Exercise on Mental Health Wards: The Covid Challenge

Lockdown has been tough on many groups of people in the UK, and the impact on the mental health of the nation – in both young and old – has been widely documented.

One issue that we at Rugged have seen at ‘almost-first-hand’ (social distancing doesn’t make these things easy) is the impact of Covid on the lives of patients in residential mental health units.

A number of NHS Mental Health Trusts have invested in CardioWalls for their wards, and we’ve been fortunate enough to speak recently to the staff themselves about how Covid has affected their service users.                     

The Importance of Exercise  

Physical (and mental) exercise plays an essential role in mental health care. Benefits include improved mood, increases in physical fitness and strength, a slow to cognitive decline and a delay to the onset of certain diseases. The NHS has a responsibility to patients in its care to ensure that they have access to regular physical exercise, and furthermore to be filling a significant proportion of their time (around 25 hours per week) with ‘meaningful activity’ – or in other words, not to leave them staring at a screen for hour upon hour every day.  Indeed, Mental Health Trust managers have specific measures – and potential financial penalties – based on these goals.

Lockdown, with its restrictions on both outdoor and indoor group activities, has been particularly hard on those people recuperating in mental health units across the country: no more group football, no more cycling or walking trips, and no more sociable gatherings in the gym to raise the heartbeat and lift the spirits. And in many hundreds of secure units across the country, where for their own safety patients cannot venture out unaccompanied, the practice of staff accompanying small groups of patients to the gym elsewhere on site has also had to stop or been significantly curtailed.  

So, you can imagine how, for CardioWall-owning MH units across the country including in Sheffield, Cambridge and Bodmin, the ability to give patients an in-ward, easily accessible and actively enjoyable exercise solution has been something of a godsend. 

Why the CardioWall?

The CardioWall requires minimal staff supervision, very little training, and, in the words of Gargi Srivastava, Head of Inpatient Physiotherapy at Sheffield HSC Trust, “everyone gets something out of it”.   It can fit into a corridor, an alcove or a small room or office. Unlike most gym or fitness equipment, a CardioWall can be squeezed into almost any ward without major effort or disruption, where it will be accessible to all in-patients whenever they want it or need it. 

You might wonder who benefits most from using a CardioWall. In our experience, we’ve found that different groups gain different, but equally valuable benefits.

Who can Benefit?

Young adults enjoy the full physicality of the workout, and they can use it to let off some steam. Focusing your mind on playing a game, while engaging in vigorous, high-energy workouts (hitting the lights as fast as possible) is a highly effective combination for stress relief and anxiety reduction.

Older adults can enjoy using the CardioWall, regardless of their level of frailty, as it is suitable for users of wheelchairs, walking frames and other mobility devices. Games can be played using only the lower half of the wall, providing a full experience for seated users. And over time, we’ve seen significant improvements in confidence, balance and mobility of older people. We’ve seen the same range of benefits in dementia wards, with a reduction in the symptoms of Alzheimers and other brain degenerative conditions.

And in more secure units and acute wards, exercise can be crucial for those who are struggling with anxiety, depression or very low confidence, yet – especially during the pandemic – exercise may not always be available.  The CardioWall changes this, giving service users the distraction of physical activity combined with the mood-boosting sense of achievement as they score points for their efforts.   

In Sheffield, for example, they’ve seen some quite dramatic transformations in patient wellbeing.  Lead physio Gargi Srivastava described one such case:

“We have a lady on one of our wards who’s in her 60’s, with mild dementia and very low confidence. She had no appetite for the gym, but within 2-3 weeks of using the CardioWall her confidence grew and she was able to start joining in with group activities.  For her it’s given a major and confidence boost.”

Social Impact

There’s a notable social impact too.  The gentle competition provided by the CardioWall promotes a sociable environment, which will further flourish post-Covid.  And this fun activity builds bonds between service users and staff, providing an outlet to relieve stress and frustration, building confidence and improving mood along the way.

Overall, the CardioWall has enabled mental health patients to get physical exercise during a very difficult time, and in the process made life easier for the highly pressured ward staff too. It’s a version of exercise, combined with some cognitive challenge and gameplay for added motivation, that has met with near-universal appeal.

To quote the US National Institute On Aging: “If exercise could be packaged in a pill, it would be the single most widely prescribed and beneficial medicine in the nation”. And for those Mental Health patients for whom the pandemic has been particularly unforgiving, we’ve been delighted to see how true this is. 

by Harry Stevens

References:

https://www.euro.who.int/__data/assets/pdf_file/0018/403182/WHO-Motion-for-your-mind-ENG.pdf