A new study will see if virtual sessions by trained volunteers can help older patients regain their strength after they return home.
At least a third of older people are estimated to be at risk of ‘deconditioning’ due to inactivity while in hospital. This causes their muscles to weaken, making them frail and more at risk of falls.
Exercising and eating healthily when they go home could help these patients get their strength back. Consultant Geriatrician Dr Stephen Lim is leading research at University Hospital Southampton to determine whether online support from trained hospital volunteers could help them do this.
The study is part of the Perioperative and Critical Care theme at the NIHR Southampton Biomedical Research Centre.
People in the UK aged over 65 spend at least 10 hours each day sitting or lying down. This makes them the most inactive age group.
A stay in hospital can reduce their physical activity even further, as people usually spend most of their time sitting or lying down in bed. While necessary for their recovery, this causes their muscles to weaken and can mean they leave hospital frail.
“The hospital process itself can often contribute to a decline in the trajectory of the patient’s frailty,” explained Dr Lim. “We feel it is important to address that to prevent a further decline.”
The Frail2Fit study is investigating whether our hospital volunteers can help these patients.
The research team are training six volunteers to run virtual sessions for groups of up to 10 patients. Each session lasts 40-60 minutes. They start with 20–30 minutes of seated exercises using resistance bands, developed by an NHS physiotherapist. Then they discuss ways to eat a healthy diet.
The study could therefore not only benefit patients, but also allow volunteers to develop new skills.
“I think the novelty of the study is that we are upskilling hospital volunteers we already have to offer them something new,” Dr Lim says, “to gain skills leading exercise classes and talking to patients about nutrition.”
Forming healthy habits
The researchers aim to recruit around 30 people over the age of 65 who leave hospital frail.
Participants attend virtual sessions three times a week in the first month, twice a week in the second month, and once a week in the third month. Those unfamiliar with the technology are given a tablet and instructed how to use it before they leave hospital.
The hope is that, by tapering off the support, participants gradually form healthy habits that they will continue to follow afterwards. This could prevent them needing to return to the hospital in future.
Raymond Jones, 85, was admitted to Southampton General Hospital with back pain and had surgery to remove gallstones that were blocking a duct in his gall bladder. After his operation, Samantha Meredith, a Research Fellow in Dr Lim’s group, asked if he would like to take part in a 12-week study.
Since a previous operation on his knee five years ago, Raymond has been unable to drive and had to give up golf, which he used to do three times a week. He was therefore keen to maintain as much strength and independence as possible this time, and so agreed to take part.
The hour-long online sessions started at 11am. He did them in a room upstairs in his own home. He says he enjoyed taking part, particularly as it was not only a chance to exercise but also to socialise.
“I felt much better when I got up there with them, because there were about four or five of us at a time, and we’d all have a giggle,” says Raymond.
“There was an old lady, she found it hard to walk. I said ‘Hold on, haven’t I seen you before? Weren’t you in the Southampton Marathon – you won it, didn’t you?’ And of course, everybody laughed.”
In his last session, Raymond spoke to his instructor about problems he’d been having with his balance when he was walking. The instructor asked him to try a particular exercise for it.
“It surprised me what happened,” he says. “I managed to get my balance.”
Raymond has now finished taking part in the trial, but continues to stay active. He enjoys gardening, walks to the shop every day with a stick, goes on his exercise bike regularly, and continues to do the exercises he was taught during the sessions.
“I’m doing everything they’re telling me to do, which I think is a good thing,” he says.
Raymond recently became a great grandad. As we end the call, he says he’s off to go and meet his new great grandson.