Neuro-Functional Training Programme (NFTP): engaging and empowering people with a neurological condition

Authors: Teresa Twohig , Trish O’ Sullivan, Elaine O’ Donoghue, Anne Reen, Liz O Sullivan, Patricia Morrisroe

Abstract Introduction: Neuro-Functional Training Programme (NFTP): An enhancing primary care initiative that supports self care in patients with a neurological condition, thus engaging and enpowering people.Problem Statement: The NFTP was established by Cork South Lee PCC Physiotherapy in February 2013 as a 4 fold initiative:1) To facilitate discharge planning of our complex Neurological patients. These include young patients with Acquired Brain Injury, discharges from the National Rehabilitation Hospital and people with congenital conditions.2) As a wait list management initiative- long review wait list for our progressive neurological patients.3) Enhancing primary care and community services- ensuring a seamless and integrated passage of care from acute to community.4) To address barriers that the neurological population experience in relation to exercise participationContext: Primary care Physiotherapists aim to optimise exercise participation thereby enhancing long term self management, preventing secondary complications and supporting self care. The NFTP is a 12 week programme that takes place in Leisureworld Gym, Cork.Aim: The aim of the NFTP is to enable patients with a neurological condition to exercise in a supervised setting . Physiotherpists devise a tailored programme that is specific to their functional impairments and limitations.Current high evidence base for exercise in the management of patients with multiple sclerosis- neuroprotection, anti-inflammatory effect and to prevent de-conditioning.Also consistent and abundant data supporting the role of exercise in the management of Parkinsons Disease, Stroke and Spinal Cord Injury.Theory of Change: Over 95% of our patients with relapsing remitting multiple sclerosis are now currently exercising in the NFTP, thus eliminating our neurological review waiting list.Neurological patients with co-morbidities ( obesity, hypertension, diabetes) clinically improving on outcome measures.Promoting self efficacy and survivorship.Neurological consultants from acute sector directly refer into the NFTP, thus ensuring integrated care between acute and primary care.In line with the recommendations of the Irish National Rehabilitation Strategy 2009 and Healthy Ireland.Reduces secondary complications, deconditioning and falls, thereby reducing clinic and hosptial admissions.Targeted population and stakeholders: Population: Patients with acute and progressive neurological conditions.Stakeholders: HSE South Physiotherapy Department, Leisureworld, Bishopstown and South/SouthWest Hospital Group.Timeline: Commenced in March 2013. It continues to evolve and grow in capacity. .Highlights:NFTP it the first in Ireland.13,000 patient contacts to dateensures seamless and integrated trasnition of care from acute to community.No longer have neurological review list.Outcomes: NFTP Audit 2016: Improvement in standing ability : 100%, walking: 88%, muscle strength 84%, outlook on life: 88% among othersCurrently, there are 195 particpants with over 13,000 attendances.Sustainability: Growing in capacity, with increase in Physiotherapy hours and an increase in patient contacts.Transferability: Cork South Lee Physiotherapy have presented nationally on how to make this model of care transferable.Conclusions:Sucessful and intergrated working collaboration between acute and community services.Overcame barriers of this patiient population to exercise.Promoting self efficacy.Lessons Learned:Need for increased staffing to cope with increasing demand.Referral pathway needed review in the first 2 years.References:1- Dalgas, U Progressive resistance training: a systematic overview. Epub 2012 April 24.2- Garrett M et al. Exercise in the community for people with minimal gait impairment due to MS. Physiotherapy 2013:19(6): 782-789

Keywords:

physiotherapy, exercise, neurological condition

How to Cite:

Twohig T, O’ Sullivan T, O’ Donoghue E, Reen A, O Sullivan L, Morrisroe P. Neuro-Functional Training Programme (NFTP): engaging and empowering people with a neurological condition. International Journal of Integrated Care. 2017;17(5):A9.

DOI: http://doi.org/10.5334/ijic.3310Published on 17th October 2017