Background: Physiotherapists’ play a key role in the management of chronic pain, and as part of the National Institute for Health and Care Excellence (NICE) guidelines, prescribe exercise to support patients with chronic pain. However, there is very limited evidence supporting physiotherapists on what type of exercise or dose of exercise should be prescribed. Physiotherapists’ therefore have more onus on their ability to clinically reason how to prescribe exercise. At present, there is no research investigating how physiotherapists’ working with patients that have chronic pain, clinically reason when prescribing exercise. This study proposes to investigate how physiotherapists experienced in pain management prescribe exercise, to understand what the key influences are on their reasoning, and how these impact on clinical practice. Methods: This will be a qualitative study, utilising semi-structured individual interviews. Participants will be Health and Care Professions Council registered physiotherapists, working predominantly with patients that have chronic pain. Recruitment will focus on physiotherapists working within the United Kingdom (UK). Up to twenty participants will be recruited. The study, including the interview guide, will be supported by a steering group consisting of academics and physiotherapists experienced in chronic pain. The data will be analysed using framework analysis. Results: The study will be reported using the COnsolidated criteria for REporting Qualitative research (COREQ) guidelines. The findings of the study will be disseminated through publication in a peer reviewed journal. Conclusion: This study will provide novel insight into how physiotherapists experienced working with and managing chronic pain patients, prescribe exercise, and will gain new insight into clinical practice to help inform future research and education.

Introduction: Despite an established evidence-base for cardiac rehabilitation (CR) improving functional outcomes and quality of life and reducing re-hospitalisation, there is limited research on CR for older cardiac patients, who require rehabilitation the most, as they are often very deconditioned due to aortic stenosis (AS). CR uptake in the UK is limited to 52% with national variability of provision and accessibility, and it is a national priority to increase uptake to 85%. Frequently, research has excluded older populations as they are deemed to be too frail or generally not suitable for inclusion. This study aimed to explore factors that can impact the uptake of CR in octogenarians. Methods: Qualitative interviews were carried out with 20 AS patients (12 female, 8 male), from a large NHS Trust in the North East of England. Results: Four main themes were identified in the data: Perceptions and Understanding, Delivery and Accessibility, Perceived Impact of Exercise and Health and Life Changes, and Transportation. Discussion: The findings suggested that the major factors were the understanding of the nature, purpose and relevance of CR to older patients, whether CR was offered, and the role of social support. Barriers and facilitators can impact uptake based on the mode of delivery and the individual circumstances identified. Future research could explore how to develop CR programmes that overcome the barriers identified in the research, such as education, monitoring strategies, use of telehealth, and home-based elements to create an acceptable and accessible programme for octogenarians.

To examine the effectiveness of Pilates on fatigue, quality of life and physical function in persons with chronic conditions and explore potential intervention moderators. PubMed, SPORTDiscus, AMED and CINAHL were systematically searched from database inception to September 2024, to identify relevant studies. Two independent reviewers screened and selected the articles and evaluated methodological quality. Studies were included if they were randomised controlled trials of Pilates to improve fatigue in persons with chronic conditions. Eighteen studies involving 812 participants were included. Pilates had a significant effect on fatigue, quality of life and physical function. Meta-analyses showed Pilates had significant effect on physical function [Hedge's g = 0.85 (95% CI: 0.30; 1.40), p = 0.01] but the effects on fatigue [Hedge's g = -0.43 (95% CI: -0.96; 0.11), p = 0.12] and quality of life [Hedge's g = 0.49 (95% CI: -0.40; 1.37), p = 0.28] were not significant. Interventions with smaller duration (6-8 weeks) influenced Pilates effect on fatigue. The type of chronic condition and control did not influence effect. Pilates has beneficial effects on physical function and may help reduce fatigue and improve quality of life in persons with chronic conditions. Pilates exercises used in rehabilitation settings can influence health outcomes.

Aim: The COVID-19 pandemic led to an unusually fast pace of change in clinical practice in the UK. An early requirement to reduce outpatient attendances to a pminimum meant that this Trust adopted remote consultations for fracture clinics whenever possible. This study aimed to evaluate patient satisfaction with the new system of telephone consultations to assess its acceptability and guide future decisions. Method: 299 patients who received remote telephone consultations for fracture clinic appointments at North Bristol NHS Trust during the COVID-19 pandemic in early 2020 were retrospectively identified and sent a postal survey. Satisfaction levels were assessed through degree of agreement with statements (9 items), yes/no answers (4 questions) and space for comments. Data was analysed with Excel pivot tables and Chi-squared tests. Results: 131 survey responses were included (43.8% response rate). The majority of patients were satisfied overall with the care they received (82%) and preferred a telephone consultation to a face-to-face appointment during the pandemic (78%). However, only 22% maintained this preference in ‘normal’ (pre-COVID-19) times. Conclusions: The positive responses to the survey reassure us that telephone consultations for fracture clinic consultations are acceptable to the majority of patients during a pandemic. The results as well as free text comments will help us ameliorate the fracture clinic service to minimise infection risk without compromising on quality of care.