Investigating whether the amount of Physical Activity in Children aged 5-18 admitted for inpatient physiotherapy matches the NICE guidelines (PH17)

Purpose

The Chief Medical Officer's recommendation for children is to do a minimum of 60 minutes of moderate to vigorous physical activity (PA) daily. This should include weight-bearing activities to improve bone health. In addition, children should complete muscle strength and flexibility activities at least twice a week. Currently, just 23% of boys and 20% of girls meet the national recommended level. Children who get enough PA are mentally and physically healthier, and have all round better development into adulthood, getting into the habit of doing short bursts of activity early can deliver lifelong benefits. The aims of this audit are to: Establish whether the inpatient physiotherapy service on Alice ward meets the NICE guidelines of PA levels in children. Which are: A minimum of 60 minutes of moderate to vigorous physical activity daily Muscle strength and flexibility activities at least twice a week

100% of patients
achieved at least 60 minutes of moderate intensity physical activity due to the use of the hydrotherapy pool.

Approach

The data was collected over a five month period from 04.02.19, using contact statistics. Physiotherapists working with the patient were educated on what activities are classed as moderate PA and weight-bearing activities. The first 50 paediatric inpatients, who had been admitted for inpatient physiotherapy regardless of disability, were sampled. 50 patients were used to reduce sample bias. The days analysed were Tuesday, Wednesday and Thursday, as these were the full days the patients attended physiotherapy.

Outcomes

Results:

· 100% of patients, irrespective of disability, achieved at least 60 minutes of moderate intensity PA While attending inpatient physiotherapy. This was due to the use of the hydrotherapy pool.

· If the hydrotherapy pool had not been used then only one patient would have achieved 60 minutes of moderate PA on dry land (two out of the three days). This patient was diagnosed with Lower Back Pain (MSK).

· 100% of patients also achieved weight bearing activities twice a week. This was achieved by a fun group strength exercise class.

· The average amount of moderate PA minutes increased gradually throughout the week; Tuesday 69.3, Wednesday 69.7, Thursday 73.6

· The mean average age (years) of the patients was 12.3, median 14, range 7-18.

Conclusion(s): Paediatric patients admitted for inpatient physiotherapy met the NICE guidelines (2009) for physical activity solely due to the use of the hydrotherapy pool, highlighting the importance of this facility being open and maintained. Other moderate PA activities need to be considered for when the hydrotherapy pool is out of use, such as cycling, dance and active game play.

Cost and savings

Not applicable. 

Implications

In the UK there is a significant drop in PA levels from the age of 10. With the average age of patients in this audit being 12.3 years this is an opportunity to advise and educate patients and parents of the benefits of PA. Advice, education and encouragement are key factors for children maintaining the minimum levels of moderate PA for children. Therefore strong community links should be developed for this service. It is also fundamental that physiotherapists have knowledge about PA. A recent study stated that only 16% of physiotherapists knew the minimum amount of PA levels children should be completing each week.

Top three learning points

No further information. 

Funding acknowledgements

The Clinical Audit was not funded.