Arthritis and Musculoskeletal Alliance
This is a category taken from the full feed of Musculoskeletal and Arthritis news provided by ARMA's members.
  • The Arthritis and Musculoskeletal Alliance (ARMA) is the umbrella body for the arthritis and musculoskeletal community in the UK, and our mission is to transform the quality of life of people with musculoskeletal conditions. We have 33 member organisations ranging from specialised support groups for rare diseases to major research charities and national professional bodies.

Treatments & Therapies

by Sarah Duncan, Head of Clinical Policy, NHS England

An interview on the news recently about stem cell research into cartilage replacement for osteoarthritis, made me reflect on the phenomenal pace of change and progress in the relatively short time of my career. As a new physiotherapist in the mid-1980s we used short wave diathermy; long flexible heated tubes wrapped around a patient’s knees, to help with the pain of arthritis. Although patients really enjoyed the heat, it made little difference to their ongoing pain and mobility.

At that time, every orthopaedic ward housed patients on traction for spinal pain. Attached to heavy weights via tape stuck to their legs, patients were on bedrest for 6 weeks. It would be the physio’s job to get them standing up for the first time. Many people would nearly faint as their cardiovascular system tried to cope with being vertical again. I often thought the subsequent manoeuvres to get them flat again must have reversed the alleged benefits of the bedrest. This was a time when there were treatment regimes for everything and the main individualising factor was the surgeon’s preference.

I was working in Somerset when I came across a different approach to chronic pain management, led by Dr Alf Collins, now Personalised Care Group Clinical Director at NHS England. His approach for people living with persistent pain was to help them understand and come to terms with their pain, and adopt strategies which enabled them to lead as fulfilling and independent lives as possible. Physiotherapists ran education and exercise groups, which also enabled people to share their experiences with others who understood and could empathise. This approach really worked for many people, supporting both their mental and physical health, and they were empowered to take control of their condition. I learned that managing pain was less about giving a treatment to a passive recipient and more about collaborating and working with them.

Fast forward 30 years and I’m in a national clinical policy role, which includes the Musculoskeletal (MSK) Conditions programme. Digital technology, genomics, stem cell research, and advances in surgery are all enabling progress to be made, beyond anything imaginable in the ‘80s. This progress also includes the evidence-based personalised care approach that the membership organisations of ARMA have long supported and developed. In partnership with ARMA, NHS England has developed the MSK Knowledge Hub enabling the MSK community to debate innovative ideas, share learning and celebrate success. The NHS Long Term Plan published yesterday, has a whole chapter on personalised care building on the  Five Year Forward View, which recognised the need for better integration of services, and connection with the voluntary sector, to enable a more personalised approach.  The NHS Long Term Plan aspires to a fundamental shift in approach to deliver more person-centred care, including for musculoskeletal conditions.

We must continue to develop the focus on people as individuals amongst the high-tech treatment options, and ensure people are properly listened to. People with MSK conditions should have choice and control over the way their care is planned and delivered, based on what matters to them and not only on what’s the matter with them. I’m encouraged to see that the Long Term Plan for the NHS will build on the evidence and examples to show how personalised care could, and should be, business as usual across the health and care system.

More people, more active, more often: three perspectives on physical activity and musculoskeletal health

21 November 2018

Introduced by Sue Brown ARMA CEO and Liam O’Toole, CEO, Versus Arthritis, who partnered with ARMA for the flagship lecture, the three presenters delivered speeches that did not disappoint the rapt audience of health professionals, commissioners, patients, public and NHS health officials and, of course, parkrunners. The discussion about how to overcome the barriers to activity faced by people with musculoskeletal conditions ranged from big-picture societal issues to practical hows-to. 

Michael Brannan, Physical Activity Programme Manager, Public Health England said that strength, balance and co-ordination were often referred to as the ‘forgotten guidelines’ included in the Chief Medical Office Physical Activity Guidelines. While two-thirds of men and half of women achieve the cardiovascular elements of the CMO guidelines, a much smaller proportion meet the strengthening, balance and coordination elements of the CMO guidelines. 

