Prehabilitation: Physical Activity Remains Misunderstood
The recent article published in The Guardian highlights how the NHS is piloting fitness programmes with patients who have received a cancer diagnosis. The initiative is based on a growing research base that shows effective prehabilitation can improve clinical outcomes, which include improved survival rates, greater tolerance to radical treatments and reduced post-operative complications. This can lead to reduced time spent in hospital or need for readmission to hospital.
The prehab4cancer scheme focuses on providing structured exercise classes in conjunction with nutritional advice and mental health counselling, all of which are designed to help the patient make healthier lifestyle choices after receiving their diagnosis and treatment. We welcome this new approach for effective ‘prehab’ as a positive step forward, however it important to note that exercise referral programmes within healthcare pathways are not new, and the challenges of measurable outcomes and the barriers to uptake are well documented. Patient uptake for exercise referral programmes has historically been low, as we can see with similar programmes such as cardiac rehabilitation where uptake sits at around 50% (British Heart Foundation: NACR Report, 2019).
Many people simply do not enjoy structured exercise, and these feelings are intensified when it is only available in an unfamiliar environment alongside other people in group-based settings. Exercise interventions are often based at a leisure centre, clinic or hospital, which also imposes a need for additional travel and time. These issues can create an immediate barrier to engagement, and uptake is often limited to only the most motivated and financially able cohorts.
For this new NHS initiative to be truly successful and inclusive it must also recognise the important role that everyday physical activity can play. Harnessing the power of movement in an individual’s daily routine is accessible to everyone with no barrier to age or mobility. Each of us has ~112 waking hours per week and this provides an opportunity for functional everyday movements to occur at varying intensities, as part of a daily routine. Embracing this concept creates a far greater window of opportunity to benefit from physical activity than structured exercise and it can deliver the same results (if not better) when understood and personalised to the individual. Moreover, this innovative approach will empower sustainable behaviour change and enable long term self-care.
At KiActiv® we have proven this approach over the past 4 years with remarkable results. Our 12-week personalised online behaviour change programme with remote guided mentor support, has witnessed outstanding improvements in levels of physical activity and engagement across a broad demographic. We incorporate the latest technology and science to empower an understanding of actionable personalised everyday physical activity, and this quantitative and qualitative data also delivers transparency for measurable outcomes.
The multi-dimensional theory of physical activity takes the emphasis away from solely focusing on forms of exercise, instead placing equal importance on other dimensions such as non-sedentary time and moderate intensity activity. This opens up physical activity to the whole population and allows individuals to find value in their everyday movements.
We are re-establishing an understanding of everyday physical activity for health benefits and challenging the narrative that it needs to be sweat-inducing and uncomfortable. The success of the online programme also highlights the appeal of personalisation and flexibility of learning to self-care outside of a gym or clinic environment.
