It is more important than ever that we encourage everyone to stay active. For some patient groups this may be particularly important, as the potential consequences of self-isolation, such as deconditioning and sarcopenia may be hugely detrimental to their health.
For adults and older people, the CMO Physical Activity Guidelines recommend 150 minutes of moderate intensity exercise a week, with at least two days to include strengthening activities. In addition, older people should do activities to improve balance on at least two days of the week. Guidance for disabled adults is very similar. This level of activity is associated with significant benefits to physical and mental health and wellbeing.
People should also be advised to minimise sedentary behaviour, by breaking up prolonged periods of sitting or lying where possible. Activities such as stair climbing, walking around the house or other adapted activities should be performed very regularly throughout the day.
Remember, doing any amount of activity is better than none and is still associated with positive health outcomes. This is particularly relevant for those with long-term conditions.
Who is this resource for?
This resource has been developed for all CSP members looking to support their patients to be active and self-manage long term conditions during this very challenging period where access to face-to-face healthcare is extremely limited. This may form part of your remote management for a specific condition or as general wellbeing advice.
How to use this resource
There are a multitude of online options for exercise of various intensity available on YouTube e.g. Joe Wicks, Les Mills, Fitness Blender etc. These may be appropriate for some patients, depending on your assessment (see below).
For many patients, however, these may not be appropriate. We have compiled resources here that include a variety of general activity advice and condition-specific self-management support. We suggest that you familiarise yourself with the resources relevant to your area of practice. Be aware that some resources for a specific condition may be appropriate for a wider population group.
You should select the most appropriate resource for your patients according to your clinical and risk assessments. This may include, but is not restricted to:
- Self-isolation/social distancing advice for your specific patient
- Assessment findings including balance, falls risk, cardiovascular compromise etc.
- Current rehabilitation needs and co-morbidities
- Current level of physical activity and subsequent target intensity of exercise
- Ability to understand the information contained within the resources you select
- The level and type of support you are able to give e.g. planned follow ups, printed resources
- How you are delivering your remote consultation e.g. phone or video
- You and your patients’ access to technology/hardware e.g. printer
- Patient preferences and goals
- Environmental risk assessment (self-reported or observed on video)
How does the guidance on self-isolation and social distancing relate to physical activity/exercise?
The government guidance on this may change therefore please check the latest information.
What safety advice do I need to give when recommending these resources to my patients?
Under your duty of care to your patients, you should only recommend resources that you have clinically reasoned are safe and appropriate. You should give personalised safety advice, according to the patient’s individual risk factors and environment. This may include, but is not restricted to:
- Adhering to the ‘Stay home’ government advice
- Highlight any part of the information in the resource that is not currently appropriate e.g. exercising with friends
- Appropriate footwear/clothing/hydration
- Advice on intensity
- Pacing advice may be necessary
- When to stop and when to seek urgent medical advice (if appropriate)
Remember that disclaimers are not appropriate for use in clinical care (more information on disclaimers here).
Why haven’t you included more Apps?
The CSP has just launched an App Library. This is supported by ORCHA who review a huge number of healthcare apps and give ratings on data security, clinical evidence and user experience. This is open to CSP members only and will allow them to confidently recommend appropriate apps to patients.
Does the CSP endorse all of the resources included here?
The CSP has gone to every effort to only include verified, respected and evidence-based sources. However, we are not responsible for the content of external websites. You must ensure the suitability of each resource for your patient on an individual basis (see above). Inclusion in this resource does not necessarily indicate CSP endorsement.
This resource will be updated regularly. If you would like a resource to be considered, please let us know.
Which resources have opened their access during this crisis period?
Particular acknowledgement and thanks must go to those organisations who are broadening their usual access to paid-for platforms and resources for clinicians to use freely during this period.