A passion for rehabilitation

Still in his early twenties, Jordan Hepburn has obtained funding to hold exercise classes for younger people who have strokes. Jennifer Trueland reports

Just months after graduating, and before he’d even landed a ‘proper’ job, physiotherapist Jordan Hepburn is already making an impact.

In an effort to help people in his community – and, he admits, boost his CV – he has been the driver behind an initiative to set up a group exercise class for younger stroke survivors.

After seven months’ hard work – during which time he also finished his physiotherapy degree – Mr Hepburn found a venue and instructor, made a successful bid for lottery funding and, finally, welcomed the first participants.

‘I always believed we could get it up and running, but I felt a huge sense of relief at the first class – seeing people doing exercise, having a laugh with each other and enjoying it. It felt really, really good.’

Mr Hepburn, 24, came up with the idea when he was an MSc student in physiotherapy at Queen Margaret University, Edinburgh.

Having completed his undergraduate degree in applied sports science at the University of Edinburgh, he had a powerful belief in the benefits of physical exercise.

A schoolboy athlete and club rugby player, he had always been interested in sport, but realised it was rehabilitation which really fascinated him.

‘I found that it was the “physio” related bits of the sports science course I really enjoyed,’ he says. ‘I suppose I developed a passion for rehabilitation.

I really enjoyed the degree and the knowledge it’s given me about exercise is really useful, but I decided I wanted to apply for physiotherapy.’

Thinking outside the box

Last March Mr Hepburn came up with the idea of setting up an exercise class for younger stroke survivors.

‘I had developed a strong interest in neurological physiotherapy, and I also value exercise and the benefits it brings, and was a CSP public health champion.

I was trying to think of something that I could do as a physiotherapy student which might make a difference. It can be hard to get work experience when you’re a student as you often need supervision to practise, so I tried to think outside the box as much as possible.’

An internet browsing session led him to Different Strokes, a charity offering services and support to younger people who have had a stroke.

‘I found it very interesting because most NHS stroke services are aimed at people aged over 65. I saw that they ran group exercise classes, but they didn’t have one in the Edinburgh area – so I contacted them to volunteer as group co-ordinator.’

Charity’s support ‘invaluable’

The process of setting up the group was harder work than Mr Hepburn had perhaps envisaged – and he suffered at least one disappointing setback on the way. He found the support of the charity invaluable, however.

‘They sent me a starter pack with lots of useful information, and my main contact at the charity, Lorraine Ayres, has always been there to answer questions.’

The key thing was finding someone to take the classes, and here Mr Hepburn struck gold. Ms Ayres was already in touch with Emma Sawyer, a physiotherapist who has also delivered training to fitness instructors on the topic of exercise after stroke.

‘She’s just perfect because she teaches the programme, but is also a physiotherapist, so really knows what’s going on with people in the class,’ he enthuses.

The next stage was seeing if there was demand out there for such a service. Mr Hepburn contacted a host of organisations, including local charities, agencies and community groups, and set up a consultation event.

‘Only one person came along,’ he says. ‘It was a bit disappointing, but actually, the woman who did come made some really valuable points. She was a stroke survivor, and was able to give me useful information about barriers to exercise – why some stroke survivors wouldn’t want to take part.’

These included clinical worries, such as fear that exercise would cause another stroke.

There were also more practical concerns which came as a surprise to the student.

Mr Hepburn recalls: ‘She said some people wouldn’t want to come to a class in case they lost their benefits – they would worry that if they were seen as able to attend an exercise class they’d be deemed fit for work.’

Free attendance

Having looked at the services already available for stroke survivors in the area, Mr Hepburn hit on East Lothian as an area with a potential need for a class.

He identified a venue in a converted church in Haddington, to the east of Edinburgh, and held another consultation day, which was attended by several people who had survived a stroke.

Helped by the charity, he applied to the Big Lottery Fund – 2014 Communities, which offers grants of from £300 to £2,000 for initiatives that encourage people to take part in physical activity (part of the legacy planning for the Commonwealth Games to be held in Glasgow next year).

The project was offered almost the maximum grant – £1,948 – which, along with £500 from Different Strokes to help with set up costs, is enough to ensure that the class is free to attend until the end of June.

‘I’ll be applying for other funding, and the idea is that my role – as co-ordinator – will be taken over in the future by a stroke survivor, and will continue to be a community exercise group in the long term,’ he says.

