Physical activity of physiotherapy students of the University of Rzeszów and its impact on the subjects’ body composition

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The 4th European Congress of the ER-WCPT / Physiotherapy 102S (2016) eS67–eS282

POS288 Five year review of an enhanced recovery program following hip arthroplasty at a UK general district hospital P. Saunders ∗ , K. Katam, S.K. Young South Warwicksire Foundation Trust NHS, Warwick, United Kingdom Relevance: With an ageing population the number of total hip replacements has increased by over 20% in the past 5 years (National Joint Registry, UK). The need to ensure patient management pathways are effective and efficient is becoming increasingly apparent. Purpose: Enhanced recovery programs (ERP) have been championed for over a decade for improving patient outcomes following elective surgery. The program described in this report is used within a UK NHS hospital and is a multi-modality treatment within which physiotherapy plays an integral component by providing pre- and post-operative intervention in both an in-patient and community setting. The service has become all-inclusive to patients regardless of medical, surgical or social status. One concern regarding ERPs is the risk of increased complications and hospital readmissions due to premature hospital discharge. The aim of this study is to evaluate an ERP following total hip arthroplasty in terms of hospital length of stay and readmission rate. Methods/analysis: A retrospective analysis was conducted of length of stay (LOS) in 1943 consecutive patients following THA surgery (primary, revision & post neck of femur fracture) at a UK general district hospital between April 2010 and April 2015. Further analysis for 28-dayreadmission was completed in 825 consecutive patients between April 2012 and April 2014. Results: LOS has reduced consistently from 4.36 to 3.27 days for primary THA, from 6.88 to 4.58 days for revision THA, and from 8.47 to 6.15 days for THA post neck of femur fracture. Relevant readmission within 28-days was 2.55%, occurring more so post revision THA, with hip dislocation and medical issues the most common causes. For those patients who were readmitted mean initial LOS was 7.34 days and time to readmission was 11.47 days. Discussion and conclusions: Our ERP incorporates a collaborative multi-disciplinary approach and has seen a 16 to 25% reduction in LOS following THAs in the last five years. The most recent years LOS figures are comparable with other reported ERP outcomes following THA across Europe. Reducing LOS is known to have positive effects on improving patient satisfaction, reducing hospital acquired illnesses and importantly ensuring cost-savings. Key concepts within this ERP including pre-operative education and community visits for inspections of wounds and exercise rehabilitation are provided by a dedicated home-support physiotherapy team. High readmission rates for ERP following hip and knee arthro-

plasty have been reported however in this report the rate is substantially lower and comparable with readmission rates for non-ERPs. Readmissions do not appear to be linked to premature hospital discharge as the initial LOS for those readmitted was twice the overall average and the time to readmission was nearly a fortnight post discharge. Impact and implications: The need to develop services that enhance patient outcome, satisfaction and reduce the financial burden of an ageing population on the NHS is becoming increasingly important. The knowledge and experience presented within this report aids in the fulfilment of these requirements along with highlighting the need for continued evaluation and audit to ensure optimal patient outcomes. Funding acknowledgement: None. http://dx.doi.org/10.1016/j.physio.2016.10.344 POS289 Physical activity of physiotherapy students of the University of Rzeszów and its impact on the subjects’ body composition J. Baran ∗ , R. Baran, E. Czenczek-Lewandowska, J. Leszczak, A. Mazur, J. Podgórska-Bednarz, T. Pop, A. Weres, J. Wyszy´nska University of Rzeszow, Medical Department, Rzeszów, Poland Relevance: Lack of exercise is one of the greatest threats to our health. In the words of Wojciech Oczko (Royal Physician at the court of Polish Kings: Zygmunt August, Stefan Batory and Zygmunt III Waza) “Movement can be a substitute for almost any medicine, but no medicine can be a substitute for movement.” Physical activity determines proper development of every living organism. The available research suggests that we are turning into a sedentary society. Purpose: The aim of the study was to evaluate the level of physical activity in Physiotherapy students at the University of Rzeszów and to check the relationship between body composition and the level of physical activity of the subjects. Methods/analysis: The study group consisted of 135 students of Physical Therapy at the University of Rzeszów, aged 19 to 30 years (96 women and 36 men), who volunteered to participate in the study. The study was performed at the Institute of Physiotherapy, University of Rzeszów. Bioelectrical impedance analysis, carried out with the use of Tanita BC420M analyzer, was applied to assess body composition in fasted subjects. The examined parameters included: body mass [kg], FAT [%], FFM [%], MUSCLE MASS [%], TBW [%], BONE MASS [kg]. The subjects’ activity level was assessed with a validated Polish-language version of IPAQ.

