North West

The role of Men's Sheds in promoting the physical and mental well-being of older men.

The active and healthy ageing agenda challenges the perception that old age is a negative experience and recognises the positive contributions that older adults can make to their communities. However, successful ageing in place requires community-based support for older adults that facilitates social participation, independence and being active. Older men are less likely to join community groups where they can develop social ties and less gender specific support services are available for them.

Men's Sheds (MiS) is an initiative that aims to mitigate this by fostering the building of social networks between older men by providing social space for them to meet and undertake physical activities such as woodwork or metalwork.

The purpose of this research is to investigate the impact of MiS on the physical health and mental well-being of the attendees.

Collaborative cross-agency service delivery to address public health issues within an MSK setting: evaluation of ´Healthy Mind, Health Body´

Patients accessing Physiotherapy in Blackburn demonstrate multiple co-morbidities, physical and biopsychosocial issues. This unique, cost-effective, collaborative service redesign addresses the specific co-existing health issues and behaviours associated with MSK conditions in Blackburn and offers a cost-effective, high quality solution to empower and support the MSK population to better manage their own health and well-being in alignment with Public Health England priorities.

Reducing emergency admissions for primary constipation: a pilot study to cut costs in an acute hospital trust.

Constipation is a common condition that impacts quality of life, often causing psychological distress and incurring considerable healthcare costs in terms of unnecessary emergency admissions due to poor management.

Aintree University Hospital offers one of the only Specialist Physiotherapy led healthy bowel clinics (HBC) in the UK that assess, treat and manage patients presenting with functional bowel problems, including constipation. Patients referred into the service are directed straight to HBC and the majority will never see a medic. The service is run solely by Physiotherapists. We can refer for appropriate tests (transit marker studies, defecating proctograms, anorectal physiology and various blood tests). We independently interpret results and decide on appropriate treatment/management. Our service offers specialist assessment, medication management, lifestyle advice, pelvic floor re-education, Posterior Tibial Nerve Stimulation, rectal irrigation and cognitive behavioural therapy. The majority of our patients are managed conservatively as surgery is rarely an option.

From December 2013 to November 2014, Hospital Episode Statistics (HES) data showed that 301 patients were admitted to Aintree University Hospital with a primary diagnosis of constipation, 216 of these through the Accident and Emergency Department (AED), with an average length of stay of 3.3 days. The HBC Physiotherapists recognised that there should be a more cost-effective, efficient way to manage these patients and proposed a new pathway. The pathway allows patients to manage their symptoms in their own home with support from specialist Physiotherapists, enhancing patient dignity. Assessment identified 5 patients with potential red flag symptoms and allowed appropriate onward referral.

Engaging public and patients to develop a website to assist people to remain in or return to work.

Musculoskeletal conditions are the second biggest cause of absenteeism in the UK representing 28.2 million working days lost per annum. Current literature suggests that work issues are generally insufficiently addressed in primary healthcare and there is little evidence that evaluates any existing workplace interventions in this setting.

To address this issue locally, North West Boroughs Healthcare Physiotherapy Service is developing a new work and health pathway, 'Work Wise', to assist patients to remain in or return to work. An element of the pathway is the development of a website to provide accessible supportive resources and signposting material.

To inform website design and content we have undertaken extensive engagement with patients, public and employers and we wish to present our findings to assist the development of other initiatives in this important area.

Developing Patient Understanding - The Effectiveness of an Educational and Exercise Programme for Persistent Lower Back Pain

Lower back pain (LBP) is one of the ten leading causes of disease burden globally. It is widely recognised that LBP produces significant detrimental effects on physical and emotional wellbeing whilst having a substantial economic burden for society. There is an inverse relationship between socio-economic status and the prevalence of pain. Increasing patients understanding of non-specific lower back pain including pain physiology, combined with completing exercises can provide optimal management. Therefore, the effectiveness of a locally run 'Back to Fitness Programme' (education and exercises) in the most deprived local authority area in England was evaluated.

The purpose was to evaluate the effectiveness of the Back to Fitness programme upon patients' understanding of pain, ability to function, symptom-report and physical outcomes.

Evaluation of the optimal physiotherapy-led mobilisation on critical care following the implementation of a mobility guideline.

Every patient on critical care should be assessed daily for the potential to begin functional rehabilitation including mobilisation.

Levels of agitation and sedation, as measured by the Richmond Agitation and Sedation Score (RASS) and consciousness measured by the Glasgow Coma Scale (GCS), can impact on the type of activity delivered by physiotherapy. A new mobility guideline was initiated on the general intensive care unit (ICU) to maximise patient rehabilitation within the limitations of their RASS score.

The purpose of this evaluation is to establish that the maximum level of rehabilitation/mobility was safely performed within each patient's physical, medical and cognitive abilities.  

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