Ms Ayres, group development manager with Different Strokes, says that ideally, exercise initiatives like this – and there are almost 50 of them across the UK – are set up by stroke survivors, rather than health professionals.

‘However, in this instance we hadn’t found anyone in the Edinburgh area – and without Jordan, I don’t think that this would have got off the ground,’ she says.

‘He’s been fantastic.

‘There’s a real need for services which are aimed at younger stroke survivors – people of working age.

They need the rehab, they need the support, and it’s great to have more groups set up.’

Since the class began in October, around three or four people have attended regularly.

Eventually, Mr Hepburn hopes this will grow to around eight people.

Referrals have come from a variety of sources, including charities and physiotherapists, and Mr Hepburn is trying to drum up more recruits by circulating information to a wide selection of potential referrers.

‘We’ve been in touch with the local community physio team and asked them to come along and see what we’re doing to make sure they are happy to refer people,’ he says.

‘It’s early days, but the feedback from the participants so far has been really positive.’

The circuit-based class is modelled on the Exercise After Stroke programme (see link below), which was developed in Scotland.

Although its primary aim is to improve cardiovascular fitness – and therefore reduce the risk of further stroke – it also has strength and functional benefits.

‘We’re trying to make it as evidence-based as possible,’ says Mr Hepburn. ‘We’re also using outcome measures to give us an objective idea of how it is working.’

Project demanded time and effort

Participants will be measured on their performance on a 10 metre walk (at the beginning, then after three months and after six months) and on the Stroke Impact Scale.

Ms Sawyer, an independent physiotherapist, says there’s a real need for community-based exercise programmes for stroke survivors.

‘There’s beautiful evidence out there that shows that it works, but there simply aren’t enough opportunities,’ she says.

‘There are also challenges such as transport – it can be difficult for people to make it to classes, however much they want to attend.’

Reaction from the group has been fantastic, she says. ‘They really want to come, and that’s great. Of course we could do with some more “bums on seats”.’

For Mr Hepburn, involvement in the initiative has been beneficial.

Even when he applied to study physiotherapy he knew it was not easy for graduates to find posts. Part of the reason for taking on the initiative was to make him look as attractive as possible to potential employers.

‘That was a motivator for me,’ he smiles. ‘As well as doing this, I’ve been doing voluntary work with a veterans’ home, and with the Multiple Sclerosis Therapy Centre in Edinburgh.

I know it’s a difficult job market and a tough financial climate, and that having a qualification isn’t enough.

You’ve got to show a real commitment. The project was partly a way of showing that I had a passion for physiotherapy, and the skills I gained along the way could only help!’

Indeed the work has paid off. Mr Hepburn has been successful in an application for his first formal post – as a rotational band 5 physiotherapist with NHS Tayside, working at Perth Royal Infirmary.

His advice to anyone else thinking of taking on a similar project is to be aware that it is a real commitment, and will require time and effort.

‘You’ve got to be prepared to persevere – it was a setback when only one person came to the first consultation day, but you have to push past that and keep going.

‘At the first class I actually felt an overwhelming sense of achievement – as a person I felt great about it, because I’d done something to benefit others.

I know it’s only a once-a-week exercise class for a few people, it’s not changing the world. But I also know from my physiotherapy training that small things make a difference, and that they really add up.’ fl

Further information

Exercise After Stroke: www.exerciseafterstroke.org.uk
Different Strokes: www.differentstrokes.co.uk
Physio Works: Stroke. Visit: www.csp.org.uk and search for ‘physio works’.

Case study: ‘It’s the discipline’

James Mitchell travels for around an hour each way to get to the weekly exercise class for younger stroke survivors – but he believes it’s definitely worth it.

The 60-year-old, who lives in Leith on the outskirts of Edinburgh, had a deep vein thrombosis followed by a stroke 10 years ago after a trip to Ecuador. His left side was paralysed as a result.

‘I’d been to the gym before, but we were just left to do our own thing – there wasn’t anyone there to tell us what we were supposed to be doing.

‘It’s different at this class because Emma really knows me and my background, so we aren’t left to our own devices.’

He also enjoys the social side of the class, he says, and has tried – unsuccessfully so far – to persuade two of his friends to come along as well.

‘I’d definitely recommend it – it’s the discipline, it gets me doing things I wouldn’t otherwise be doing.’

Jennifer Trueland

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