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Sunday
Mar192017

Physiotherapy, Exercise & Physical Activity 2016 Post-Course blog by Dr Anne Griffin @AnneGriffinDiet

Physiotherapy, Exercise & Physical Activity 2016 #PEPA16 Post-Course blog

by Dr Anne Griffin, Registered Dietitian and Member of Irish Nutrition & Dietetic Institute.

Figure 1: Equipment to promote being more active is now brought along to all health events

#PEPA16 caught my eye on a post from the AHPs4PH Facebook page.  In Ireland, statutory registration was being introduced for dietitians with a responsibility to maintain planned continuous professional development (CPD) that is relevant to role and supports competency to practice. #PEPA16 1 was a free online course lasting 6 weeks. It was developed by two educational organisations who had experienced practitioners in physiotherapy and health promotion to develop the content. I had to pass a short quiz, reflect on my learning from each module and its relevance to my practice, participate in the online discussion forums, and complete assignments to progress.  So, it ticked all the right boxes when it came to CPD!

However, what I really wanted was a better understanding of activity.  When it comes to lifestyle there are two givens – you must eat and move, in some sense, everyday!  I can assume that I have a good understanding around nutrition after nearly 20 years of qualification. But, when it came to recommending activity I would quote the national recommendation “aim for 30 minute of moderate activity most days of the week”.  But, if the patient complained of barriers to achieving this (e.g. arthritis, asthma, diabetes, too old, too sore, too heavy, no time, etc.), I would document it as “not possible now due to …, refer to physio”.

Increasingly, I was frustrated with inability to motivate and empower my patients.  Physical inactivity is linked with many chronic health problems including cardiovascular diseases, type 2 diabetes, obesity, cancer, dementia, depression and osteoporosis.2 All my patient types. I have previous experience in health promotion so the concept of having a life-stage approach to encourage greater physical activity particularly appealed to me.1,3, 4

The course covered all aspects of the evidence for physical activity, health benefits and best practice models, based on a variety of national and international guidelines.  The modules included:

  •  Basic principles of the relation between exercise and health
  •  Global issues surrounding physical activity
  •  Role of physical activity in chronic illness
  •  Role of physical activity in specific conditions
  •  Integrating physical activity into clinical practice       

What did I learn? The key message I received was making every contact count!  Simply knowing and having a better understanding of the use of the terms and their implied definition of ‘exercise’ (implies lots of sweat and energy), ‘activity’ (implies frequent walking, aerobic classes), and ‘moving more’ (implies sitting less) helps identify barriers to physical activity. I can work with my patients to overcome these.5 Overall, my better understanding of physical activity means I am no longer afraid that advice I give to increase physical activity levels will do harm. Indeed, I am convinced it will benefit overall health and wellbeing.

Where am I now? I prescribe activity using the FITT principal.6 I have integrated physical activity to ALL patient care plans, developed specific resources to promote physical activity depending on patients’ capabilities and a local directory of available classes (from aerobics to dancing) and venues offering a safe place (e.g. lighted parks) to be active.  I give time and importance to physical activity within a range of settings: workplace, school, charities, community groups.  I have hula hoops, skipping ropes and marbles amongst my equipment of scales and stadiometers!

Where to next? I personally believe that MECC is a skill that must be revisited, reviewed and reflected upon continuously. I also recognise experiential learning as an important aspect to motivating patients to change and so I hope to undertake some new activity classes that I haven’t tried before, such as tai chi. 

Finally, I aim to advocate for physical activity among my patients, contacts, colleagues, peers, my family and friends. Supporting a global #movementformovement

A NEW, free, open, online exercise and health course is available via The Peoples Uni: you can register for the exercise and health course here.

 

1. Physiotherapy, Exercise and Physical Activity Course http://www.physio-pedia.com/Physiotherapy,_Exercise_and_Physical_Activity_Course (accessed 18/03/2017)
2. Sallis R. (2010) Developing healthcare systems to support exercise: exercise as the fifth vital sign. British Journal of Sports and Medicine; 45:473-4
3. World Health Organization and International Longevity Centre-UK (2000) The Implications for Training of Embracing a Life Course Approach to Health. World Health Organization, Geneva. Available at: http://www.who.int/ageing/publications/lifecourse/alc_lifecourse_training_en.pdf (accessed 18/03/2017)
4. HSE National Health Promotion Office (2011): The Health Promotion Strategic Framework.  http://www.healthpromotion.ie/hp-files/docs/HPSF_HSE.pdf
5. Content in the "Personal Barriers" section was taken from Promoting Physical Activity: A Guide for Community Action (USDHHS, 1999).
6. Cardiorespiratory Exercise Prescription in ACSM's Resource Manual for Guidelines for Exercise Testing and Prescription (2012). P466.  Eds David P. Swain & Clinton A. Brawner, Lippincott Williams & Wilkins.
Blog moderated by Ann Gates, CEO @exerciseworks

 

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