Abstract

This speaker's experience spans thirty three years living with severe Rheumatoid Arthritis and had treatments and care to deal with a myriad of very difficult challenges involving multiple surgeries. Her medications included gold injections when she was first diagnosed to life changing biologic therapies for the past fifteen years. She will speak about her experiences and reflections of engaging with and monitoring and reviewing physical activity strategies and share her insights of new experiences using IT solutions to support this. Her exercise habits have been influenced by a fear of increased disability and serious co morbidity along with a desire for enjoyment and camraderie.

Alongside medication her favourite ally has been exercise and she self referred for physiotherapy advice and treatment, an experience which liberated her and provided new coping skills. Therapeutic exercises were prescribed and only performed intermittently for various reasons e.g. as there was not much fun involved! Through the Stanford self management programme and support from her physiotherapist she learned to experiment with gym and pool exercises, gaining confidence and enjoying the social aspect of leisure club membership. Monitoring her exercise programmes was limited initially to simple talk tests and increasing frequency, distance and duration of exercise.

The ongoing severity and nature of the disease continued to drive her and she has since become a self management educator, facilitating workshops in the community. This rewarding opportunity has helped her and many others to allay fears about exercise, monitor exercise activities, set new goals, review techniques and develop new pain management strategies. An opportunity arose to participate in a controlled gym based exercise study in 2009 which improved her fitness and increased her capacity for exercise. This motivated the speaker to organise some community based exercise groups for people with arthritis. Currently she exercises regularly by Aqua jogging in an Aqua Aerobics class, Nordic walking and gym based exercises all of which have increased her quality of life.

In 2015 she cautiously joined a modern gym with state of the art equipment to help improve cardiovascular health, maintain bone density and monitor her physical activity more closely. A longstanding trust in physiotherapy professionals has always prompted her to crosscheck her exercise regime. Perhaps there is a need for physiotherapy professionals to work more closely with community based exercise instructors so that patients with chronic disease can learn how to monitor and adjust their exercise habits for optimum effect and enjoyment?

For the past year she has been using a smartphone pedometer and it has motivated her to increase the frequency of walking. Choosing electronic monitoring devices has become very difficult as there are so many products and accuracy varies – patients with arthritis need accurate information from health professionals and exercise instructors. Monitoring exercise is not just important for individual patients. Patient organisations, family, carers, health providers, town planners, designers and community organisations can play a key role by promoting accessible facilities and exercise monitoring tools in their cultures and values. On reflection, she noted a number of concerns namely, affordability, accuracy, reliability, usability, information quality and potential inequality for patients.

During the past twenty years many advances have been made in the fields of medicine and allied care for rheumatology patients. As the field develops further, how important will exercise monitoring become? Will it change the way patients interact with health professionals and services? Will we see monitoring devices and state of the art gym equipment in hospital settings, health centres and outdoor parks to support personalised patient exercise compliance?