SOME COURSE FEEDBACK FROM PROFESSIONAL TRAINERS IN AREAS COVERED BY THE NECVN

Through my work as a Personal Trainer, Exercise Referral Consultant and Cardiac Rehabilitation Instructor I have trained and rehabilitated clients with a wide range of medical conditions. However, I always felt that my knowledge, skills and therefore confidence, were always lacking whenever I was presented with a stroke survivor. At the time there were no courses available that offered an exercise professional the opportunity to learn these skills.

In July of 2008 I accepted a post as a Stroke Service Improvement Manager for the North of England Cardiovascular Network and took the lead on the Stroke Rehabilitation Project across the North East. Through this work I was able to establish that it wasn’t just me that felt my knowledge and skills in the stroke field needed improving. This was a problem across the region and due to this only stroke patients with a good level of recovery were being able to access Exercise on Prescription schemes around the area.

I was put in contact with Tom and between us we were able to arrange for Tom to come up to the North East to deliver two days of practical ARNI training to 17 qualified Personal trainers from the region. The training was great. It covered aspects of rehabilitation that are really important to stroke survivors being able to gain a better level of independence and help them to cope with day to day tasks (walking up/down stairs, getting up and down from the floor, coping with falls). The exercises were not just practical but also worked in being able to improve the stroke survivor’s strength and balance. Both Tom and Michaela (a stroke survivor who participated in the course) were an inspiration. It was also incredibly useful to see how the techniques we were learning were actually executed by a stroke survivor who had problems with arm or leg paralysis and muscle tone problems.  I’ve come away from the two days training feeling more confident that I have added more skills to back up my professional knowledge that will make a difference to someone’s life.

I’m looking forward to attending the two days theory training at Middlesex University and feel this will help to underpin the knowledge gained through the practical training. I have my own Sports Therapy Business and plan on being able to accept stroke survivors through this means and offer them rehabilitation in the future.

Gail Morris – Stroke Service Improvement Manager (NECVN), BSc (Hons) Sports Science, MSc Chronic Disease Management, Advanced Diploma in Sports Therapy, Personal trainer, Exercise Referral Consultant, Cardiac Rehabilitation Instructor.

The way the practical was very good in terms of being very hands on over the two days as the techniques showed couldn’t just be explained or demonstrated by Tom without practice by us. I would benefit from some visual aids now to assist me with the techniques we were shown. I am currently running stroke and M/S rehabilitation exercise sessions in the community; however, I learnt a great deal of techniques and found it very inspiring. I am looking forward to using these techniques with my current survivors. Having never done any martial arts, I found the movements surprisingly easy to follow. I later tried a variety of movements with a stroke survivor who has been unable to open his hand since I have known him without using his good hand. The ‘opening the hand’ technique worked well and I have done it for the last 3 weeks on him. A course manual that covers equipment, movements, techniques and an actual example exercise programme for a one to one basis and group work is to follow and will help us.

The two days in London were structured well in terms of breaks and lectures. I’m personally unable to take things in / retain information first time round, especially when it has all been in presentations so I need something to read and diagrams to study. I’ve been given a book, a full stroke research review (EBSCR reviews). These are hundreds of pages long, but have been broken down into conclusions so that they are easy to read. We also have a very handy stroke glossary in jpgs and many website names given to us in preparation for the Stroke Knowledge Assessment day in Newcastle in July. The lecture by Dr Alex Nowicky was excellent. I found him very easy to listen to, follow and understand him. He did a great job of putting the information across at a level I understood. The lecture on speech and language, although a good lecture I found it hard to follow and not sure how this could help me within my rehabilitation role. The lecture by Nick Ward was excellent and once again he did a superb job of bringing the information down to the right level in order for me to understand it. The lecture covered many parts for me that had already been mentioned in previous lectures but this clarified my understanding (like the last piece of a jigsaw). Although I took notes, I am now struggling to recall the information which was explained. I hope some of the information can be included in the course manual which is being published.

Andy Brown - Health and Physical Activity Co-ordinator, Durham Council. Wright Foundation L3 GP Exercise Referral, BACR Phase IV, BTEC Sports Science.

The two days spent with at Eldon Leisure Centre on the ARNI Course were both informative and interesting, and the knowledge I gained was invaluable. I was inspired by Toms’ enthusiasm, first hand knowledge of the devastating effects a stroke can have, and dedication and determination to improve the quality of life for stroke survivors.Tom was highly entertaining, motivational and knowledgeable and provided us with many techniques and hands on practical ideas that helped me think outside the box, all of which will hopefully give me more confidence and inspiration when dealing with stroke survivors and their specific needs.

