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

NASS has just released a new series of videos showing how everyone living with axial spondyloarthritis (axial SpA) – including people with ankylosing spondylitis (AS) – can fit some simple but very effective stretches into their daily life.

No Lycra. No trainers. No gym.

These videos were developed with with a group of specialist axial SpA (AS) physiotherapists from AStretch. They include stretches which patients can do in bed in the morning and stretches for while waiting for the kettle to boil, at the kitchen table and on the sofa to name a few. Everyone featured in the videos has a diagnosis of axial SpA (AS).

Watch them here.

The Society of Musculoskeletal Medicine (SOMM) has produced a short paper mapping capabilities within the published ‘Musculoskeletal core capabilities framework for first point of contact practitioners’* to the Society’s course provision.  

The domains identified within the framework provide categories for the capabilities that underpin first contact practice. Practitioners can be signposted to appropriate modules to facilitate the development of the advanced skills required for their MSK First Contact Practitioner (FCP) role. The Society’s programme of courses already accommodates key capabilities that learners across a range of health professions need, to be able to develop as FCPs. The ‘Theory and Practice of Injection Therapy’ module is currently emerging as essential to support the FCP role and provision has increased to fulfil demand.

As with the Society’s other advanced modules, the injection module builds on the principles and practice of the musculoskeletal medicine approach, as taught through the Society’s educational pathway, but is suitable for all allied health professionals practising at an advanced level in MSK.

The ‘Capabilities (MSK Capabilities Framework) Mapped to SOMM Courses’ paper can be viewed here.
Contact: admin@sommcourses.org

* Health Education England. NHS England and Skills for Health 2018.  NHS England Publications Gateway Reference: 082896

Last October, Moving Medicine was launched by the Honourable Matt Hancock, Secretary of State for Health and Social Care. The free, evidence-based resources, available at movingmedicine.ac.uk support high quality conversations on physical activity across a broad range of chronic diseases including musculoskeletal pain, inflammatory rheumatic conditions and primary prevention, to mention a few.

The resources are all developed with experts, healthcare professionals and patients, and are endorsed by professional bodies and charities, including ARMA. Whether you have 1 minute, 5 minutes, or more minutes to speak with patients about physical activity, Moving Medicine will help support this. 

For further information visit movingmedicine.ac.uk, contact us contactus@movingmedicine.ac.uk, or follow us on social: @movingmedicine on twitter, facebook.com/movingmed or @movingmedicineuk on Instagram.

by Catherine Holmes, National Service Improvement Manager, Anchor

I was thrilled to read Sue Brown’s (CEO, ARMA) September blog and the proposed plan for an event on physical activity. The importance and benefits of staying active is already widely accepted and understood in terms of maintaining joint movement, bone and muscle strength and this is especially important for residents living in care homes. The challenge for care is to create opportunities for people with a wide variety and often multiple and complex health needs such as musculoskeletal, limited or a lack of mobility and living with dementia to keep engaged and active. I believe the solution may require us to rethink what constitutes activity and movement within the context of the individual and use alternative methods including technology, where appropriate, to create a sense of achievement and wellbeing.

If we do this, we first need to accept that some residents may not feel inclined, able or confident to join in energetic physical exercise sessions to the beat of ‘Tiger Feet’ or that they may feel distressed and anxious being outside of the care home. This in turn should challenge us to look more closely and creatively at what could work, considering musculoskeletal and wider health needs such as individual ability and capacity, together with guidance from healthcare professionals. This may mean that participation in gentle, seated stretching exercises possibly on a one-to-one basis might provide an initial starting point, and the NHS website provides clear guidance. Technology is often perceived as an expensive option, but it certainly has a place in encouraging physical activity, especially where mobility is restricted. In Anchor care homes we are using Memoride  – technology based on google maps where sensors are placed to a fitness device such as foot pedals or rollers to enable residents to move through familiar streets or countryside at their own pace. We’ve also invested in OMI Vista interactive projectors which project onto communal tables, floors or bed trays encouraging residents to stretch and move as they engage with quizzes, games and therapeutic activities; all which link with visually stimulating reminiscence and music.

AgeUK states ‘our bodies were made to move and it’s a myth that getting older means an end to being active,’ which is something I genuinely believe to be true regardless of where or how you live. Whether it’s taking a walk in the garden, reminiscing about the plants and seasons, or creating stimulating environments in hallways which invite and intrigue our residents to keep moving onwards, we should recognise, encourage and celebrate all that is active in whatever context individuals can achieve.

