How to get your patients exercising… COPD study day 17th 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? Less well understood. And to what intensity?

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 Strength exercises on 2 or more days / week 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 physios….. The patients…

…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 ‘HELLO, MY NAME IS…….’ 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…….’