Claire Harris, Physiotherapist from NASS, spoke of the general and specific barriers people face to activity, such as time, transport – especially for people in rural communities – fatigue, financial problems, family support, pain, stiffness, disability, low self-esteem, disability and co-morbidities and how to overcome these, for example, motivational interviewing. 

Nick Pearson, CEO of the popular weekly parkrun, was thought-provoking and unafraid to challenge the status quo. He said, “Many populations most at risk of life-impacting, disabling health conditions are the populations most likely to be inactive, doubling down on their risk levels and potentially creating a ‘health underclass’; these populations are exposed to the highest environment and social risk factors, cut adrift and deprived of the vast majority of health initiatives and interventions. Parkrun has been able to cut through some of these structural, political, and social challenges.”  

The panel then considered questions such as how some of the success of Parkrun could be imitated, followed by audience questions. 

In case you missed it, or want to see it again, the recording of the event is available here.

Twitter, with vlogs from attendees, was popular at the event, you can see the range of tweets and vlogs on #MSKactivity.

by Dr Hamish Reid, Consultant in Sport and Exercise Medicine, Moving Medicine design and development lead

Moving Medicine is an exciting new initiative by the Faculty of Sport and Exercise Medicine in partnership with Public Health England and Sport England. It is dedicated to spreading best practice, research and advice to clinicians and patients to create a healthier, happier and more active nation. On the 16th October 2018 the initiative was formally launched by the Honourable Matt Hancock, Secretary of State for Health and Social Care, headlining the flagship set of resources to support high quality conversations on physical activity across a broad range of chronic diseases including musculoskeletal pain.

Why is it important?

The UK is currently suffering epidemic levels of physical inactivity in keeping with global trends. This inactivity causes a heavy burden of morbidity and mortality. This burden, In contrast to communicable disease, can be prevented and effectively treated through moving more. In no areas is this more important that musculoskeletal conditions.

At the heart of intervention in healthcare lie conversations between healthcare professionals and members of the public. These conversations provide a unique opportunity to interact with the least active members of society, but many healthcare professionals currently lack the skills, knowledge and systems to deliver impactful conversations on physical activity.

How has it been developed?

The ‘prescribing movement’ resources have been developed by a large team of Sport and Exercise Medicine doctors in consultation with 300 medical specialists, general practitioners, researchers and patients. The foundations of the content lie in robust reviews of the literature on physical activity in specific diseases and differ from other resources summarising the evidence base on physical activity as the structure has been designed by clinicians for clinicians to use in practise. A knowledge into action framework, Delphi study and behavioural change framework have underpinned this iterative development process. The result enables the user to dig as deep as they want to into the evidence base, embedded in a time-based framework to support good quality conversations based on established behavioural change techniques and motivational interviewing theory.

What does this mean for musculoskeletal care?

The Moving Medicine musculoskeletal pain resource has been designed with experts in musculoskeletal care in partnership with many ARMA members. Due to the exceptional input from the ARMA network this resource has been developed to fulfil an unmet need in the excellent resources available. It is a practical resource to support and inform clinical staff in routine practice and has been designed to support conversations.

We encourage everyone to use and share the resources. If you are keen to find out more or contribute to the Moving Medicine to get in touch with us at contactus@movingmedicine.ac.uk, join our Facebook ambassador group or follow us on twitter @movingmedicine – we would love to hear from you.

Visit the website at www.movingmedicine.ac.uk.

Taking place on Wednesday 21 November 2018 at 6pm in London.

