRIME) Clinic was developed in response to the increasingly frail population undergoing complex major surgery. Due to this, it was recognised that clinicians with advanced skills were required to manage and optimise this patient group pre-operatively, which led to the formation of a multi-disciplinary team consisting of consultant geriatricians, consultant anaesthetists, a senior physiotherapist and a senior occupational therapist. The aim of the team was to optimise patients from a medical, physical and social viewpoint.

The focus of physiotherapy input was to increase physical activity pre-operatively, improve respiratory function and identify falls risks in order to contribute to a reduction in post -op length of stay and improve patient function.

This service evaluation demonstrates the benefit of a highly specialised MDT model with frail elderly elective surgery patients.

Functional Restoration Service

To provide group based, interdisciplinary, combined physical and psychological treatment (CPPP) service to patients with persistent non-specific back pain, to help restore function and quality of life. 

The service’s aim is to train patients to become experts at understanding their persistent low back pain, to manage flare-ups in pain effectively, to set goals to improve function, to reduce reliance on analgesic medication, and to engage in healthy behaviours

The service uses a cognitive behavioural approach, as recommended in the National Back Pain and Radicular Pain Pathway (Pathfinder) (2017) and NICE Guidelines (2016) as an effective way to manage persistent non-specific back pain and disability.

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