Hydrotherapy - supporting neurological communities to live well


Following the building of a local state of the art hydrotherapy facility a local umbrella charity Bolton Neuro Voices approached SP Therapy Services to design and deliver a 5 week hydrotherapy programme to persons living with a neurological conditions in Bolton and the surrounding area.

The brief was to be safe, inclusive and effective and to be within a specific budgetary and time constraints of a specified charity bursary. In addition we needed to provide sufficient evidence to enable future applications for bursary funding.


This was achieved by:

  1. Design group exercise programmes for 5 week physio led course
  2. Design online self-referral form empowering participants to select own goals
  3. Follow up telephone pre assessment by physiotherapist
  4. Allocation to ability based groups
  5. Provide detailed pre-course pack
  6. Weekly feedback to physiotherapist via coordinator
  7. End of course participant satisfaction questionnaire
  8. Evaluation of questionnaire and feedback to participants and funding bodies via AGM and report


140 participants of all ages and levels of mobility (from independent walkers to full time wheelchair users) representing 20 different neurological conditions successfully completed the course.
Attendance was high (83%) with high satisfaction rates with regards to facilities, support and course content.

Self-selected participant reported outcome measures constantly exceeded the Physiotherapists expectations across the diverse range of diagnosis. The 5 week course led to impressive improvements in social contact and psychological well-being which had been anticipated. However participants also reported sustained improvements in pain, stiffness, mobility, balance and posture.

The data collected each year at the end of each 5 week physio led course has secured further bursary funding for annual course and a continuation programme which has run since 2012.

Cost and savings

The total cost of the 5 week physiotherapy led course per participant averaged £142.00 each yearly intake.


This is a successful pathway providing a cost effective and safe way for persons living with a neurological condition to self-refer to hydrotherapy and take ownership of their health and well-being.

Campaigns to assist people with neurological conditions to "Live long, Live well" (CSP) should be a national priority, however there are very limited resources. The nature and diversity (stable, relapsing/remitting and progressive) of neurological conditions means finding and signposting to appropriate and safe activities difficult for professionals.

Engaging people in voluntary and community sector activities is a cost effective and inclusive. Self-referral and sign posting should not be prescriptive or be about objective-makers but focus on whether an individual engages. The challenge for any professional attempting to conduct person-centred research is to ensure that at a time when many patients feel abandoned by statutory services, as professionals we support and remove barriers to their involvement in community and voluntary physical activities.

Top three learning points

This was a true participant led project & listening & responding to participant feedback is crucial to gaining & sustaining engagement

By focusing on improving strength & balance various neurological conditions could successfully exercise in water together

People with MS can successfully exercise in warm water

Funding acknowledgements

This joint project has been supported by annual acquisition by Marie Oxtoby of bursaries and grants including National Lottery monies

Additional notes

This work was presented at Physiotherapy UK 2018 and ACPIN International Conference 2018.