When hospitals stopped seeing non-urgent heart attack and stroke patients, those patients didn’t stop needing the assessment, support and rehab many were forced to do without.
Withdrawing or offering only skeleton cardiac rehab services is likely to lead to a 30% rise in unplanned hospital admissions harming quality of life, mental health and daily activity.
Patients in one north London borough though were spared the frightening fallout from foregoing key follow-up treatment when fast-moving physiotherapy students scooped them up over Zoom.
Sixty heart attack and stroke survivors are getting life-changing virtual rehab through students at Brunel University London in an ambitious innovative move that could shape physiotherapy’s future.
“Students are leading the way in delivering physiotherapy remotely to people with heart and circulatory conditions, effectively supporting this high-risk population in their homes, while learning first-hand,” said lecturer Dr Jenni Jones. “It’s a win-win.”
People with long-term chronic heart disease and stroke conditions, living in Boris Johnson’s Uxbridge constituency, have been supported by Dr Jones’ Exercise4MyHealth programme since 2018. Working alongside NHS community services, students would assess and run classes for locals with these conditions on campus. That stopped with lockdown in April, when students started to adapt.
“Our students have been phenomenal getting people, some totally non-technical, up and running to continue their rehab virtually despite some having only a landline,” said Dr Jones.
“I’ve seen some real innovation with students designing health promotion workshops and leaflets, creating bespoke programmes and videos and watching videos of their participant’s progress.”
Cardiovascular conditions like heart attack and stroke are one of the biggest killers in the UK. Patients are mostly more vulnerable and less technically enabled, and about 80% of them have at least one other condition – putting them at high-risk from COVID-19.
After screening and help with Zoom, Exercise4MyHealth Zoom patients are sent an activity monitor to wear on their thigh. Unlike most other motion sensors such as Fitbit, the device, ActivPAL, can tell if the wearer has been standing or sitting and accurately captures sedentary time. After seven days, they post the monitor back to the student who then makes a report and is supervised to design the patient a personalised activity and health plan.
“One of the biggest problems with conventional cardiac rehab services is access, said Dr Jones. Half of heart patients in the UK miss out on vital recovery care known to improve survival and quality of life. Our virtual delivery is innovative, person-focused and enables a tailored personalised approach. We’re seeing virtual can be done, it works incredibly well."
Since they took services virtual, not one patient has dropped out of their rehab and the university is soon looking to roll it out further.
“I think this is definitely going to become a part of my career in the future,” said Gillian Makepeace a second year MSc Physiotherapy pre-reg student. "For the participants, it has been extremely beneficial not only for the physical aspect but also for the social aspect during this difficult period.”
Phil Rumball, 73, has a long-standing heart condition and angina. “Zoom came to the rescue,” he said. “There have been so many benefits for me in respect of my health, fitness and socialisation. Working with the students makes me feel valued and helps my self-esteem. l am able to give something back”.
Find out more about physiotherapy courses at Brunel