Tom also gave us many ideas on how to make, or adapt equipment, proving that you don’t need specialised kit to ensure safe and effective workouts. It was an honour to meet Michaela, the stroke survivor, who kindly gave us an insight into how frustrating the effects of a stroke can be, the difficulties faced, and the sheer determination she has to improve her condition. Michaela worked brilliantly with Tom in competently demonstrating the effectiveness of his techniques, despite just meeting him for the first time. I’m sure by urging stroke survivors not to let their condition hold them back, Toms work must make a huge difference, and from what I saw at Newcastle, I’m sure the motivation and encouragement Tom gives ensures he gets the best from his clients.

Val Jones – Cardiac Rehab Phase IV: FFI Advanced Instructor Exercise Referrals: L3 Frailer, Older Adults and Falls Prevention: YMCA Disability Awareness L3.

The course with ARNI was completely different from what I expected. A really informative programme, unique in its approach to the rehabilitation of stroke survivors. A basic understanding can help to educate people on how they can adapt techniques to suite themselves rather than sticking with conventional rehabilitation as the only way to recover. If you are a good instructor with the ability to devise programmes and exercises with limited equipment and / or room, then the ARNI course will help to progress and further the understanding of stroke rehabilitation. I feel that the ARNI course is the way forward in stroke rehabilitation and needs the instructors to further the knowledge already passed on by DR Balchin. I was amazed at all the different exercises and equipment that could be used in-order to improve the functional capabilities of stroke survivors and the range of which they could be used, from the simplest techniques to the advanced for people further into their recovery. Having people with a martial arts background to help explain some of the techniques made it easier to understand and perform. Therefore anyone with a martial arts background would find the practical side of this course a lot easier to understand. Also having another stroke survivor other than Dr Balchin, with a greater limitation in movement, helped in-order to understand the techniques involved.

I am pleased to see that the North East is showing such an interest in this area and is showing the way for other areas of the country in what they can do with different techniques. Running a pilot scheme in the North East will help to educate the people of the North East and allow a greater understanding of the problems that may arise from surviving a stroke. The booklet given at the start of the course was a valuable piece of information which was important for linking everything together. A little bit more structure to the class would have helped to understand everything as it was difficult to make notes. Exercise need to be linked to other conditions as some of the techniques contradict information learnt on other courses as everything is just based on stroke survivors, most of which may have other comobidities. The days could have been shortened slightly and more regular breaks to help keep people more alert throughout the day. All in all I enjoyed the course and I think the 2 days at Middlesex University will help to clear everything up.

Chris Foster, Exercise Referral Consultant, Sunderland City Council. Wright Foundation L3 GP Exercise Referral, NVQ L3 Instructing Physical Exercise, YMCA L3 Advanced Instructor.

Having a stroke survivor in the family and working closely with stroke survivors as a referral instructor, I was curious as to what I would learn on the ARNI course. All I can say is that it has to be one of the most informative and beneficial courses I have attended in recent years.
From the first morning when Tom introduced himself and got straight down to business the course was very informative and hands-on in nature, which I feel everybody on the course found enjoyable and very useful. It was very refreshing to attend a course delivered by someone who has actually experienced the subject matter first hand and has used their own experiences to design a series of techniques that are grounded in the real world.
Working with stroke survivors, I have always tried to push them a little further each time in order to take them that one step ahead to a more active and functional life. What I have come to understand from the two practical days is that stroke patients need to be taken to the edge of their abilities each session in order to permanently affect changes. Very useful information that I have already started to use in my work.
The course also gave us valuable lessons in how to teach the stroke survivor day-today coping strategies such as getting down and up from the floor safely and effectively.
The only way I can see to add to the course is to have instructors take part in an actual rehabilitation class where they can see the techniques being put into practice, which apparently is being set up for us in a few weeks with a Different Strokes class in our area.

The second part of the course was the science bit, which, again was very interesting and informative. The varied seminars that were set up for us gave us the ‘behind the scenes’ stuff that usually never gets looked into by instructors used to being hands-on with their clients/patients. I found this part of the course particularly useful as I have always believed that in order to achieve successful results with a patient, you should know as much about how the stroke or other condition is caused in order to understand how the training needs to be structured.
Of the speakers at the course, I found Dr Alex Nowicky ( Neurorehabilitation ), and Dr Nick Ward ( Motor Neuroscience ) very interesting. The detailed yet easy to follow presentations helped me to understand the mechanisms of stroke more clearly and how the training can help the brain ‘re-learn’ what is has lost. Overall I feel fortunate to have been given the opportunity to attend this new course and I am looking forward to putting all the new skills I have acquired into practice when myself and my colleagues set up a pilot course for stroke survivors in the North East.