Hear and debate three perspectives on physical activity at the Annual ARMA Lecture, this year in partnership with Versus Arthritis. Three outstanding speakers, Nick Pearson, CEO parkrun, Michael Brennan, Physical Activity Programme Manager, Public Health England and Claire Harris, Physiotherapist speak to the theme: More people, more active, more often: three perspectives on physical activity and musculoskeletal health

Physical activity is good for promoting musculoskeletal health and helps alleviate the symptoms of musculoskeletal conditions. Yet nearly a quarter of adults in the UK are physically inactive. Getting people active is an obvious way to reduce the costs of MSK conditions to individuals, the NHS and the economy. If activity brings such benefits, why is this so difficult? How can we overcome the barriers people face in getting more active? And what additional barriers are faced by those who have an MSK condition? How can we harness the powers of statutory, voluntary, private sectors and communities to tackle this?

The evening will begin with a drinks reception and the lecture will conclude with a question and answer session, with questions taken from an audience of leading health and public health professionals, policy makers, commissioners, patients, and representatives of professional bodies.

Tickets are available here

The ARMA annual lecture will be on 21 November on the theme of physical activity. Three speakers will discuss three different perspectives on how to get more people, more active, more often. The event will discuss the roles of statutory, voluntary, private sectors and communities in addressing this important challenge.

  • the CEO of parkrun
  • the physical activity programme manager from Public Health England
  • a musculoskeletal specialist physiotherapist.

Look out for booking details coming soon.

Help us guide future research about problematic knee replacements

The British Association for Surgery of the Knee (BASK) is running a Priority Setting Partnership (PSP) in partnership with the James Lind Alliance (JLA). The aim of this process is to bring patients and carers together with a range of healthcare professionals. We want all groups to highlight uncertainties relating to the assessment, management and rehabilitation of ‘patients with a problematic knee replacement’. We will thereby identify future research questions and ultimately publish a list of ‘top 10 research priorities’. This will guide funders for future research.

What can you do to help?

If you have experience of problematic knee replacements as a patient, carer or professional: Tell us the top 3 questions you would like to see answered by future research at www.jlarevisionknee.com. The survey goes live on Monday 10 September 2018 and we are hoping to get as many responses within the first month as possible.

For any queries or please email jlarevisionknee@gmail.com

The Chartered Society of Physiotherapy launches a summer campaign which aims to tackle the growing issue of physical inactivity across the UK.

‘Love Activity, Hate Exercise?’ addresses the emotional as well as physical barriers millions of people with long-term conditions face in being more physically active.

The campaign is aimed at people aged 40-70 years old that are living with conditions such as arthritis, diabetes and heart disease, after research from the CSP found that more than 30% are completely inactive each week.

It was developed through a series of focus groups and research with patients and physiotherapists, and is designed to raise awareness of the expertise the profession has in getting people with long-term conditions more active.

CSP assistant director Sara Hazzard said: “We wanted to develop something that harnessed the expert knowledge our members possess to ultimately promote Physiotherapy and its unique role to improve the health of the nation.”

“Our research found that patients see physios in a really positive light but that they aren’t always associated with physical activity. So unlike campaigns that are often aimed at the general public, ours has been designed to reach the people who can be – or are already being – helped by their advice. It aims to take an empathetic approach and build on the trust that the public has for the profession.”

The CSP has developed digital content that is built around the specific barriers that were identified in the insight phase, along with practical advice on how those concerns can be overcome. Additionally a series of case study interviews will aim to inspire conversations between physiotherapists and their patients about activity levels.

For more information visit csp.org.uk/activity or join in the conversation on Twitter using the #loveactivity.

The MSK physio-themed review is now live.

Moving Forward – Physiotherapy for Musculoskeletal Health and Wellbeing  highlights evidence from the National Institute for Health Research and others on why research in this area matters, assessment and matching patients to treatment, restoring musculoskeletal health and maintaining musculoskeletal wellbeing.

 

It features:

  • 37 published studies
  • 25 ongoing research projects
  • Questions to ask your physiotherapy musculoskeletal services

 

You can download this review from the National Institute for Health Research website.