As occupational therapists, our profession is based around the basic tenet that occupation influences people’s health and wellbeing, with occupational therapy having the potential to be a health promoting profession (Wilcock 1998). But do we see ourselves as health promoters in our work roles, and if so, what does this mean?
At least 60% of occupational therapists in the UK work in the NHS or adult social care (Health & Care Professions Council 2021), and current pressures on these services have been highlighted through the Royal College of Occupational Therapists’ recent survey (RCOT 2023). Taking all of this into account, it can feel that promoting the health of service users and the wider population through physical activity is a ‘nice to have’, another thing we need to add into our already incredibly busy everyday work as occupational therapists.
But what if it could be different?
What if when you thought about where an occupational therapist works, you thought of a leisure centre, or a golf club, instead of a hospital or clinic? What if knowledge of the benefits of physical activity was embedded in our practice, so it became second nature for this to be part of a standard occupational therapy assessment or intervention?
Seems like a distant dream?
It’s already happening here in the UK! Community Interest Companies (CICs) such as Sport for Confidence, and Golf in Society, are already tackling health inequalities by supporting access to opportunities for physical activity, and building wellbeing, belonging and connection into their communities. An example of this work includes the Prevention & Enablement Model (PEM), a joint initiative between adult social care, Active Essex and Sport for Confidence, which evidences the value of occupational therapy in promoting the health of population including those in care homes and people with learning disabilities. More information on this project can be found in the ‘More Resources’ section below.
For those of us working in statutory services, we can support our service users to consider physical activity by increasing our knowledge of the benefits of movement …
Firstly, let’s define what we mean by physical activity, and talk about what the current guidance for how much physical activity we need. The World Health Organisation (WHO) defines physical activity as:
‘any bodily movement produced by skeletal muscles that requires energy expenditure. Physical activity refers to all movement including during leisure time, for transport to get to and from places, or as part of a person’s work. Popular ways to be active include walking, cycling, wheeling, sports, active recreation and play, and can be done at any level of skill and for enjoyment by everybody.’ WHO 2022
What are the benefits of regular physical activity? WHO (2022) states that ‘physical activity is proven to help prevent and manage noncommunicable diseases such as heart disease, stroke, diabetes and several cancers. It also helps prevent hypertension, maintain healthy body weight and can improve mental health, quality of life and well-being.’
And how much physical activity is recommended on a weekly basis? Here are the WHO (2022) recommendations for children and adults:
Children and adolescents aged 5-17 years
- should do at least an average of 60 minutes per day of moderate-to-vigorous intensity, mostly aerobic, physical activity, across the week.
- should incorporate vigorous-intensity aerobic activities, as well as those that strengthen muscle and bone, at least 3 days a week.
Adults aged 18–64 years
- should do at least 150–300 minutes of moderate-intensity aerobic physical activity;
- or at least 75–150 minutes of vigorous-intensity aerobic physical activity; or an equivalent combination of moderate- and vigorous-intensity activity throughout the week
- should also do muscle-strengthening activities at moderate or greater intensity that involve all major muscle groups on 2 or more days a week, as these provide additional health benefits
- as part of their weekly physical activity, older adults (65+) should do varied multicomponent physical activity that emphasizes functional balance and strength training at moderate or greater intensity, on 3 or more days a week, to enhance functional capacity and to prevent falls.
In addition, for all age groups, the World Health Organisation recommends limiting the amount of time spent being sedentary.
Back to our focus on occupational therapists as promoters of physical activity … There’s a lot of support from our governing bodies on increasing access to physical activity for clients and communities. The World Federation of Occupational Therapists (WFOT), in its statement in response to the Physical Activity Strategy for the WHO European Region (2016), states:
‘Occupational therapists are experts in adapting and grading activities and environments to help remove barriers and facilitate full participation and satisfaction in physical activities.’ (WFOT 2015).
This document also states that OT member organisations, as well as OTs themselves, should be involved in advocacy, supporting access to physical activity:
‘WFOT and its European member organisations are deeply committed to working with governments at all levels, non-governmental organisations and clients to promote societal change and increase physical activity across the life course.’ (WFOT 2015)
This advocacy is very much needed due to the health inequalities that are present in our communities. Focusing on England, Sport England have produced their 10 year vision for reducing health inequalities through sport and physical activity, called ‘Uniting the Movement’. This aims to create more connected, equal and inclusive communities. Check out the ‘more resources’ list below for further information.
In this #OTalk, members of the @MovingOTs account will invite participants to discuss their own experiences of physical activity as part of occupational therapy practice. The @MovingOTs Twitter account is run by members of Sport for Confidence’s National Team, who sharing the learning from Sport for Confidence’s delivery model with organisations from health, sport and leisure; connect OTs to harness good practice; and co-produce training and resources with healthcare organisations and higher education institutions for embedding physical activity into practice. We look forward to seeing you for the #OTalk we’re hosting on Tuesday 27th June 2023!
Here are the questions we’ll be considering during the #OTalk:
- Are you promoting health through physical activity in your OT practice? If so, how?
- Have you come across any barriers or downsides to including physical activity in your practice?
- What evidence are you aware of, that supports using physical activity as part of occupational therapy practice?
- At Sport for Confidence, we have a huge focus on co-production. What do you understand by the term ‘co-production’, and how do you use it in your practice?
- What questions do you have for the Sport for Confidence and MovingOTs team around tackling health inequalities through physical activity?
More Resources:
Sport England (2021) Uniting the Movement. Sport England, London. doi: https://sportengland-production-files.s3.eu-west-2.amazonaws.com/s3fs-public/2021-02/Sport%20England%20-%20Uniting%20the%20Movement%27.pdf?VersionId=7JxbS7dw40CN0g21_dL4VM3F4P1YJ5RW
PEM Evaluation Consortium (2022) Prevention & Enablement Model Evaluation Report. PEM Evaluation Consortium, Essex. doi: https://www.sportforconfidence.com/_webedit/uploaded-files/All%20Files/Prevention%20and%20Enablement%20Model%20-%20Evaluation%20Report%20-%20Sport%20for%20Confidence%20Active%20Essex%20%20Adult%20Social%20Care%20at%20Essex%20County%20Council.pdf
References
Health & Care Professions Council (2021) HCPC Diversity Data Report 2021: occupational therapists. HCPC, London. doi: https://www.hcpc-uk.org/globalassets/resources/factsheets/hcpc-diversity-data-2021-factsheet–occupational-therapists.pdf
Royal College of Occupational Therapists (2023) Occupational therapy under pressure: Workforce survey findings 2022–2023. RCOT, London. doi: https://www.rcot.co.uk/sites/default/files/Workforce%20survey%202023%20-%20Demands%20and%20impacts.pdf
Wilcock, A. A. (2006) An occupational perspective of health (2nd Ed.). Slack, Thorofare NJ.
World Federation of Occupational Therapists (2015) Statement in response to EUR/RC65/9 Physical activity strategy for the WHO European Region 2016 – 2025. WFOT, London. doi: https://www.wfot.org/assets/resources/WHO-EUR-RC65-9-Statement-020915.pdf
World Health Organisation (2016) Physical activity strategy for the WHO European Region 2016–2025. World Health Organisation, Copenhagen. Doi: https://apps.who.int/iris/bitstream/handle/10665/329407/9789289051477-eng.pdf?sequence=1&isAllowed=y
World Health Organisation (2022) Physical Activity. World Health Organisation, Geneva. Website accessed on 22.5.23, available at: https://www.who.int/news-room/fact-sheets/detail/physical-activity
OTalk 