Developing a physiotherapy-led exercise group for older adults with frailty


A case study from Newcastle-upon-Tyne Hospitals NHS Foundation Trust, examining the benefits of specialist exercise groups for older adults with frailty.

What was the aim?

Rising numbers of older adults living with frailty typically have impaired mobility, balance, strength and endurance. Specialist physiotherapy can identify and target such deficits through individually tailored exercise and health education.

Group exercise may have advantages over individual care, such as peer support, shared experience and the formation of health relationships.

The trust therefore wanted to develop an exercise group for older adults with frailty, to improve their functional performance.

What was the solution?

'Stay Strong': a physiotherapy-led exercise group held at the Freeman Hospital's Melville Day Unit. All patients were referred for day unit physiotherapy assessment and those who were suitable were offered a choice of individual or group exercise.

Participants attended eight weekly groups of individualised and progressive exercise targeting flexibility, strength, balance and endurance, with supplementary home exercise. Health education topics included exercise recommendations and benefits.

All 29 participants, with a mean age of 83, used walking aids and rarely went outdoors alone.

What were the results?

The Timed Up and Go test (TUG) and a patient experience questionnaire were used to evaluate the project. At the start, the mean TUG score was 31.7 seconds. The evaluation found:

  • 84% of those completing the eight sessions achieved an improved TUG score, with a mean gain of 6.6 seconds
  • of the 89% who completed the patient questionnaire, all 'enjoyed' the group and most felt it 'made a difference'
  • 71% highlighted the group's 'social element' as beneficial

What were the learning points?

  • Frailty management and inactivity in older adults are gaining priority in NHS care.
  • Specialist physiotherapists have the skills to delay deterioration and improve frailty through exercise and health education.
  • The 'Stay Strong' group showed psychosocial and physical gains in older adults with frailty.
  • Implementing 'Stay Strong' in the day unit was an innovative service improvement that supports active ageing.
  • Investment is needed to develop community-based opportunities to support older adults to achieve better health, and prevent the morbidity associated with frailty.

Next steps

The trust's other day unit has introduced a therapy programme with similar principles to the 'Stay Strong' group.

'Stay Strong' is now part of the therapy pathway for managing older adults with frailty.

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