Positioning itself in the final stage of rehabilitation and re-enablement in health and social care, Fit 4 Health has established itself as a 'step-down' service bridging the gap between clinical rehabilitation and community exercise.
Aims of the Programme
- To encourage, engage and increase physical activity levels amongst people who have had a Transient Ischaemic Attack (TIA) or stroke.
- To offset the post-stroke decline in activity tolerance and subsequent risk of cardiovascular disease.
- To reduce social isolation via empowering the risk population to use local parks, sports, leisure and community facilities.
- To encourage, engage and increase quality of life and wellbeing.
The Programme
Each client has an initial assessment to determine risk and mobility.
Staff are able to assess clients’ needs and inform them of the programme content.
Clients are invited to attend a 16 session exercise programme. The maximum intake for each programme is 8-12 per class (1:4 staff to client ratio). Management of staff to client ratio is crucial where clients present with high level needs. Sessions are one hour, which includes a warm-up, cardiovascular component, light resistance exercise, and a cool-down. The format of the training is either gym-based or circuit design depending on the venue or resources.
At the end of their 16 sessions, clients are invited to undergo a final assessment. During this appointment clients are re-assessed for levels of health and wellbeing so that a pre-post comparison can be recorded. Clients are then directed to appropriate exercise choices and encouraged to maintain a healthy and physically active life-style.
Enablement Day events
During each programme, Fit 4 Health clients are offered activities that encourage autonomy, independence and raise awareness of the Borough’s wide ranging services.
Reward/Feedback Day events
Periodically Fit 4 Health clients are invited to attend feed-back/reward events. These social gatherings include refreshments, fun-activities and presentations enabling clients to celebrate their success and also give information that helps to evaluate the programme.
Advanced Sessions
For those clients who may not be ready to engage in independent exercise and require further support, provision has been provided as follows:
- A further 8 weeks of gym activity at a Hackney leisure centre
- A slow-paced mobility walk is held weekly spring to autumn at Clissold Park
- An advanced circuit class in partnership with the Hackney New Age Games programme.
Eligibility criteria
Inclusions
Fit 4 Health
targets people who have had a TIA or stroke, are 18+, reside in Hackney or belong to a Hackney based GP surgery. Clients are to be referred by health professionals. Exclusions
To be checked by the referring health professional:
Clients suffering from the following conditions are not suitable for referral:
i. Uncontrolled atrial or ventricular arrhythmia, uncontrolled sinus
tachycardia (>100/min) or valvular heart disease
ii. Cardiomyopathy, ventricular aneurysm or uncontrolled cardiac
failure
iii. Symptomatic ischeamic heart disease – angina, MI or cardiac
surgery
iv. Hypertension – with blood pressure greater than 180/100
(World Health Org. 1989)
v. Postural hypotension, reduction of BP greater than 20 mmHg
SBP within 3 minutes of standing
vi. Vertigo, unexplained “dizziness” or episodes of loss of
consciousness
vii. Any (current or recent) acute febrile illness e.g. respiratory
tract infections
viii. Uncontrolled asthma or PEF ≤ 50%
ix. Deep venous thrombosis
x. Recent injurious fall without medical assessment
xi. Diabetes -poorly controlled < 4 and ≥ 16 mmol particularly with
ketosis
xii. Uncontrolled visual or vestibular disturbances
xiii. Proven inability to comply with the recommended adaptation to
the exercise programme
xiv. Inability to maintain an upright posture in sitting
xv. Extreme obesity with weight exceeding the recommendations
or the equipment capacity (usually >159kg or 350lb)
How to refer
The following clinicians can refer to this service:
GPs, Nurses, Physiotherapists
Referral methods: e-Referrals, Email
Please visit our website address and complete the online referral form under the heading of how to get involved.
Alternatively print of and complete PDF version and return to darren.english@hackney.gov.uk or send to the postal address at bottom of form.
If you prefer be emailed the referral form in word format this can be arranged.
We will notify referer that we have received the completed client referral form.
On receipt of referral we will contact the client to arrange an initial assessment.
