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.

Tag: exercise

Interventions to increase physical activity

We know that keeping active is important for maintaining MSK health. The challenge is always how to encourage people to be more active. This themed review from NIHR provides some evidence about what works (and what doesn’t).

The review outlines evidence from over 50 studies of what is effective in getting people more active. Evaluations range from programmes in schools and communities to changes in transport and the environment, which are designed to promote greater activity. The report summarises the evidence and includes prompts for reflection to help make practical use of the findings.

The review covers studies of:

  • Early years
  • Children of primary school age
  • Young people of secondary school age
  • Adults
  • Workplace changes
  • Older adults
  • Changes to the built and natural environments

It shows which interventions are effective and some which looked promising but showed no long term increase in activity. Perhaps unsurprisingly the review shows that there are no single solutions. What may drive us to keep and stay active depends on who we are, where we live, and wider system issues. Moving Matters will be a useful resource for anyone looking at what might help increase activity levels and so increase MSK health.

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.

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.

The Fit4Change app converts miles to money for charities, giving an extra incentive to take regular physical activity that will improve your MSK health. You can use it for running, walking, cycling and exercising indoors.

Just download the Fit4Change app to your phone, select Arthritis and Musc Alliance as your chosen charity, remember to start before you begin your activity and finish at the end, and the app does the rest. It’s a simple way to support our work – just remember to start the app whenever you start your activity.

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.

Mental health problems are common and account for the largest single source of disability in the UK.

Recognising the many benefits physical activity can bring to mental health and wellbeing, The Faculty of Sport and Exercise Medicine UK and the Royal College of Psychiatrists with the support of Mind has published an evidence-based position statement: “The Role of Physical Activity and Sport in Mental Health“. The statement contains a guide to physical activity as an intervention for health professionals, sports participants, schools, parents and carers.

The Faculty recognises that living with an MSK condition can lead to mental health issues and this evidence-based statement promotes physical activity, including the use of green space, as way to prevent and manage mental health problems connected to MSK conditions such as depression, anxiety and stress.

Read the position statement on the fsem.ac.uk website.