How a team challenge with teenagers and young adults positively impacts activity levels and engagement.

Purpose

Current guidelines suggest teenagers should complete 60 minutes of physical activity a day, including strengthening exercises 3 days a week. Research shows that only 20% of teenagers meet these recommendations. Teenage years can be challenging for a variety of reasons; this period is made even harder when you are given a life changing diagnosis of cancer. At the University College London Hospitals Macmillan Cancer Centre we initiated the #JOGLE challenge on our teenage and young adult (TYA) unit. The challenge was to collectively travel the distance from John O'Groats to Land's End - a total of 874 miles - using the equipment in the therapy gym. This service evaluation aimed to look at the impact of this challenge on physical activity levels and engagement with therapy services in TYA with a diagnosis of cancer.

Approach

#JOGLE started in November 2018 and was advertised with posters throughout the TYA unit. The teenagers could self-refer to the physiotherapy service and those already on the case load could take part. The challenge could be completed by cycling, walking or on the cross-trainer in the therapy gym and was supervised by the physiotherapist. The patients individual miles were added together to track the cumulative total. Adolescents were excluded if they were medically unstable. A large map of the UK was placed in the gym and each week the collective distance travelled was plotted on the map along with a local picture, allowing patients to track progress. Data was collected on patient demographics, diagnosis, distance and time. Qualitative data was collected in the form of questionnaires, a guest book and 1:1 interviews, then analysed using thematic analysis.

Outcomes

Over an initial 5 month period patient participation rate increased by 170%, with 27 patients engaging in gym sessions; the average number of sessions with the therapist increased by 50%. Patients completed 458 miles over 147 sessions; the most popular piece of equipment was the static bike, used in 93% of sessions. The average distance travelled per session was 5km. There were no adverse effects encountered. Feedback from the patients showed that they felt increased confidence to engage in physical activity outside of the unit, also that the map, weekly update and overall challenge led to increased motivation to do physiotherapy sessions. Finally the TYAs reported that they enjoyed the competition with other patients which provided further motivation and improved mental well-being.  

Overall this has shown that a group exercise challenge has helped to increase physical activity levels and overall well-being in TYA patients receiving cancer treatment as well as increasing engagement with physiotherapy services.

Implications

Physiotherapy departments can safely implement group exercise challenges to help increase physical activity levels in teenagers and young adults as well as increase engagement with their services. This principle could also be applied to other patient populations outside of TYA and include the use of step counters where equipment isn't available. Resource dependent this could also be implemented in the community to maintain physical activity levels after discharge and promote independence with physical activity.

Fund acknowledgements

Unfunded, this was a project for the rotational physiotherapist.

Additional notes

This work was presented at Physiotherapy UK 2019