HOW TO GET YOUR PATIENTS EXERCISING COPD STUDY

HOW TO GET YOUR PATIENTS EXERCISING… COPD STUDY DAY 17 TH OCTOBER 2017 VICKI MASEY

Patient’s perceptions of exercise • Important to differentiate between exercise and being generally active • ‘oh I never sit down for long, I’m always on the go’. • ‘I take the dog for a walk every day, but he’s so old and slow now’…. . • ‘I walk to the shop every day to get the paper’ • ‘I do a Tai Chi / seated exercise class every week’ • Most people know that exercise is ‘good for you’ BUT • What are the benefits? • How much exercise? • And to what intensity? Less well understood.

Respiratory benefits • Reduces sensation of breathlessness • Improves airways clearance.

CURRENT EXERCISE GUIDELINES NHS Choices Guidelines for the over 65 population: • At least 150 minutes of moderate aerobic activity / week eg cycling or walking AND • Strength exercises on 2 or more days / week that work all major muscle groups OR • 75 minutes of vigorous aerobic activity / week eg running or singles tennis AND • Strength exercises on 2 or more days / week OR • A mix of moderate and vigorous aerobic activity equating to 150 minutes of moderate exercise (I minute of vigorous exercise = 2 minutes of moderate aerobic activity)

Who the what now? . . . The patients… The physios…. .

…and in plain English? • Advice given to patients during PR Benefits of Exercise talk • Aim for 3 x 60 minutes of SUSTAINED exercise where you get breathless (not speechless) regularly. • Includes warm-up and cool-down time • It does not have to be non-stop exercise • Home Exercise Programme given to patients which aims to replicate the format of the exercise component of PR • Alternating aerobic and resistance work • rest and ‘catch your breath’ between activities • Aerobic activity to Borg score 3 -4 – ‘hello, my name is…’

CONTINUING EXERCISE • The message from Day 0 of the course: • the PR course is aimed at developing a habit of regular exercise into the weekly routine. • Any benefits gained during rehab will be lost within 6 months if no further exercise after completion of the course. • All patients are given an Exercise on Referral on completion of the course. • Information is given regarding gym schemes – • induction, programme setting and review by Gym staff

AND FOR THE GYM HATERS… • Emphasise the importance of exercise • Find something they enjoy • Keep boredom at bay – music, TV etc. • Make it a social occasion – less chance of cancelling if you’ve made a commitment • Can mix and match activities PROVIDED they meet the criteria (sustained activity, inducing breathlessness or challenging muscles) • They don’t even have to leave home - plenty of opportunities to exercise in the house.

SUGGESTIONS • Home exercise DVD’s • British Lung Foundation • Generation Games / Age UK • Health Walks • Oxfordshire Age UK - Generation Games activity databases • Local classes / groups – community noticeboards, area magazines. • Dancing – ball room, tea dances etc • Interactive games systems eg Nintendo Wii • Home exercise kit – resistance bands, water bottles, borrow exercise bikes etc ‘HELLO, MY NAME IS……. ’