Arthritis Action has launched a new webpage featuring arthritis-friendly exercises using animated images (GIFs). These chair-based strength and conditioning exercises were developed in partnership with wellbeing organisation Oomph!,  mobilising different parts of the body.

The exercises were designed with the aim to recondition and build mobility and confidence in people who have not been keeping active. The can be viewed on the Arthritis Action website.

A new campaign, We are Undefeatable, launched on 2 September from Sport England and associated partners including Versus Arthritis.

The campaign aims to help people with health conditions find ways to get active. With a long term condition you are two times more likely to be inactive. Physical activity plays a powerful role, it can help manage 20 or more conditions and reduce the risk of many health conditions by up to 40%.

Sport England are challenging the existing narrative and working with partners to challenge the status quo. They created a unified physical activity campaign which challenges misconceptions and finds a strong emotional platform to engage and motivate and sustain behaviour change across health conditions.  It’s designed with the perspective and lived experience of people with health conditions.

It’s aimed at an audience from ages 30-64 years old and beyond and at people who are doing a little physical activity, less than 30 minutes, or none. For more information see Twitter @undefeatable or www.weareundefeatable.co.uk

Case study of improved mobility and independence

Listen to Regina’s story of how she overcame osteoarthritis and difficulties with mobility with the help of the ESCAPE-pain group at her local leisure centre.

The ESCAPE-pain Programme: Helping people with chronic joint paint to self-manage their condition and become more physically active

At 76 years old, Regina had been suffering with osteoarthritis for over ten years and it was having a big impact on her life physically and emotionally. “I was in a bad place; I was in a wheelchair to start with.”

Regina found walking very difficult and a journey that should take five minutes, would take her thirty minutes. “It came to a point where I wouldn’t dare to cross the traffic lights, and my daughter would have to drive me everywhere, because I was so scared. Of course, getting on a bus – that was way beyond me. The furthest I ever went was to church and going to church I had to have a carer because I didn’t have the confidence to go on my own.”

In 2018, Regina signed up to a programme being run by Mytime Active in a local leisure centre for chronic knee and hip pain, called ESCAPE-pain. “ESCAPE-pain has really given me my independence back, more than anything else it has given me my confidence.” From having been too scared to travel alone, Regina’s physical function improved so much so that she felt confident to be able to use buses again and travel independently.

Regina also described how crucial the group aspect of the ESCAPE-pain programme was for her. “They make you feel comfortable even before you go into the class, and once you are there you meet other people who are like you, and you know that you are all in this together and that is what works more than anything else. I have made loads of friends at ESCAPE-pain, and I even go shopping with some of them.”

The programme was also important in helping her to adopt a more physically active lifestyle. “Now, I go to gym classes, I go to Zumba (it’s a dance class), and I go to yoga. I would recommend ESCAPE-pain because it makes you be yourself, I would recommend it to anybody, no matter what your state at the moment is.”

Scale of the problem

Regina’s experience is not uncommon. Osteoarthritis has a major impact on individuals, healthcare services and society. The social and economic burden of osteoarthritis is substantial and results in decreased quality of life, loss of productivity, and increasing costs of healthcare. In 2016, an estimated 30.8 million working days were lost to musculoskeletal pain in the UK, accounting for 22.4% of all sickness absence1. It is estimated that one in three people with osteoarthritis retire early, give up work or reduce the hours they work because of their condition2.

People living with osteoarthritis often believe it is an inescapable consequence of ageing and worsening disability is inevitable. Too few people with osteoarthritis receive core advice and support in line with NICE guidelines for care and management of osteoarthritis (CG177)4, 5, such as increasing physical activity and maintaining a healthy weight.

What is ESCAPE-pain?

ESCAPE-pain is an evidence-based exercise-based group rehabilitation programme for people with chronic knee and/or hip pain, also known as osteoarthritis, designed to improve people’s function by integrating exercise, education, and self-management strategies to dispel inappropriate health beliefs, alter behaviour, and encourage regular physical activity.4,6,7,8

The ESCAPE-pain programme was developed by Professor Mike Hurley and is hosted by the Health Innovation Network and supported by NHS England and Versus Arthritis.