The 4th European Congress of the ER-WCPT / Physiotherapy 102S (2016) eS67–eS282

The results were statistically analyzed using Mann– Whitney test and Spearman’s rank correlation coefficient. Results: The study showed that the mean total level of activity was approx. 2879.4 MET min/week. The average sitting time was approx. 3.5 hours. 57.8% of the subjects reported high level physical activity, 31.3% moderate, 9.6% satisfactory and only 1.5% of the subjects reported low level physical activity. We also investigated the level of various types of activity among the women and the men. Like in the general analysis most of the women and men reported physical activity at a high level (53.1% and 69.2%, respectively). The findings show a statistically significant difference between the women and the men in the average time allocated to sitting, walking and transportation. A comparison of the average levels of these measures shows a slightly higher level of transport activity in the case of the women, and leisure activity in the case of the men. Analysis of the relationship between physical activity level and body mass composition shows that transport activity increases with the growth in the content of fatty tissue (P = 0.0128*) and decreases with the content of muscle tissue (P = 0.0151*) and water in the body (P = 0.0069**). Discussion and conclusions: Despite the large advancements related to motor vehicles, and the general trend showing a decrease in the time designated for active leisure, in most cases the subjects reported very good physical activity which is a good predictor for young adults. Impact and implications: Adequate level of physical activity is important for proper functioning of the human body. It reduces the risk of obesity and keeps our body in good shape. As a result, we can continue to enjoy good health and a better quality of life for many years. Funding acknowledgement: The research was financed by the University of Rzeszów. http://dx.doi.org/10.1016/j.physio.2016.10.345 POS290 Creation of a population based early intervention falls prevention service in two areas of south London, UK (Southwark and Lambeth) J. Hall ∗ , G. Battarbee, C. Rossouw, E. Hanley, A. Hopper, C. Ingram Guy’s & St Thomas’ NHS Foundation Trust, Community Rehabilitation and Falls Service, London, United Kingdom Relevance: In 2012/13 there were 13,039 falls-related attendances and ambulance call-outs, and 3029 admissions into a hospital bed. In one year this amounts to a whole system cost of £8.4 million in our local population of 680,000.1 With approximately 1/3 of people aged over 65 falling each year2 we calculated that only 2% of the 16,000 people over the age

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of 65 potentially at risk of falling were offered falls prevention services locally. As community-based falls prevention services are evidence-based, cost-effective and recommended in national guidelines3 we wanted to address this unmet need. Purpose: The aim of the project was to attract high volumes of people at risk of falls, safely fast-track them to community falls prevention classes without prior assessment by a health professional, and support them to complete the programme. Approach/evaluation: The project team developed a new self-referral pathway to include a telephone helpline (Monday to Friday 8.30 to 17.00 with an out of hours answer phone) and a robust triage process operated by clinical assistants as the main decision makers. Therapists provided skills training and the development of a triage tool to ensure clinical safety and appropriate referrals. The helpline was actively promoted from June 2014 including posters, leaflets and business cards for display in general practitioner (GP) surgeries, and other community sites, directly mailing people over the age of 65 on local GP registers, and developing partnerships through local voluntary and community sector organisations. Additional trained instructors were recruited and new community falls prevention classes were added to meet the identified need. The programme is provided over 30 weeks. Adherence strategies were co-produced with participants and wider citizen engagement including telephone followup, the development of a workbook, the production of a supplementary exercise DVD, the testing of a volunteer support programme, and strengthening partnerships with other exercise providers to offer appropriate ‘follow-on’ activities. Outcomes: By 25th February 2016 we had received 1034 referrals through the new triage system, achieving a 99% success rate at directing referrals to the most appropriate falls intervention. 76% of participants demonstrated improvements in one or more clinical measures, 75% reported improvements in the quality of life, function and confidence using the FESI and EQ-5D-5L. 75% completed the programme. Discussion and conclusions: To meet the increase in demand we created 11 additional community falls prevention classes and 1 additional 8 week exercise group, reaching 6% of the community potentially at risk of falls. A business case has been submitted proposing the continuation of the telephone triage service and further increases in classes to meet the needs of our local population. The project demonstrated that, when combined with effective promotion, self-referral and telephone triage is safe and effective at fast-tracking people into early falls prevention services. Participants in the classes demonstrated good clinical outcomes and maintained good attendance and completion of the programme. Impact and implications: Developing a self-referral pathway and telephone triage system can safely improve access to falls prevention services and has the potential to