The Allied Health Group Therapy program in Residential Aged Care Facilities across Australia
Why was the Allied Health Group Therapy Program introduced?
During the COVID-19 pandemic, outbreaks in aged care facilities have led to full lockdowns in Residential Aged Care Facilities, where residents were restricted to their rooms. Normal exercise and access to the outside was not possible. This led to a significant level of deconditioning amongst residents in facilities that were forced to implement full lockdowns.
What is the Allied Health Group Therapy Program?
The Allied Health Group Therapy program led by a physiotherapist, occupational therapist or exercise physiologist in Residential Aged Care Facilities across Australia’s East Coast, aims to improve physical functioning of residents; who are or have been at risk of deconditioning due to COVID-19 lock downs in 2020. Vivir Healthcare were successful in a tender to deliver the Allied Health Group Therapy program across Victoria and New South Wales.
What is the Allied Health Group Therapy Program trying to achieve?
The supervised Allied Health Group Therapy program aims to support the immediate and ongoing achievement of physical activity guidelines for residents of Residential Aged Care Facilities impacted by full lockdowns. Implementation of the prescribed group program has been shown by Sallis et al., (2021) to significantly improve physical functioning (strength, endurance, and balance), and subsequently has been linked with a decrease the impact of deconditioning and reduced risk of developing severe COVID-19 related illness.
Breakdown of the Allied Health Group Therapy Program
Context
The Allied Health Group Therapy program is based on the Sunbeam program, developed by Dr. Jennifer Hewitt, Physiotherapist, Researcher, and Educator from the University of Sydney. The Sunbeam program consists of individually prescribed progressive resistance training and balance exercise performed for 1 hour twice per week for 50 hours, in groups of 4.
Program
At the beginning of each program’s rollout, the Allied Health Professional (AHP) will assess each resident and prescribe an individualised exercise dosage to accommodate his/her preferences, co-morbidities and abilities. Each resident’s program and dosage is reviewed on a regular basis to maximise their outcomes.
Resistance Training
Resistance training exercises are set at an individually assessed load where the resident completes 2 to 3 sets of 10 to 15 repetitions for each exercise at a self-determined “moderate” intensity. Once the resident reports this load to be easy, either the resistance is increased, or the number of sets/repetitions are increased, to make the exercise more challenging.
Examples of resistance training exercises may include:
Seated knee extensors
Seated Hip adduction, Sit to Stand (Leg Press)
Seated Elbow Extension (Triceps Activation) with use of body weight, resistance or weight
Resistance training can also be tailored for a facility gym, if available.
Balance exercises
Balance exercises are challenging enough to result in improvement but is conducted in a safe and controlled environment. The Allied Health Professional may place a table in front of one resident and a chair behind them while standby assistance may be required for another resident.
Balance exercises may be made more challenging by:
reducing the base of support (feet apart/together),
reducing hand support (holding on to a support table with two hands, one hand or no hands)
performing with eyes closed.
We are extremely excited about what the Allied Health Group Therapy program has accomplished so far. We have received great feedback on the program’s effectiveness, scope, social interaction and versatility from our residents and our team. Following our successful tender process and the program’s roll-out during the second half of 2021, we hope to expand our Allied Health Group Therapy Program in the future.
Resources
Brownie, S. and Horstmanshof, L. (2012) ‘Creating the conditions for self-fulfilment for aged care residents’, Nursing Ethics, 19(6), pp. 777–786. doi: 10.1177/0969733011423292.
Hewitt, J. et al. 2019. ‘An economic evaluation of the SUNBEAM programme: a falls-prevention randomized controlled trial in residential aged care’, Clinical Rehabilitation, 33(3), pp. 524–534. doi: 10.1177/0269215518808051.
Hewitt, J. et al., 2014. Does progressive resistance and balance exercise reduce falls in residential aged care? randomized controlled trial protocol for the sunbeam program. Clinical Interventions in Aging, p.369.
Hewitt, J. et al., 2018. Progressive resistance and balance training for falls prevention in long-term residential aged care: A cluster randomized trial of the sunbeam program. Journal of the American Medical Directors Association, 19(4), pp.361–369.
Sallis, R. et al., 2021. Physical inactivity is associated with a higher risk for severe COVID-19 outcomes: A study in 48 440 adult patients. British Journal of Sports Medicine, 55(19), pp.1099–1105.