RNHRD Rehabilitation Programme

Standard 2-week rehabilitation programme

The Royal National Hospital for Rheumatic Diseases in Bath (RNHRD) has a long tradition of providing excellent clinical care for axial spondyloarthritis (axSpA) patients. We run a specialist axSpA rehabilitation course; whereby, the aim of this course is to promote self management and provide patients with the resources to optimise their health.

The AS course aims to help:
- People with a new diagnosis of spondyloarthropathy (mainly axial spondyloarthritis, but also psoriatic spondyloarthritis, undifferentiated spondyloarthritis and inflammatory bowel disease associated spondyloarthritis)
- Those experiencing a flare of their condition
- Post surgery. For example after hip replacement
- Maximise outcome on anti-TNF therapy

The programme is provided at three different levels of intensity to cater for different levels of disease severity and functional ability. People who go on the course are usually accommodated in flats close to the hospital. However, at present, the course is running virtually via Zoom. Groups are made up of a maximum of 12 patients, and for people for whom group management is not suitable, the option of hospital admission for individualised treatment is usually available.

The programme is run by a multidisciplinary team, which includes:
- physiotherapists
- consultant
- rheumatologist
- occupational therapist
- counsellors
- pharmacist
- dietician
- health care assistants
- administrator

The programme is largely delivered by the physiotherapy team who supervise the exercise and hydrotherapy sessions and provide the majority of the education sessions. Each person on the course is reviewed by the consultant rheumatologist on a weekly multidisciplinary ward round where individual progress on the course is discussed and any issues around medications, investigations and complications of disease are dealt with. The other health professionals on the team provide group and, if needed, individual sessions on their specialist areas over the course of the two-week programme. This is done in a number of ways:
- Education – helping people learn about their disease and the best way to manage it
- Exercise – reducing pain and stiffness, maintaining erect posture and preserving mobility through graded exercises and stretches
- Pain management – developing pain management strategies
- Networking – giving people with axSpA the opportunity to meet, learn from and work with others with axSpA

Virtual axSpA rehabilitation programme

Whilst social distancing measures remain in place for COVID-19 we have created a virtual AxSpA Rehabilitation Programme. The aim of the course is to provide you with education and self-management strategies to empower you to feel in control of your condition.

How it works
The course is run over seven days, split into two sections, with a maximum of eight participants per group. The first section is run Monday to Friday, there is then a week's break and the second section runs on the following Monday and Tuesday. Each day has a varied mix of learning, including; live educational talks, exercise and stretching sessions. We have spaced the day with regular breaks, and will ensure we pause the talks for some moving time. You will be sent your own Participant Workbook, and there is also pre-recorded material to view in your own time.

We are pleased to be able to maintain our strong multidisciplinary team ethos with input from Clinical Nurse Specialists, a Podiatrist, an Occupational Therapist and our Psychologist. You will also have two consultations with Dr Sengupta, our lead Consultant Rheumatologist. We will conduct some virtual assessments before and after the course to chart your progress. You will then be followed up by a doctor after six months.

If you have attended a previous face to face 'AS course' we hope to have maintained the same themes and believe there is a lot to be gained from this new style of delivery.

How to take part
To be able to take part in the course you will need a computer/tablet and a sufficient internet connection to be able to run Zoom (virtual communication platform).

Accessing the rehabilitation programme

Patients can be referred to this NHS run course by their consultant rheumatologist or by their GP to a rheumatology consultant at the RNHRD in Bath to be assessed for their suitability for the course. Referrals should be made via Choose and Book or in writing to:
Dr Raj Sengupta, Consultant Rheumatologist, RNHRD and Brownsword Therapies Centre
Royal United Hospital NHS Foundation Trust
Combe Park, Bath, BA1 3NG

Further information about the course can be obtained from: Belinda Jones, Course Bookings Administrator on 01225 821349 (belindajones@nhs.net).