- Exercise is an important part of MS care but often healthcare providers don’t feel confident or have the skills to deliver exercise programmes.
- This study assessed the Behaviours towards Aerobic and Strength Exercise in MS programme (BASE-HCP) to improve healthcare providers’ confidence and skills in delivering exercise programmes by telehealth.
- Healthcare providers’ confidence, skills and knowledge improved greatly, but they need support to keep using their skills in this part of MS care.
Exercise is important in managing MS but healthcare providers worry about delivering it
Exercise is an important part of MS care, improving both physical and mental health. However, at least four out of five Australians living with MS are not getting enough exercise to improve their health.
People with MS often prefer to get advice about exercise from healthcare providers. But many healthcare providers don’t feel confident or have the knowledge or skills to deliver exercise programmes to people with MS. This includes providers who are normally considered experts in exercise, such as physiotherapists and exercise physiologists.
What is the Behaviours towards Aerobic and Strength Exercise in MS programme (BASE-HCP)?
The BASE-HCP is a programme that trains healthcare providers on delivering exercise programmes by telehealth. It was co-designed by Australian physiotherapists and a person with MS to improve confidence, knowledge and attitudes towards telehealth-delivery of exercise programmes to people with MS.
The BASE-HCP is made up of an online theory component and a 16-week practical component where healthcare providers delivered exercise programmes to people with MS.
What did the researchers do?
MS Australia-supported researchers led by Professor Yvonne Learmonth, recruited 40 healthcare providers (physiotherapists and exercise physiologists) to take part in the BASE-HCP. The researchers surveyed the healthcare providers over the course of the programme and afterwards, on their confidence, knowledge and attitudes towards delivering exercise programmes. Providers were also surveyed on their quality of life.
Healthcare providers were surveyed four times: just before they started the BASE-HCP, right after the online theory component, after the 16 weeks of working with people with MS and then a year after starting the BASE-HCP.
What did the researchers find?
The researchers found healthcare providers who participated in the BASE-HCP greatly improved their confidence in delivering exercise programmes by telehealth each time they were surveyed compared to when they started the BASE-HCP. The improvements were large, by two-and-a-half times at the time they finished the theory component, to more than four-and-a-half times by the end of the BASE-HCP and 12 months from the start of the programme.
However, the improvements plateaued over the last three surveys, showing that the bulk of the improvements were from the start of the programme at Survey 1.
Healthcare providers’ belief in their skills for delivering exercise programmes to people with MS improved over the 16 weeks period. There was also a trend towards improved quality of life in terms of reducing professional burnout.
Healthcare providers were highly satisfied with the BASE-HCP. However, after 12 months healthcare providers had a large drop in using many of the behaviour change techniques for delivering exercise programmes.
What does this mean for people with MS?
Improving healthcare providers’ confidence and abilities to deliver exercise programmes and by telehealth provides a model to improve access to an important part of MS care. This is especially important for people with MS who live in remote locations or who are unable to or not comfortable with attending an exercise programme in person. Better-trained healthcare providers and more of them could help deliver better quality care to more consumers, improving health management for people with MS. There is also potential to expand the BASE-HCP to a broader range of providers such as nurses and occupational therapists.
The BASE-HCP improves healthcare providers’ knowledge, confidence and abilities in delivering exercise programmes to people with MS by telehealth. But healthcare providers also need support and continuing education to keep using these new skills in this part of MS care.
