39. United Kingdom survey of Physiotherapy group exercise classes in paediatric Rheumatology

Abstract

Background: Patients with Rheumatological conditions and associated deconditioning benefit from prescribed exercise programmes (Bohr et al., 2015; Bout-Tabaku et al., 2014; Kemp et al., 2009). Conventional practice has favoured one-to-one patient-physiotherapist sessions. Limited physiotherapist resource within the National Health Service may be more efficiently utilised through provision of group exercise classes. Group classes may also promote peer support between patients and families. Aim(s): 1. Describe paediatric rheumatology group exercise class provision across the United Kingdom (UK). 2. Collate physiotherapist opinion of group exercise classes. Methods or History: A 16-point questionnaire was developed and distributed using SurveyMonkey software (shared on the Interactive Chartered Society of Physiotherapy website, emailed to all BSPAR Allied Health Professional members). A two-month period was allowed for respondents to complete the survey. Respondents were asked to provide data regarding provision of, or perceived barriers to group exercise classes, descriptive data of classes provided and perceived patient-related outcomes. Results or Progress: Thirteen responses were received. Four (31%) respondents reported providing regular exercise classes. Common reported barriers to provision of exercise classes included low patient numbers, low staffing levels and a lack of appropriate space. Three respondents provided further qualitative data and themes were drawn from these responses. Three respondents provide classes for patients aged 5-16 for inflammatory (n = 3), non-inflammatory (n =3) and chronic pain (n= 1) conditions - one respondent highlighted their plan to provide additional classes for chronic pain in future. Inclusion criteria for classes involved: reduction in activities of daily living independence, poor coping, low school attendance or acute admission to hospital. Table 1 summarises data regarding planning and scheduling of exercise classes. Two respondents provided additional education (pain management (n= 3), Physical Exercise (PE) advice (n =1), hypermobility (n= 1), footwear (n =1), lifestyle management (n=1)) to complement the classes and 1 centre required funding for its classes in response to increased outpatient referrals. All 3 respondents perceived group exercise classes had benefited their patients both subjectively and objectively using validated outcome measures (CHAQ (n =2) and PedsQL (n=2)). Conclusion(s): 1. A minority of UK paediatric Rheumatology centres currently run regular exercise classes for patients with inflammatory, noninflammatory and chronic pain needs. 2. Common barriers to providing classes include low staffing, lack of appropriate space and low patient numbers. 3. Classes are typically provided in blocks of 6-12 sessions (groups of 5-15 patients aged between 5-16), weekly for 1-1.5 hours by 1 qualified and 1 unqualified therapist. 4. Exercise classes benefit overall patient outcome both subjectively and objectively. 5. Education is also currently provided to complement exercise classes.