Hospital to Community: How Siel Bleu Bridges the Gap


Written by Shane Lee

Siel Bleu’s community based exercise classes can play a major role in bridging the gap from clinical rehabilitation and physiotherapy. Specific exercise classes for patient groups like Arthritis, Parkinson’s, Stroke, COPD and more general strength and balance programmes can increasingly contribute to the overall  health system.

Community based exercise classes will never replace clinical interventions but can as a follow on service to reduce the likelihood of needing clinical intervention again. This is perhaps best illustrated with Chronic Obtrusive Pulmonary Disease (COPD) where many patients with the condition participate in hospital based pulmonary rehabilitation for a cycle of 8 weeks. Patients with COPD respond extremely well to this hospital based intervention through the brilliant work of respiratory specialists. Upon completion of the clinical cycle many patients wish to maintain the level of fitness and aerobic capacity which they have built up. Through joining a local (Siel Bleu Exercise, COPD & Me) class, not only can participants manage their condition and maintain their progress but, they also join a wider social support network of people all experiencing the same challenges in relation to breathlessness, lack of energy and other related challenges.

Strength and balance programme’s can also play a huge preventive role for community dwelling older adults. Many older adults first engagement with the health system in terms of the discussion on falls and being directed towards exercise based interventions is unfortunately after a fall has occurred. Increasingly community classes can help to prevent and halt a potential decline in older adult’s physical strength and balance. Through learning and practising functional strength movements and through safely practising elements of balance, coordination and multidirectional movements the risk of decline in muscle mass, bone density and falls can all potentially be reduced.

While many participants may understand the need to exercise, it is ultimately the sense of community, social engagement and enjoyment that will draw participants back to exercise session’s week in week out. Siel Bleu classes will always focus on functional strength movements, mobility, balance and building up overall cardiovascular endurance but it is the fun that is created within the classes that is so important in a community setting. Incorporating team exercise games and cognitive challenges are two methods in which this balance between exercise and fun can be fused. Having two teams race a piece of equipment with the losing team having to walk or perform squats is a particular favourite amongst groups which not only provides great enjoyment and a fun rivalry between opposing teams but important movements and exercise are the end result of the fun races.

Community exercise classes also must represent the participants themselves and for this reason must include a participant driven approach with appropriate trainer guidance. Particular areas of muscular weakness, daily challenges faced or areas which have been neglected since hospital or physiotherapy sessions can be facilitated and incorporated into classes through engaging with the participants. The work from rehabilitation can be followed and continued in a more relaxed community setting.

Going forward developing stronger pathways and collaborations between different health disciplines can play a major role in the Irish health system. It’s important to be proactive not reactive in facilitating follow on exercise classes related to conditions like Stroke and Parkinson’s which allow participants to build on the foundations of physiotherapists  and not regress after progress has been made over a number of weeks perhaps in a hospital setting. Similarly more general community programmes which are accessible to all and do not require special criteria to join can help create fewer hospital interactions through falls and fractures. Fall prevention classes have become a hugely important topic in the sphere of older adults and health but the interaction before this stage of preventing decline should be considered equally important in these discussions.

Siel Bleu have also begun collaboration with hospital and physiotherapists through exciting new programmes such as Breast Cancer, Young Stroke Survivors and Strength and Balance programmes which have been created through various different organisations and health professionals coming together with the shared goal of creating an exercise class for participants who are experiencing the same rehabilitation journey. The journey does not end after hospital and this is where a follow on community exercise class can play a major role in bridging the return from clinical to normal everyday life.

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