Courses at AStretch

AS workshop 23/24 April 2009
Queen Alexandra Hospital, Portsmouth

This two day AS course held at Queen Alexandra Hospital, Portsmouth was attended by 17 physiotherapists (including one physiotherapy assistant) working in NASS groups nationwide.  The course was designed to provide physiotherapists working with AS patients a greater understanding of the disease and what role they play in helping to manage it. There was a wide variety of topics on AS covered from theory in the classroom to practical sessions in the gym and hydrotherapy pool. The course was run by Karen Irons and Claire Jeffries, both senior NHS physiotherapists who have many years experience running NASS groups. 

The course covered the symptoms of the disease and its progression: Karen drew on her extensive experience in this area and gave an in depth presentation to the group.

The important role a physiotherapist plays in helping a patient manage their AS was covered.  The main areas outlined were pain management; liaising with rheumatologists; prescription of strengthening and stretching exercises and low impact work outs; home programmes specific to the needs and abilities of the patient, general education regarding daily life and encouraging the joining of a NASS group in the area.

The psychosocial influences upon AS were also discussed with regards to barriers to exercise i.e. physical, emotional and ‘other’ factors. 

The group was split into three teams and each team was tasked with identifying the elements involved in each type of barrier to exercise.  The feedback included pain during exercise as a physical barrier. Emotionally there can often be anger and frustration as the disease is usually diagnosed at an age when most demands are being made on time i.e. career and family.

 The ‘other’ factors which can influence exercise included time-trying to fit the exercises in to daily life, lack of facilities and also transport to facilities. Karen stressed that the role of the physiotherapist was to help overcome these barriers and motivate patients to exercise. Karen encouraged the physiotherapists to talk to their patients regarding the benefits of exercise. Possible solutions to all of these problems were discussed, and suggestions were made as to how physiotherapists can help their patients through time management strategies, pain management, relaxation methods and reward systems.

Each team was asked to think about the advantages, difficulties and disadvantages of group exercises.  The physiotherapists felt the advantages to being in a group meant it was more fun and the patients were spurred on by each other. It was felt one of the difficulties facing exercise is trying to achieve a homogenous group where abilities in the group were well matched. One of the main disadvantages, the physiotherapists reported, were some individuals may prefer to exercise alone. However the advantages clearly outweighed the disadvantages and many difficulties could be overcome.

During the theory, the history of how the four Bath indices were developed was discussed. The physiotherapists were briefed on how to use the indices so that they can be incorporated into a NASS group and patients can be regularly monitored.

The medical management of AS was discussed, highlighting the benefit of drug therapies in allowing the patient to exercise more easily once pain is decreased.

Four practical sessions were taught covering land based exercises (2 sessions) and hydrotherapy (2 sessions) specific to AS patients. The land based exercises included partner stretches in the gym and gymnastic ball work to aid in muscle work and also the additional effects of maintaining balance. The hydrotherapy sessions incorporated stretches, strengthening exercises and games that could be used during classes. The importance of making the NASS sessions fun using an array of exercises and games was highlighted.  

All course attendees are provided with a detailed handbook which can be used as a reference on future occasions.

This informal environment but well structured course allowed for the physiotherapists to effectively network and share their experiences working in a NASS group.

Karen Irons

I would like to give our special thanks to Karen and Claire for all their hard work in the organisation and running of this course.  I know how valuable these courses are to the physiotherapists who take NASS groups and for this course NASS was to able to provide financial support for those physios who would otherwise not have been able to attend. Profits from the course are then used to purchase equipment that can be utilised by the local NASS group and Physiotherapy Department who hosted the course.

If your NASS group or local physiotherapy department would like to host a course in your area, or attend one in Portsmouth, please contact Karen and Claire via the AStretch website (through the NASS website) or directly on Karen.Irons@porthosp.nhs.uk, or  the director at NASS on director@nass.co.uk

Jane Skerrett

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Organisation of Ankylosing Spondylitis Course

Thank you for considering/agreeing to organise an Ankylosing Spondylitis course at you hospital/facility. To assist you in preparation of the course and to ensure its smooth running we have enclosed a set of preparation checklists for you. Whilst extensive, the lists will guide you in important areas of payment for the course and facilities that will be required.

Also enclosed is a “costing” sheet that lists the outgoing expenses that need to be paid to run the course ie: tutors fees, printing of course manuals. Please consider this list carefully as it may have bearing on the cost at which you place each participant’s course fees. Whilst course tutor fees remain fixed for the period 2011/2012, please be advised that the prices listed for other items are only rough estimations; costs may vary slightly from area to area according to your own requirements/preferences.