ESCAPE-pain is shown to:

  • Reduce pain, improve physical function and mental wellbeing, and improve health beliefs4.
  • Sustain benefits for up to two and a half years after completing the programme6.
  • Create an estimated £1.5 million total savings in health and social care for every 1,000 participants who undertake ESCAPE-pain6, 7.

Currently, over 170 sites are delivering ESCAPE-pain across the UK in both clinical and non-clinical community sites (e.g. community centres and leisure centres) with more than 11,000 people having successfully completing the programme. As ESCAPE-pain has spread into ‘real world’ settings on-going collection of outcome data from sites demonstrates that participants are benefiting from the programme.

How the programme works

Participants attend 12 sessions twice weekly for six weeks, which is led by a trained facilitator* (i.e. either a clinician or level 3-4 fitness instructor). Each session comprises a 15–20 minutes facilitated discussion on a specific topic relating to the self-management of osteoarthritis. This is followed by a 35–40 minutes individualised exercise regimen. Once participants complete the programme they are signposted to local opportunities to help them maintain their physical activity.

*All ESCAPE-pain facilitators completed an accredited 1-day training course to ensure the quality of the programme.

How to find a local class

The programme is being offered in a variety of venues from hospital physiotherapy departments to leisure centres and gyms, from church halls to community centres. To find a local class either visit the site map on the website or email your postcode to hello@escape-pain.org.

Support tools

We have designed some support tools to help people continue exercising safely in their homes once they have completed the face-to-face ESCAPE-pain programme.

See here for further information about the ESCAPE-pain app and the web-based version of the app, ESCAPE-pain Online. Both are free to access.

For more information email us at hello@escape-pain.org or visit the website escape-pain.org.

References

  1. Sickness absence in the labour market – Office for National Statistics [Internet]. Ons.gov.uk. 2017 [cited 1 May 2018]. Available from: https://www.ons.gov.uk/employmentandlabourmarket/peopleinwork/labourproductivity/articles/sicknessabsenceinthelabourmarket/2016
  2. State of Musculoskeletal Health 2018 | Arthritis Research UK [Internet]. Arthritisresearchuk.org. 2017 [cited 1 May 2018]. Available from: https://www.arthritisresearchuk.org/arthritis-information/data-and-statistics/state-of-musculoskeletal-health.aspx
  3. NHS England: CCG programme budgeting benchmarking tool. [Internet]. NHS England. 2014 [cited 1 May 2018]. Available from: https://www.england.nhs.uk/resources/resources–for–ccgs/prog–budgeting/
  4. Hurley M, Walsh N, Mitchell H, Pimm T, Patel A, Williamson E et al. Clinical effectiveness of a rehabilitation program integrating exercise, self-management, and active coping strategies for chronic knee pain: A cluster randomized trial. Arthritis & Rheumatism. 2007;57(7):1211-1219.
  5. National Institute for Health and Care Excellence. Osteoarthritis: care and management. Clinical guideline [CG177]. 2014.
  6. Hurley M, Walsh N, Mitchell H, Pimm T, Williamson E, Jones R et al. Economic evaluation of a rehabilitation program integrating exercise, self-management, and active coping strategies for chronic knee pain. Arthritis & Rheumatism. 2007;57(7):1220-1229.
  7. Jessep S, Walsh N, Ratcliffe J, Hurley M. Long-term clinical benefits and costs of an integrated rehabilitation programme compared with outpatient physiotherapy for chronic knee pain. Physiotherapy. 2009;95(2):94-102.
  8. Hurley M, Walsh N, Mitchell H, Nicholas J, Patel A. Long-term Outcomes and Costs of an Integrated Rehabilitation Program for Chronic Knee Pain: A Pragmatic, Cluster Randomized, Controlled Trial. Arthritis Care & Research. Vol. 64, No. 2, 2012, 238–247.

On 8 May, Versus Arthritis published a new policy report looking at the impact of home aids and adaptations for people with arthritis, and the barriers that people face when trying to access them. Read the full report here, which includes powerful stories from people with arthritis who benefit from aids and adaptations.

We found that aids and adaptations – from perching stools and grabbing tools, to grab rails and stair lifts – can help people with arthritis, and related conditions such as back pain, achieve a better quality of life and maintain their independence in the home.

60% of all people with arthritis, across all genders, ages, and severity of condition, used an aid or adaptation. Of those, 95% felt that these products had a positive impact on their lives. However, too few people are aware of the support available to them. 

The report makes recommendations to both local and central government that would help widen access to these vital services.