Cardiac and pulmonary rehab teams join forces for breathlessness rehab

^{Senior physiotherapist in cardiac rehab Amye Watt}

Amye Watt, a senior physiotherapist in cardiac rehabilitation, is part of the multidisciplinary programme run by University Hospitals of Leicester NHS Trust.

She told Frontline that the programme was piloted from May to July 2017. Following positive feedback and successful results, the trust has now implemented it on a permanent basis.

‘Breathlessness rehab is delivered twice weekly for six weeks and preliminary outcomes have shown an overall improvement in functional capacity and quality of life measures,’ said Ms Watt.

‘Breathlessness is one of the most common reasons for people seeking A&E care and the number of such attendances is increasing steadily year on year.

‘Rehab can help such patients reduce their symptom burden, secure a better quality of life and reduce the need for subsequent expensive healthcare.’

Focus on symptom burden

Ms Watt said the programme is currently open to people with a diagnosis of heart failure, HFPEF [heart failure with pre-served ejection fraction] and chronic obstructive pulmonary disease. However, the trust aims to be able to accept any person with a primary diagnosis of breathlessness. 

‘The programme is innovative as it focuses on symptom burden, not the disease process, and the exercise and education components have been specifically developed with this in mind,’ said Ms Watt.

It is delivered at Loughborough University’s National Centre for Sport Exercise Medicine, which the trust uses for rehabilitation as a legacy of the 2012 Olympics. This year, the programme will also launch at Glenfield Hospital, Leicester.

As well as physiotherapists, the rehab team includes specialist nurses, occupational therapists, behavioural psychologists and exercise instructors.

Exercise and education

The programme offers classes that include aerobic exercise and strength circuit sessions. People are also encouraged to exercise at home and to document their progress, so the rehab team can review this before each class.

‘We have found this allows continual progression from home to class and, throughout the course of the six-week programme, we also see greater adherence to the programme resulting in high attendance and completion rates,’ said Ms Watt.

‘Outcomes to date show significant improvements in exercise capacity, quads strength and endurance and significant reductions in anxiety and depression.’

The classes are followed by education sessions, which provide guidance on self-management, symptom control, behaviour change, exercise and long-term management.

Positive feedback

Ms Watt says the feedback from patients has been ‘overwhelmingly positive’.

Comments from participants have included:

• ‘More strength, easier to do everything. Not just back to what used to be, but better!’
• ‘I feel I can cope better - stronger and can do more, now feel more confident in self and in going out and doing things.’
• ‘Not only me but everyone has seen an improvement and benefited from it.’"
• ‘Brought me back to normality.’

Members interested in finding out more about the service can email Ms Watt at amye.watt@uhl-tr.nhs.uk

Author: Robert Millett