Please note that it is a requirement by ASTRETCH and the course tutors that an advert for your course is placed in physiotherapy frontline. This is to ensure that adequate numbers of participants are found to attend the course and to avoid cancellation of the course.

Once a course date has been agreed your course tutor/liaison will also organise advertisement of the course with NASS HQ and the AStretch database/website.

If you do have any inquiries about the organisation of the course please do not hesitate to contact the designated course tutor. Please ensure you make a note of your course tutors details below:

Downloads

• Breakdown of costs – 2011 / 2012
• Ankylosing Spondylitis Course – Organisation check list
• Advert - running a course
• timetable Portsmouth 2011 -Students copy

Ankylosing Spondylitis Course – Organisation check list

Course Advertisement

Place course advert in Physiotherapy Frontline Journal
Distribute fliers of course details to all local clinical areas/hospitals
Course adverts should include:
1. Course title
2. Location of course
3. Time and date of course
4. Contact numbers for course application
5. Course organisers details
6. Process to secure course place
7. Price of course
8. Deposit arrangements (non-refundable for late cancellation)
9. Payment methods inc. details for cheque payee
10. Tutors details
11. Brief synopsis of course content/aims

All course adverts should be placed 3 months prior to course commencing

Securing course places and course payment

Course places should only be secured on receipt of deposit payment.
Deposits should be set at half of the full course fee - non-refundable on late cancellation
Full course payment should be received 3 weeks before course commences
Applicants should be sent receipt of payment for deposit and/or full course fees

Pre-course pack to be sent to participants

Maps to include location of hospital and rooms for lectures/hydrotherapy
Details of parking facilities and potential payment requirements
Details of canteen facilities
Details of local Hotels/Bed & Breakfast establishments for those participants who may
require overnight accommodation
Pre-course reading list (provided by course lecturers)
Timetable of course content for both days (provided by course tutor)
Dress requirements for hydrotherapy and gym practical sessions ie: swim suits/towels
Request for applicants to bring tape measure and Cx goniometer to course if able

Participant packs should be sent 2 weeks before course commencing

Administration pre-course

Calculate number of course manuals required – 1 per participant
- contact course tutor 2 weeks before course commencing to advice of numbers
Photocopy required number of course certificates
- template provided, to be completed by course lectures on final day of course
Book appropriate lecture rooms/access to hydrotherapy for both days of course
Book presentation equipment required – as advised by course tutor
Inform appropriate security staff of course schedule (as applicable)
Organise local NASS members to attend as models for measuring - day/time according
to agreed course timetable (x1 model to every 2 course participants if possible)
Organise 2 of the above NASS patients to give informal, 5 minute talk to course
participants entitled: “AS – a patients perspective”

On the day of the course

Ensure adequate signs are placed in the hospital to direct course participants to meeting area on first day
Ensure provision of tea/coffee/juice for arrival & morning/afternoon breaks on each day

Ankylosing Spondylitis Course

Breakdown of costs – 2011 / 2012

The following figures are based on 16 course participants attending a two-day Ankylosing Spondylitis course. Whilst planned for 16 participants, it is assumed that there are the customary 2 “free” places for hosting staff included within the total numbers of participants. Therefore overall calculations and profit from the course are made on the assumption of 14 “paying” attendees. The course however can be extended to as many applicants as you are able to accommodate with the facilities to be used and these places can be “paying” or “free".

NB – some alteration on the cost of tutor travel and accommodation may need to be considered depending on your location. This costing will be calculated immediately on agreement of a course booking to allow you to set your course fees accordingly.

Tutor fees £1200

Tutors travel £200

Accommodation £420

Course Manuals (including printing and binding) (£9.00 each) £144.00

Photocopying of course certificates (20pence per copy) £3.20

Refreshments (including tea/coffee/milk/juice/biscuits) £15.00

Advertising – physiotherapy frontline £100

Extra pool/gym equipment (i.e: neck collars, woggles)* £ ???

Lecture room/hydrotherapy pool hire* £ ???

Total £2082.20

14 course participants @ £165 each £2310.00
(allowing 2 “free” places for hosting staff)

Remaining course profit £227.80

The cost per participant may need to be adjusted according to costs that are currently uncertain e.g: room hire fee.

• *cost items that may not be required/applicable
• It is suggested that any profit is donated to ASTRETCH to aid the groups work in raising awareness of AS amongst physiotherapists and members of the medical team.
• On previous occasions donations have also been made to the local NASS groups who assist on the workshop days.