Studying our Wellness Program

The following is taken from a presentation done by Joan Norman, PT, GCS, Gretchen Reid, RNC, FCN and Natalie Mandolfo, APRN who are part of the St. Columbkille Parish Nurse Team.

The presentation was called "A Multidisciplinary Approach in a Faith-based Wellness Program for Seniors Yields Significant Benefits in Physical Function and Balance."

Figure 1



Description:

In 2003 the health and wellness committee at St. Columbkille Church in Papillion, NE began to encourage members to increase their physical activity through participation in two seasonal self-monitored and self-reported walking programs. After several years of evaluating these, the need for a more targeted intervention focused on the older individuals in the church was identified. Physical therapists were asked to join in the planning and implementation of this program and became integral members of this health and wellness team.



Figure 2



Initially there was a once a week exercise program with the participants using pedometers and home exercises to complement it. Most participants did not use weights and could only do 1-3 repetitions of sit to stand. The group exercises included upper extremity (UE), upper back and lower extremity (LE) strengthening and cervical range of motion. Currently elastic bands are used for UE and LE exercises as in figures 1 and 2 and most participants can do 20 repetitions of sit to stand.



Figure 3

 Members were educated in the functional activities or balance components related to the exercises. During the first year of the program a Tai Chi class (figures 3 and 4) was added on two other days of the week to provide a three day per week exercise/activity program. Blood pressure monitoring was offered at each session for those interested.

Figure 4

In addition, education sessions were incorporated to coincide with the monthly senior luncheons. A dietician was brought in to do lectures on heart healthy diet modifications. A physician and a physical therapist each gave lectures on osteoporosis. A health related topic is currently scheduled once per quarter as a result of the exercise program.

Observations:
Attendance for the exercise class has stabilized at 15 to 20 and at the Tai Chi classes between 20 and 30 participants with 55 participants on the roster. The mean age of participants (49 women/8 men) in this program is 68 years old (range 55-85 years old). To assess the impact of the program on participants a modification of the OPTIMAL© instrument was used, incorporating a 10 cm. visual analog scale for detecting change in key physical activities. Participants completed this retrospective self-reporting activity comparison survey looking at 14 of the items from the OPTIMAL© outpatient evaluation questionnaire as community dwelling seniors.

Table 1

The activities demonstrating the greatest percent improvement in performance were balancing and stair climbing (Table 1). Anecdotal improvements have been noted in posture, balance, strength and flexibility by many of the members as well as an improved sense of “well being”. Almost all who have had their blood pressures monitored have had a decrease in blood pressure following exercise or Tai Chi and several have been able to reduce or discontinue blood pressure medication.

Implications:
A multidisciplinary team approach to providing a faith-based community wellness program can have a dramatic improvement on the physical function of older individuals, especially in the realms of balance and stair climbing. Physical therapists are encouraged to be involved in faith-based wellness programs and can play an important role in planning and implementing activities which may be crucial to older individuals maintaining independence and remaining functional in their homes.

Acknowledgements:
Seed grant funding to initiate this program was obtained through the Sarpy Cass County Department of Health and Wellness. Exercise supplies were donated from the Thera-Band division of the Hygienic Corporation and Hillcrest Health and Rehabilitation (Bellevue, NE). The program is now sustained by monies donated to St. Columbkille Church’s senior programs. Dr. Joseph F. Norman, MS PT, PhD, CCS assisted with statistics.