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Promotion of exercise in the management of cystic fibrosis - summary of national meetings

Owen William Tomlinson, James Shelley, Sarah Denford, Alan R Barker, Patrick J Oades, Craig A Williams

Abstract


Rationale, aims and objectives: Physical activity (PA) and exercise are important in maintaining and improving health and wellbeing in people with cystic fibrosis (CF) and measures of exercise capacity are useful outcomes in monitoring disease progression. The roles and responsibilities of CF multi-disciplinary team (MDT) members in supporting PA and exercise have yet to be fully defined. This communication reports on national meetings of CF MDT staff whose interest is to improve and standardise person-centered exercise provision and testing as part of routine CF care. We also introduce the role of the physiotherapy technician in supporting PA interventions.

Meetings: The two meetings covered a range of presentations, discussions and workshops, focusing on the role of exercise and PA in CF management. Forty people from 15 NHS Hospital Trusts and 3 universities were asked to provide feedback via a questionnaire.

Results: The common roles and responsibilities of clinical staff involved in exercise testing and prescription are described, with a wide range of duties identified. In addition, physiotherapists were reported as the main MDT member responsible for exercise provision. The majority of teams reported discussing exercise at every clinical visit (57%) and felt confident in discussing exercise with patients (67%).

Conclusions: While this report highlights the current provision of exercise in CF MDTs, it also provides insight into the resources MDTs may require in order to enhance the profile of exercise within CF services, including enhanced training, guidelines and standardised clinical roles.

Keywords


Activity, clinical personnel, clinical practice, exercise prescription, exercise provision, multidisciplinary clinical team, patient engagement, person-centered healthcare, physiotherapy technicians

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References


Hebestreit, H., Schmid, K., Kieser, S., Junge, S., Ballmann, M., Roth, K., Hebestreit, A., Schenk, T., Schindler, C., Posselt, H.G. & Kriemier, S. (2014). Quality of life is associated with physical activity and fitness in cystic fibrosis. BMC Pulmonary Medicine 14, 26.

Bradley, J. & Moran, F. (2008). Physical training for cystic fibrosis. Cochrane Database of Systematic Reviews (1), CD002768.

Stevens, D., Oades, P.J., Armstrong, N. & Williams, C.A. (2010). A survey of exercise testing and training in UK cystic fibrosis clinics. Journal of Cystic Fibrosis 9 (5) 302-306.

Rowbotham, N.J., Smith, S., Leighton, P.A., Rayner, O.C., Gathercole, K., Elliott, Z.C., Nash, E.F., Daniels, T., Duff, A.J.A., Collins, S., Chandran, S., Peaple, U., Hurley, M.N., Brownlee, K. & Smyth, A.R. (2018). The top 10 research priorities in cystic fibrosis developed by a partnership between people with CF and healthcare providers. Thorax 73 (4) 388-390.

Prasad, S.A. & Cerny, F.J. (2002). Factors that influence adherence to exercise and their effectiveness: Application to cystic fibrosis. Pediatric Pulmonology 34 (1) 66-72.

Cystic Fibrosis Trust. Standards of Care and Good Clinical Practice for the Physiotherapy Management of Cystic Fibrosis. London 2017.

Hebestreit, H., Arets, H.G., Aurora, P., Boas, S., Cerny, F., Hulzebos, E.H., Karila, C., Lands, L.C., Lowman, J.D., Swisher, A., Urquhart, D.S. & European Cystic Fibrosis Exercise Working Group. (2015). Statement on Exercise Testing in Cystic Fibrosis. Respiration 90 (4) 332-351.

Franklin, B., Fern, A., Fowler, A., Spring, T. & Dejong, A. (2009). Exercise physiologist's role in clinical practice. British Journal of Sports Medicine 43 (2) 93-98.

Brown, R.F., Willey-Courand. D.B., George, C., McMullen, A., Dunitz, J., Slovis, B. & Perkett, E. (2013). Non-physician providers as clinical providers in cystic fibrosis: survey of U.S. programs. Pediatric Pulmonology 48 (4) 398-404.

Cottrell, J. & Burrows, E. (2009). Community-based care in cystic fibrosis: role of the cystic fibrosis nurse specialist and implications for patients and families. Disability and Rehabilitation 20 (6-7) 254-261.

Cystic Fibrosis Trust. (2016). UK Cystic Fibrosis Registry 2015 Annual Data Report. London 2016.

Swisher, A.K., Hebestreit, H., Mejia-Downs, A., Lowman, J.D., Gruber, W., Nippins, M. & Alison, J. (2015). Exercise and Habitual Physical Activity for People With Cystic Fibrosis: Expert Consensus, Evidence-Based Guide for Advising Patients. Cardiopulmonary Physical Therapy Journal 26 (4) 85-98.

Smart, N.A., Williams, A. & Lyndon, K. (2016). The Role and Scope of Accredited Exercise Physiologists in the Australian Healthcare System. Journal of Clinical Exercise Physiology 5 (2) 16-20.

Warburton, D.E.R., Charlesworth, S.A., Foulds, H.J.A., McKenzie, D.C., Shephard, R.J. & Bredin, S.S.D. (2013). Qualified exercise professionals: Best practice for work with clinical populations. Canadian Family Physician 59 (7) 759-761.

Cystic Fibrosis Canada. (2016). The Canadian Cystic Fibrosis Registry: 2014 Annual Report.

Cystic Fibrosis Australia. (2016). Cystic Fibrosis in Australia 2014: 17th Annual Report Australian Cystic Fibrosis Data Registry.

Specialised Respiratory Clinical Reference Group. Service Specifications: Cystic Fibrosis Adult. NHS England.

Specialised Respiratory Clinical Reference Group. Service Specifications: Cystic Fibrosis Children. NHS England.

Balfour-Lynn, I.M. (2014). Personalised medicine in cystic fibrosis is unaffordable. Paediatric Respiratory Reviews 15 (Supplement 1) 2-5.

Barker, M., Hebestreit, A., Gruber, W. & Hebestreit, H. (2004). Exercise testing and training in German CF centers. Pediatric Pulmonology 37 (4) 351-355.




DOI: http://dx.doi.org/10.5750/ejpch.v6i2.1430

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