May 9, 2017

Tasmania’s First Lungs in Action class hits five year milestone

2017 makes five years of Lungs in Action running out of University of Tasmania’s (UTAS) exercise physiology clinics in Launceston. Originally launched under exercise physiologist Dr Andrew Williams in 2012, Dr Sibella Hardcastle, also an exercise physiologist is now leading the team and shares her insights to running a successful and sustainable pulmonary maintenance exercise program.

  1. What was the major reason that UTAS exercise physiology clinics chose to take on the Lungs in Action program back in 2012?

We began LIA after being contacted by a community member who was head of a local lung support group.  This man was looking for somewhere for members of his group to exercise together.  Our clinic head then got in touch with the local hospital pulmonary rehabilitation program, which led to discussions with Lung Foundation Autsralia and introduction of Lungs In Action classes at UTAS.

  1. How many Lungs in Action classes do you now run, and approximately how many clients are registered to attend?

We hold four Lungs in Action classes per week with 78 people actively registered.  However, given our clients’ health status, actual attendance per week is around 55 attendees over the four classes every week.

  1. What contributes to the success of the class?

I think the success of our LIA classes comes from the friendly atmosphere in our clinic, plus the benefits clients see in their physical function, symptom control and quality of life.  We have an excellent relationship with the coordinators of our local hospital Pulmonary Rehab program and a steady referral pathway from them.

  1. What are your perceived benefits to running a program like Lungs in Action in a university clinic (As opposed to a general community locality)?

We have the innate trust and respect of the “brand” of the University of Tasmania which is a benefit over a having LIA in a community delivery space.  Our clients benefit from having a higher supervisor to client ratio in that exercise physiology students are involved in their care, plus our students benefit hugely from assisting with the delivery of exercise to people with lung conditions in a safe, supported, and controlled environment.

  1. What would you identify as barriers to class success (including client retention and uptake)?

Barriers for retention are around client motivation / illnesses / exacerbations.  We seem to even out with a steady stream of new referrals.  Common barriers to class success can be around accessibility (distance from venue and transport), cost, and class timing.

  1. What does your class look like? (In terms of the physical structure (equipment etc), class numbers, space and duration/frequency of classes available?)

We run our LIA as a 1 hour class with 5 min group warm up at the beginning and cool down stretches at the end.  Exercises include a 25min strength and balance circuit then ~25 mins endurance exercise (outdoor walking or gym-based cardio equipment).  Class numbers range from a max of 18 people per class to a low of ~8 per class, depending on time of day and time of year.  There are four class options over two days (Tues / Thurs).  Our gym space can accommodate up to 18 or 19 circuit stations safely.

  1. Where do you obtain your referrals from?

Mostly from the local hospital pulmonary rehab program discharges, but also from several respiratory physicians and general practitioners that are aware of us, plus a fair bit of word of mouth from clients.

  1. What is your relationship like with the local pulmonary rehabilitation service?

Our relationship with our local hospital pulmonary rehabilitation program is excellent.  We have had multiple meetings with them over the years to ensure the best possible communication.  As a university, we also have our exercise physiology students there on placement which further strengthens the relationship and professional reputation of local exercise physiologists.

  1. What strategies do you use to maintain the links with the local rehab services?

Clinic staff aim to attend as many of the hospital final education sessions as possible to put a face to the name, explain our program and answer questions from potential new clients.

  1. Do you have additional services available that your LIA clients can access?  For example: additional one on one services, other appropriate class options like tai Chi, yoga, balance?

Our clinic has several other classes that may be suitable for LIA clients eg. Individualised programs, Pilates for older adults with a falls reduction focus. Clients can also access one-to-one services under Medicare chronic disease management plans, or funded by their private health insurance.

  1. What opportunities have opened up since commencing Lungs in Action? (For example increase in local community knowing about your service, stronger links with local rehab program etc)

The success of our LIA program has increased community awareness and professional reputation of our clinic, which is vital given that we do not advertise.

  1. What strategies would you suggest for programs struggling to keep sustainable numbers?

Maintaining excellent relationships with referrers is essential to our success, but also success comes from having quality staff that make the LIA program so enjoyable, effective, and safe for participants.  We also ensure regular reviews of progress which can be a fantastic motivator when a client shows improvement  (or maintenance) of physical and emotional functioning from last testing session.

  1. Do you have any advice for an exercise professional considering undertaking Lungs in Action?

Our LIA is an ongoing class with steady referrals, plus the rewards lie in seeing quality of life and function returned to clients that were previously almost incapacitated by their lung condition.

  1. Do you have any particular good news stories / patient outcomes you would like to share from the last 5 years?

We have several long-standing clients that have had marvellous increases in functional capacity and quality of life.  Just recently one 54 year old lady with severe and debilitating asthma and other health conditions, had, at her last review assessment, an increase of 190 m in her incremental shuttle walk distance, which is a significant clinical improvement.  There was also an increase in her overall self-report quality of life score (SF36) from 34 at previous review in Feb 2016, to a score of 70 (where 100 is the best you can get) at her review in March 2017.  This client was over the moon with excitement at her improvements and shared her success with the class which was a wonderful boost to her self-esteem and self-efficacy as everyone shared in her happiness.

  1. How will you be celebrating to mark the 5 year milestone?

During warm up and cool downs of classes of the week of our anniversary, we shared stories and took some photos of the group, which were shared among group members.

  1. Additional comments?

Our enduring client base is testimony to the efficacy of the LIA program and the ongoing support we receive from Lung Foundation Australia.

Thank you Sibella for taking the time out to answer all the questions above. Thanks to UTAS for their commitment in running Lungs in Action, and  best of luck for the next 5 years head!