A researcher from the University of the West of England has been awarded two grants to fund work that will encourage people with serious joint conditions to move and excercise more.
Dr Nicola Walsh has recently won more than £500k that will fund projects looking to improve clinical delivery of treatments and therapies within the community and primary care. The research will look into the feasibility of offering self- management advice and exercise for people with chronic musculoskeletal pain and osteoarthritis in a more joined up way.
Currently treatments and therapies are offered to patients based on their pain location eg back, hip or knee even though strategies for managing the conditions are broadly similar irrespective of the pain location.
Dr Nicola Walsh has been awarded £250k from the Chartered Society of Physiotherapy Charitable Trust CSPCT) for a study into the clinical and cost effectiveness of exercise and self-management for people with chronic musculoskeletal pain and osteoarthritis.
The grant will complement a five year fellowship grant from Arthritis Research UK for £346k to develop community-based models of care for people with degenerative musculoskeletal pain.
Professor Alan Silman, Arthritis UK Medical Director, said,"Painful osteoarthritis of the knee affects millions of people and we know that exercise can be hugely beneficial, but often people need a lot more encouragement than they currently get from the health professions to not only start exercising but to keep at it. We hope that Dr Walsh's work will help to provide the motivation they need."
The work funded by CSPCT is in collaboration with the University of Bristol, St George's University of London and Peninsula College of Medicine and Dentistry. Dr Walsh explains, "Current management strategies are expensive and frequently ineffective as they fail to encourage long-term exercise participation.
"The tendency with current management strategies is to treat people with site specific problems rather than taking joint pain and reduced function as broad entities. The ongoing treatment for degenerative joint pain management is similar whatever the condition or location of the pain.
"So there is an argument to work in a joined up way and merge management rehabilitation classes to include people with the various manifestations of pain whether it be knees, backs or hips
"The key message to get across is the crucial part exercise has to play in helping people with joint problems. Often as soon as people realise that they have degenerative joint problems the tendency is to rest joints when in fact proven benefits that help manage the pain better include a focus on building up the muscles that support the joints to make movement less painful. As practitioners we recommend a combination exercises to aid strength, mobility and functionality.
"Good examples include walking and swimming as well as more specific exercises to strengthen muscle groups and increase joint movement. The key thing is to encourage people to move their joints as a sedentary life style can lead to further joint problems. Other self management strategies include helping people to cope with the pain through pacing activity, relaxation techniques, joint protection and ice and heat pain management."
The CSPCT study, aims to evaluate the effects of generic exercise and self-management classes to people with degenerative knee, hip and/or lower back pain. The team will also determine the cost-effectiveness of this combined approach compared to continued GP management.
Dr Helena Johnson, Chair of CSPCT, commented on the quality of Dr Walsh's submission in a strong field of applications. "Prescribed exercise is a core area of physiotherapy practice and the CSP looks forward to the outcomes of Nicola's important research."
This work complements the concurrent Arthritis Research UK Fellowship award investigating the development of a community-based model that encourages exercise, self-management and social interaction as means of encouraging long-term adherence to lifestyle change. The focus of this research is to integrate the skills of physiotherapists and other community exercise practitioners to support older people with degenerative joint pain to continue exercising in the long-term.
Dr Walsh concludes "We hope that these projects will enable us to develop a clinical and cost-effective strategy that is acceptable to patients and professionals and will achieve long-term improvements in patient function."
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