Authors (including presenting author) :
Ho WHC (1), Cheung WT (1), Lo TM (1), Lau FO (1)
Affiliation :
(1) Physiotherapy Department, Tai Po Hospital
Introduction :
Individuals with severe mental illness (SMI) have a reduced life expectancy, which is largely attributed to poor physical health. They are in general physically inactive which may be due to negative symptoms of the illness, side-effects of medications and lack of motivation. One of the contributed factors which are potentially modifiable is to encourage people staying active with exercise. Thus, exercise should be recognized as an important component of psychiatric care to manage their physical health. Even though majority of people realize the benefit of exercise, they often encounter difficulties to make exercise as a daily habit. The obstacle may be due to difficult in self-monitoring, translating initial motivation into sustained behavioral change. Hence, physical activity, like walking, is recommended as it may be a feasible method to reduce sedentary behavior and easily to integrate into their daily schedules. Physiotherapy department of TPH provides different exercise programs in psychiatric in-patient setting and helps them to build up exercise habit during hospital stay. Post-discharge “Move and Get Idealized Changes (MAGIC)” program is designed to move one step forward, to consolidate the long term exercise habit and extend the benefit of exercise out of hospital.
Objectives :
To consolidate the long term exercise habit and extend the benefit of exercise out of hospital, promote active lifestyle with exercise.
Methodology :
Patients who discharged from in-patient psychiatric physiotherapy service of TPH were encouraged to join the “MAGIC” program. A pedometer was given, as a mean for self-monitoring and encouragement. They were encouraged to walk more than 5000 steps daily and do other forms of exercise. The “MAGIC” program lasted for 6 weeks and weekly phone follow-up were conducted after discharge aiming at promoting self-awareness, encouraging active lifestyle and providing support for patients continuing to stay active after discharge. Readiness ruler, steps count, quality of life (using WHO-5 well-being index) were taken at baseline, 3 weeks and end of program.
Result & Outcome :
20 patients had completed the program. Their daily step count increased significantly from 6438±5867.4 to 10150±4870.7 (p<0.001). The readiness ruler (0-10) slightly raised from 7.3±1.5 to 7.6±1.4 (p=0.358). WHO-5 well-being index also improved from 15.3±5.2 to 16.5±3.8 (p=0.355). 60% of patients reported they tried other forms of exercise, like swimming, jogging, light aerobic exercise and stretching after discharge. The result was encouraging that psychiatric patient can extend their exercise habit after discharge from hospital. MAGIC Program is a good start empowering psychiatric patients to consolidate their long term exercise habit out of hospital and hopefully extend this benefit as a protective factor after discharge.
