Cardiac rehab: What patients desperately need is graded exercise


Health clubs could offer short-term ‘rehab memberships’


resistance and is off-load bearing, allowing people to immediately do things they couldn’t do on land. Swimming itself is not generally recommended, however, since this involves trunk torsion, which can compound injuries. After a while, they can progress to land training, with exercise options including pilates. Staff don’t need any special training to


oversee this, as it’s a set protocol and a set plan which patients need to follow. There is, however, an opportunity for personal trainers to get involved, especially when patients progress to exercising out of the water. Yet in spite of this obvious opportunity,


hydrotherapy is still effectively non- existent in this country. Traditionally it takes place in a few depressing physiotherapy departments, in ancient pools built in the 1960s, and with mind- numbing regimes. Certainly generalised aquarobics and swimming are widespread, but off-weight-bearing programmes of rehab are scarce. But it’s both inexpensive and vital in the early recovery of patients with a wide variety of orthopaedic and spinal problems. It can be the therapeutic bridge to the beginnings of recovery and mobilisation, rather than patients foundering in pain because their ‘land- based’ programmes are too advanced for their level of recovery. The Germans have made an art of it, with equipment such as underwater steppers and resistance jets. But we can use fairly simple equipment, including children’s swimming aids and Aquajogger fl oat belts that allow people to walk and run in the water.


integrated approach I feel the future heralds combined medico-fitness facilities, staffed by allied medical and exercise prescription professionals working together.


july 2010 © cybertrek 2010 Saying that, in my


experience, having GP clinics in health clubs doesn’t tend to work, because people don’t think of going to their gym if they’re ill. It’s also not good to bring germs into that environment. However, it could be really benefi cial to have specialist GPs – those with expertise in, for example, sports injuries – spending a day a week at the club, with members referred to them as appropriate; Nuffi eld Health is already starting to bring this in. GPs could then use the health club facilities instead of referring to ageing physio departments, while PTs – many of whom have sports science degrees – would be provided with an exciting new challenge. It would also homogenise the whole process, as everyone involved in an individual’s rehab would be able to easily communicate. This leads into another area: clubs


offering ‘rehab memberships’. Nuffi eld already offers rehabilitation memberships to people who just need its services for a short while. However, people are then more likely to stay as members if going to the gym has helped fi x their knee, and they’ve lost three stone into the bargain.


cardiac rehab Though it’s a step up and conceptually more frightening, cardiac rehab is also a massive market for gym operators to tap into. There are many cardiac, diabetic or hypertensive patients out there with very little knowledge of what they’re able to do exercise- wise. They fear climbing stairs and even making love. These are scared people, so retention is high. Graded exercise is what they desperately need and yet, in a


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