Posted by Callum Bradford, Research Associate, Teesside University
Chronic Breathlessness is predominantly caused by pulmonary conditions, such as chronic obstructive pulmonary disease (COPD), impacting 75 million people globally. With Covid-19 and an ageing population this number is expected to rise, increasing the burden on families, carers, and health and social care services. For individuals, breathlessness is associated with a lower quality of life, decreased capacity to do exercise, and higher levels of anxiety and depression
Pulmonary rehabilitation is recommended for everyone with breathlessness. Consisting of both exercise and education, its benefits on health are unequivocal, however, any benefits gained by patients are often reduced three months after completion. This is primarily because patients go back to doing less physical activity once the programme has finished and support from healthcare professionals is removed. With this in mind, we wanted to develop an intervention that could step-in when patients finish their rehabilitation, offering a form of exercise maintenance and continued social support. Given the nation's love of football (most of the time), we believed walking football might have potential.
To develop the intervention, we initially consulted pulmonary physiotherapists, and a local walking football team. The physios were initially very sceptical, raising concerns that the pace would be too fast, and highlighting the number of people with breathlessness who required oxygen or walking-aids. Walking-aids?! Oxygen?! I hadn't even considered that. I was starting to worry that this idea might be a complete non-starter.
So next stop was to see some walking football for myself at Middlesbrough’s Herlingshaw Centre. I left the session with mixed feelings. They played three-touch, meaning everyone got the opportunity to play, forcing that one player who thinks they're Allan Saint-Maximin to pass the ball. It was also proactively refereed to the benefit of everyone, with players encouraged to talk to the ref if they felt the pace of the game was too fast. However, after giving it a go myself, the pace was still surprisingly quick, despite what Father Ted might have you believe, bringing back concerns as to whether it would be too high an intensity. What I really needed to know was what patients themselves thought of walking football.
So we linked up with Breathe Easy Darlington, a local support group for people with lung conditions. Describing the input from Breathe Easy members as invaluable to our research over the last few years would be a massive understatement. So much so that, as a small thank you, we held a fundraiser for them last month on World COPD Day, raising £1120.76.
Their opinions would be vital to walking football’s success... however, they were also dubious of the idea. Again, concerns were raised about the speed, the walking-aids, and the balance required to play. So I asked, under what circumstances – if any – would they consider giving walking football a go? They stated that if the football was exclusive to people with breathlessness like themselves, they would give it a try, as they would be able to dictate the pace of the game and not feel too self-conscious of their footballing abilities. Our original plan involved asking patients to join onto sessions at the Herlingshaw. Luckily, by consulting with Breathe Easy members, I now understand how that plan – to mix people with and without breathlessness - would have likely ended in disaster, demonstrating the importance of including end-users when designing research studies.
Twelve Breathe Easy members agreed to play and the stage was set for our walking football taster sessions, and as you can see from our video, I don't think it could have gone much better.
The players embraced the competitive aspect of football, stating that “On the pitch you forget about breathlessness”; and the concern for walking-aids was turned on its head after we agreed that hitting the ball with a walking-stick is a perfectly fine way to score a goal. Our coach, Monty Towers, was key to its success, mixing up the session with fun games, while allowing everyone to play football at their own pace. In our follow-up conversations, members also suggested implementing a buddy system, where more experienced participants take responsibility for introducing new patients to the group so they feel more welcome – a brilliant idea that we intend to implement in the future.
Throughout 2023 we will be assessing the feasibility of walking football following pulmonary rehabilitation in collaboration with both North Tees & Hartlepool and South Tees NHS Foundation Trusts, plus the North Riding FA; and I’m confident if it’s anything like our sessions with Breathe Easy members, it will be a great success.
And if you’re still upset about the World Cup, don’t worry, I’m sure our walking football team will bring it home next year.
Pulmonary rehabilitation is recommended for everyone with breathlessness. Consisting of both exercise and education, its benefits on health are unequivocal, however, any benefits gained by patients are often reduced three months after completion. This is primarily because patients go back to doing less physical activity once the programme has finished and support from healthcare professionals is removed. With this in mind, we wanted to develop an intervention that could step-in when patients finish their rehabilitation, offering a form of exercise maintenance and continued social support. Given the nation's love of football (most of the time), we believed walking football might have potential.
To develop the intervention, we initially consulted pulmonary physiotherapists, and a local walking football team. The physios were initially very sceptical, raising concerns that the pace would be too fast, and highlighting the number of people with breathlessness who required oxygen or walking-aids. Walking-aids?! Oxygen?! I hadn't even considered that. I was starting to worry that this idea might be a complete non-starter.
So next stop was to see some walking football for myself at Middlesbrough’s Herlingshaw Centre. I left the session with mixed feelings. They played three-touch, meaning everyone got the opportunity to play, forcing that one player who thinks they're Allan Saint-Maximin to pass the ball. It was also proactively refereed to the benefit of everyone, with players encouraged to talk to the ref if they felt the pace of the game was too fast. However, after giving it a go myself, the pace was still surprisingly quick, despite what Father Ted might have you believe, bringing back concerns as to whether it would be too high an intensity. What I really needed to know was what patients themselves thought of walking football.
So we linked up with Breathe Easy Darlington, a local support group for people with lung conditions. Describing the input from Breathe Easy members as invaluable to our research over the last few years would be a massive understatement. So much so that, as a small thank you, we held a fundraiser for them last month on World COPD Day, raising £1120.76.
Their opinions would be vital to walking football’s success... however, they were also dubious of the idea. Again, concerns were raised about the speed, the walking-aids, and the balance required to play. So I asked, under what circumstances – if any – would they consider giving walking football a go? They stated that if the football was exclusive to people with breathlessness like themselves, they would give it a try, as they would be able to dictate the pace of the game and not feel too self-conscious of their footballing abilities. Our original plan involved asking patients to join onto sessions at the Herlingshaw. Luckily, by consulting with Breathe Easy members, I now understand how that plan – to mix people with and without breathlessness - would have likely ended in disaster, demonstrating the importance of including end-users when designing research studies.
Twelve Breathe Easy members agreed to play and the stage was set for our walking football taster sessions, and as you can see from our video, I don't think it could have gone much better.
The players embraced the competitive aspect of football, stating that “On the pitch you forget about breathlessness”; and the concern for walking-aids was turned on its head after we agreed that hitting the ball with a walking-stick is a perfectly fine way to score a goal. Our coach, Monty Towers, was key to its success, mixing up the session with fun games, while allowing everyone to play football at their own pace. In our follow-up conversations, members also suggested implementing a buddy system, where more experienced participants take responsibility for introducing new patients to the group so they feel more welcome – a brilliant idea that we intend to implement in the future.
Throughout 2023 we will be assessing the feasibility of walking football following pulmonary rehabilitation in collaboration with both North Tees & Hartlepool and South Tees NHS Foundation Trusts, plus the North Riding FA; and I’m confident if it’s anything like our sessions with Breathe Easy members, it will be a great success.
And if you’re still upset about the World Cup, don’t worry, I’m sure our walking football team will bring it home next year.
The views and opinions expressed by the author are those of the author and do not necessarily reflect those of Teesside University or Fuse, the Centre for Translational Research in Public Health.
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