270 Tackling Chronic Disease Burden and Building Resilience in Frail Community Populations in an Integrated Model- the ExWell Project

Abstract

Abstract Background ExWell is a research validated, large scale, community-based chronic illness rehabilitation service. It is a collaborative project between local acute hospital, community organisation, local authority, and exercise medicine specialists. The mission of ExWell is to transform the lives of people with chronic illness through Physical-activity based rehabilitation. Participants are medically prescribed to the ExWell program by hospital physicians or their GP. Methods Referred participants have a two-day induction which includes strength and fitness testing that are covered by key metrics - hip/waist ratio, BMI, grip strength (upper body strength), sit to stand time for 10 repetitions (lower body strength), 6 minute time trial and posterior chain flexibility. These metrics are retested in 3 and 6 month intervals to assess progress. Participants are instructed on exercise technique and class fundamentals. These comprise of 4 stations (1) strength/resistance training; (2) Aerobic conditioning; (3) Balance/core strengthening; and (4) Dynamic movement. The regular full class comprises of 10min warmup, 40minute exercise and 10min cooldown. Results Since its inception in May 2018, ExWell based in the local leisure centre has grown exponentially with classes having tripled to 6 pw, with a further 3 classes pw starting in May 2019. Over 600 referrals have been received in the first year, 85% of these were from hospital services. Approximately 400/600 of referred participants were inducted into classes. Reasons for non-induction include diminished motivation, transport, work commitments. The average attendance each week is approximately 150 visits with an age range 27-92 years. (Average 68.3 years with 63.5% over the age of 65 and 10.7% over the age of 80). Conclusion ExWell demonstrates a scalable integrated partnership model for delivering sustainable exercise based programs to target chronic illness and frailty in community populations. Next steps include consolidating the ExWell program here and in two partner sites, with subsequent expansion to other areas.