On the move with Exercise Alley

Patients at the Royal Alexandra Hospital in Paisley are being supported to be active before and after surgery.

Our dementia friendly strength and balance panels are a great addition to Exercise Alley

Known as Exercise Alley, Ward 24 features a 60m signposted walking circuit and our strength and balance wall stickers to encourage patients to get out of bed, walk and move more during their time in hospital.

The aim is to help patients recover faster, return home sooner and then continue to enjoy the physical, mental and social benefits of being active in their community.

The work has been done thanks to a partnership between NHS Greater Glasgow and Clyde, Macmillan Cancer Support, Renfrewshire Leisure and Paths for All.

Ruth Miller, Macmillan Health and Wellbeing Lead at Renfrewshire Leisure, and Jane Porteous, Enhanced Recovery Nurse at Royal Alexandra Hospital, have been working to improve the physical activity pathway for people undergoing surgery.

Patients receive support to optimise their health prior to surgery, including access to free physical activity classes. After surgery, patients are supported in their rehabilitation in ward and with continued support via an onwards referral into Renfrewshire Leisure Community Services which includes group exercise classes and community Health Walks.

Jane and her team support patients on Ward 24 to get mobile as soon as possible after surgery. Key elements of this are:
• providing structured physical activity on the ward - Exercise Alley is a 60m waymarked walking circuit with eight strength and balance exercises
• a daily walking chart on the wall where patients add their initials and mark the number of times the circuit is completed each day. This can foster a bit of friendly competition between patients and helps staff to keep track of progress
• asking patients to bring leisure wear and comfortable shoes to hospital
• changing the culture of “rest is best”; staying in PJs or hospital gowns is discouraged
• supporting patients with pain control to aid mobility
• encouraging patients to try to do things for themselves and get mobile
• all staff on this ward are confident to prescribe physical activity.

Previously, just a few of the more able patients received this physical activity support, but now everyone is getting involved.

Jane said: “Exercise Alley is being put to good use here on Ward 24. Patients who are stepping down from the high dependence unit are encouraged to participate in circuits then progress to adding one or two of the strength and balance exercises to their laps. 
“It really is of great benefit to the ward and our patients’ recovery.”

Ruth has identified that “a familiar face is a key enabler to supporting someone successfully throughout this physical activity journey and encouraging sustained behaviour and lifestyle change, beyond the hospital stay".

She added: "The social aspect of group exercise classes and Health Walks once patients have left the hospital are important too."

Maggie Clark, Emergency Laparotomy Nurse, also supports her patients on the ward to use Exercise Alley. 

She said: “The strength and balance exercises really help as patients can build up and gradually increase their goals. It’s a structured way for patients to build confidence in their own ability to live independently again.”

Daren Borzynski (47) from Dumbarton was a patient in Ward 24 in December 2019 following surgery for a perforated bowel.
Six days after surgery, Daren started taking to his feet, slowing increasing his step count from 100 to 8000 a day.
He said: “One of the things for me was that I wasn’t just sitting dwelling on things, I was getting up and active and enjoying the walks.
“During one of the laps, I noticed the strength and balance stickers. It was a great prompt. It was great to see Paths for All doing this kind of thing in a hospital. The exercises were great. I knew that if I was sitting down getting blood or hooked up to an IV drip, I could do leg raises at the same time.“With encouragement from the ward staff, I could feel my health, strength and especially my mental health improving.”

Professor Susan Moug, consultant surgeon at RAH, is a champion for promoting positive lifestyle change with patients and has supported the exercise alley programme every step of the way.

She said

Patients and hospital professionals are now seeing physical activity as an essential part of the surgical pathway. We engage early with our patients at diagnosis, through treatment and into the community, to support them to get more active. We continue to work together (hospital and community) to ensure what may be a daunting experience is seamless for the patients. In addition to empowering patients to guide their own care - which they like - we believe that increasing activity levels is essential to improve pre-operative, post-operative and long term outcomes.

The team at Royal Alexandra Hospital have plans to expand the Exercise Alley programme and these include:
• creating a more challenging walking and strength and balance circuit in the hospital setting as a progression from Exercise Alley.
• improving and promoting outdoor walking routes in the hospital grounds
• strengthening community links for emergency laparotomy patients, who don’t currently receive the pre and post-surgery support
• replicating this physical activity pathway in other locations and within disciplines

For more information on this programme and the resources used, please contact:
Zoe Niven, Senior Development Officer, Paths for All

Ruth Miller Renfrewshire Leisure

Susan Moug  NHS Greater Glasgow and Clyde