Stuart Moon, Health and Fitness Instructor, Darlington Borough Council, REPs L4 (upgrade), Wright Foundation Referral Programme Consultant, WABBA Fitness Instructor, BASK Life Support (R.L.S.S Guidelines)

Brilliant two days with regards to the type of speakers on show. Thought the last speaker around Neuroplasticity really helped. I know he duplicated a tad on the first speaker but maybe that's why he made more sense. Can't really fault anything other than it was quite above what most would want but that for me made it more interesting. Thought the different backgrounds was also brilliant idea to see acupuncture etc as it helps that I can now speak about it. Really enjoyable two days and good easy to find location.

Gavin Cogden, Exercise Referral Team Leader, Sunderland City Council. REPs L3, BSc Sport and Exercise, BACR Phase IV, Personal Trainer Cert.

From the practical 2 days, I found the course very helpful especially in some of the techniques used for getting up and down of the floor for stroke survivors.  I thought the course was well delivered and presented really well by Tom.  It was also helpful that Michaela and Tom were there too as stroke survivors so I could see how well they have progressed over the years of their hard work and determination. It would have been good if we could have seen Tom in the early stages when he had his stroke so we could see how much he has progressed.  It would have been helpful to see in stages how he became stronger and more able, getting strength in his muscles again, especially how he got the use of his finger movement back really well, it would have been a good tool to use to show clients what is achievable if you work hard at it, being a good motivation tool. It was also helpful to get some other ideas on using other equipment that myself I would not have thought of using, such as a broom handle and free weights. I like to thank Gail for giving me this opportunity to take part in this course and increase my knowledge in helping stroke survivor. Thank you again for excellent course. I really enjoyed the three days in London: the lectures were very interesting and I learned a lot from them. The two days where very good with a lot of interesting stuff about how stroke occurs in the brain. My favourite bit was with Master Lee who taught us some exercises for stroke survivors - I found him a very interesting man, with the stretching prior to exercise and learning the pressure points in the body. Also, looking at his demonstration of the use of needles and explanation for that was very good. Thanks for a great time Gail for giving me the opportunity to take part in this course.

Julie Palfreeman, Exercise Instructor, Darlington Council. REPs L3 Exercise Instructor, Wright Foundation L3 GP Exercise Referral.

Having worked with a small number of stroke survivors, mainly referred to me through GP referral schemes and not having had much in the way of specific training for stroke survivors.  My main reasons for attending the course were to identify if the methods and techniques I had been using were effective and to help me to be more effective when working with stroke survivors and individuals with similar neurological restrictions, (to do my job better). The training given was practical and realistic.  This has allowed me to acquire a wider vocabulary of training activities and techniques and to understand the needs of the stroke survivor better.  A pictorial handbook of the techniques used would be a useful addition to the training, but this is in publication. I enjoyed the 2 days in London. The quality of the speakers were top notch and a good variety of sessions.

Brian Parkes, REPs L3, BACR Phase 4 Cardiac Rehab, Wright Foundation L3 GP Exercise Referral, YMCA Cert Inclusive Health, Fitness & Activities for Disabilities, HND Science & Management in Health and Fitness, Diploma in Sports Therapy,

Theory part of the course was as interesting and as brilliant as the practical part. In my opinion it was easier to understand after attending a practical part first and it all fitted in nicely. I think it will be very valuable and beneficial to attend Tom’s exercise session, see how it is delivered and getting involved will improve our confidence when it comes to delivering our own classes and give us some more ideas perhaps

Dragana Hanzen, Assistant Exercise Officer - Physical Activity, Gateshead Council. NCFE Teaching Cert in Exercis Studies, BACR Phase 4 Qualification. Exercise & Fitness for Disabled People (IFI Level 3)

The practical sessions on the course were fantastic and very informative. Most courses that I have attended are very much theory based so to do the practical element was refreshing but to be learning something completely new with techniques that I would never implement had it not been for this training was very good. I’m looking forward to the theory element of the training but feel like I have taken away so much learning from this already.

Dawn Harvey, Exercise Referral Developer, Gateshead Council. Wright Foundation L3 GP Exercise Referral, BACR Phase 4 Qualification.