Literature Review Messent et al (1998,1999) Robertson et al (2000) Beart et al (2001) Heller et al (2002)

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Text of Literature Review Messent et al (1998,1999) Robertson et al (2000) Beart et al (2001) Heller et al...

  • Literature ReviewMessent et al (1998,1999)

    Robertson et al (2000)

    Beart et al (2001)

    Heller et al (2002)

  • Barriers

    Resources e.g. staff support

    Policy/priorities

    Opportunities

    Transport/finance/access

  • Method

    Subjects. 45 adults(m27/f18) 24-49yrs Settings. 2xDay centres(35) 6 Houses (10) Design. Interview /ethnographic based Procedure. 12mths Multi/site/off road/key access Analysis. Transcript (78) Thematic content

  • Barriers to cycling

    all about support and staff initiative. That has been the same before and after this intervention Findings

  • Staff Interface:they tend to do the minimum and only one or two drive things through Staff support :Not enough staff to cope with ever bodies wants and needs. Cant keep them all happy (TV3)

  • Opportunity for activityWe need more activity choice and variation. We downgrade the activities to fit the circumstances (RV2; TV6)it is difficult to keep them on task and motivated There is an awful lot of sitting about for people with learning difficulties.

  • If we had more bikes we could get more cycling. Its brilliant. (AdH2).Opportunity for activity-cycling Options have been enriched, and provided an extra activityit is an activity that involves real participation, and it is just what we are looking for. (RV2, RV4, TV 1),

  • 1) Accommodating impairments it is comfortable and secureCycling is so simple and a most basic thing can dobuilds teamwork, develops relationships and gives independence motivation is a biggy. Fun.+++

  • 2. Offering Accessibility and FlexibilityImpact on staff support It is the flexibility. Even if you are short of staff you can still find time to take them out, (LW2; RV4) Impact on the interface

    was more motivating for us and them It gets us and them out of a rut,

  • Cycle use Day centre 1. 1-3 weekly @ 30min plus a session (*Max 6 hours)Day centre 2. 1 session week @ 20 30 min Housing network. Average one per month (* 5 x week)

  • ConclusionsMeets NeedOffers opportunitiesBreaks BarriersFUN +++

  • jbartley@churchnet.org.uk

  • Welcome my name- physio researcher fellowship

    Inactivity general population challenge

    Inactivity - Learning difficulties?? more problematic?

    Limited research change slide History RAH,Soly, anecdotal past therapy sessions/funding stoped. and moderation message Inactivity in ld few studies but more inactive due to range of barriers above and beyond general population Messent most up to date and few examples of physical activity others into leisure per se

    Beart etal paper and his outline of other studies looks at others ie Rose Jahoda&cattermole (1995) Hoge &Dattilo (1995)Mostly state external factors eg Finance /transport carer/friend supportResources staff cover for users ie group based not a lot of one to one Parents cant do all need support to access opportunities if there

    Priorities ie other activities in day centres and in houses ie college shopping etc and some leisureOpportunities not enough choice etc narrow menuImpairment mobility medical epilepsy motivation (Heller) Internal motivation Task- remove barrier's intro passive/active exercise modalities(Heller)

    ???? Is it environment that influences or impairment i.e. Messent =all = Primary barriers Has disability debate implication ie social model versus medical; model; more later

    Opportunities ? Is that due to impairment ie skill fitness etc or does it tell us about societal assumptions of the NORM?How much external how much internal?? Disability debate ie structure not individual/?

    Findings-Barriers to cycling slide Staff SupportAs shown in lit review ie Day centre or houses all group care and that diminishes individual choice and opportunity ie others have to be involved ie one staff on at night cant do it all sleep overs etc staff sickness chronic pay and conditions etc Policy changes White paper ambitions etc Staff Initiative slideIdentified these two main threads but complex mix of course Not identified or given the priority that it deserves in other studies. but it is at this level of service interface that it all happens and how policy and empowerment will be fulfilledIssues of ind interest motivation ie tired sleep avers team dynamics type of impairment staff numbers and sickness and employment issuse all combine so complex mix -dynamics but intervention will have to be particularly attractive to engage these issues.Even this process has problems ie left to do it and others can get out of it etc so becomes a management problem then etc andof course dedcated staff may leave etcTHESE issuse impact on all lifestyle options and reason why sedentary options are taken But all agree that they want more opportunities for users to be active but within the parameters shown by reality new slide Opportunity for activity slide but despite these barriers they still want opportunities to be activeIssue of staff induced inactivity i.e. catering for all needs thus sat down activitesAnd impairment issue which is also challenge and part of the staff equation Opportunity for activity cycling slide Examples of what cycling brought to opportunities WHY 1) accommodates impairments and 2) key and multi access impact on staff and interface Platform for activity behaviour,nervous overweigh, low fitness levels, epilepsy etcSimplicity important if low skills and spasticity , coordination etc Move in environment team work i.e. rare to work together spatial awareness ,decision making, reactions, choice ie hands off show choice? control INDEPENDENCEMotivation to move Biggy self motivating Why? Man and machine? Ease of use ? Secure all factors special ingredient =FUN result continuous cycling 30 min plus? How many other options give you that ??-lead to endurance etcStaff different in centres versus houses ie more support around spontaneous but in reality had to be put in routineInterface Motivting ie mor choice , change from boring routine and less need to promt and do things for user ie impirment effect??so knock on effect ie seeing user becoming more self sufficientMeets needs of all ie complex, mobility behaviour etcOpportunities to be active safe and progressive activity for fitness and long term adherence for control and empowermentBreaks barriers of assumptions of society and opportunites for being actice ie larger menu etc ,staff and interface shown to be rigid but still able to influence Not the solution to staff nos and interface but because of all its advantages it stands well set to answer some of the challenges put by limited research in this area. one way to get ld more active