NHS Prehab Fitness Programmes
The NHS is piloting fitness programmes with patients who have received a cancer diagnosis, as discussed in a recent article published in The Guardian. The initiative is based on a growing research base that shows effective prehabilitation can improve clinical outcomes – including improved survival rates, greater tolerance to radical treatments and a reduction in post-operative complications. Ultimately, this leads to reduced time spent in hospital and the need for later readmission.
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 evidenced in similar programmes, such as cardiac rehabilitation, where uptake sits at around just 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 new 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 guarantees that physical activity is accessible to everyone – with no barrier to age or mobility. Each of us has ~112 waking hours per week and this affords a vast opportunity for functional everyday movements to occur at varying intensities, simply as a part of your 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, if not better, results when understood and personalised to the individual. Moreover, this innovative approach will empower sustainable behaviour change and enable long term self-care. This 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. Ultimately, this opens up physical activity to the whole population and allows individuals to find value in their everyday movements.
At KiActiv® we have proven the effect of 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 evidence-based science to provide an understanding of actionable personalised everyday physical activity, and this quantitative and qualitative data also delivers transparency for measurable outcomes. We are re-establishing an understanding of everyday physical activity, and challenging the narrative that it needs to be sweat-inducing and uncomfortable to elicit effective health benefits. The success of our online programme also highlights the importance of personalisation and learning to self-manage your activity levels outside of a gym or clinical environment.
