Prof Doherty's research is themed around `safe and effective exercise for
patients with complex cardiac disease' where, until his leading research
had been carried out, thousands of patients were denied access to such
services. Prof Doherty implemented the first prospective randomised
control trial (RCT) in this population which has: benefitted patients
directly by enabling more programmes to offer rehabilitation to this group
of patients; impacted on clinical guidance nationally and internationally;
contributed to Department of Health policy; and influenced the public and
clinical populations through the NHS, British Heart Foundation, Arrhythmia
Alliance and professional clinical groups.
The pioneering research carried out by Brookes' Movement Science Group
(under the umbrella of the Centre for Rehabilitation) into the barriers
and benefits of safe community led exercise for people with long-term
neurological conditions, has significantly improved quality of life for
many sufferers. Their research has raised awareness amongst healthcare and
fitness professionals, and led to specific measures being put in place to
facilitate and encourage exercise. These measures include the development
of: clinical exercise and rehabilitation units, web-based physical
activity support system, national occupational standards, and the only
level 4 accredited exercise training course in the UK. The research has
also led to the establishment of a registered charity that aims to
increase exercise participation of people with long-term neurological
conditions across the UK.
It is widely acknowledged that increasing physical activity (PA) levels
within `hard-to-reach' groups
is challenging. Researchers in the School have addressed these challenges
resulting in impacts in
two recognized `hard-to-reach' groups: ethnic minority communities and
patients who are at risk of
disease onset and/or are suffering from diminished quality of
life/disability due to chronic disease.
In the former, our research has demonstrated how to make PA accessible and
appropriate; in the
latter, in addition, we have increased physical activity levels. In both
examples, our research has
changed professional training and/or standards.
In this case study we describe an interrelated collection of impacts
on healthcare in the NHS; these are summarised in the Table below.
Smith's research in Exercise Science focuses on exercise adherence and
health enhancing physical activity (HEPA). Doherty's research looks at
`safe and effective exercise for patients with complex cardiac disease'
and implemented the first prospective Randomised Control Trial in this
population. Smith and Doherty have collaborated on an RCT, on `Active
York' and on a successful proposal to the BHF. Smith's work has had an
impact on practitioners and professional services by shaping regulatory
frameworks for `exercise on prescription' schemes. In health, Doherty's
research has benefitted patients directly by enabling hundreds of
programmes to offer rehabilitation to patients with complex cardiac
disease and has impacted on national and international practice.
This research into the effective management of exertion intensity,
symptoms and pain in the treatment of cardiovascular and neuromuscular
diseases has resulted in the setting of national and international
standards for safe and effective education, training and professional
Physical activity forms a core component in the prevention and
rehabilitation of cardiovascular disease and in genetically acquired
neuromuscular disorders. Physical activity benefits are linked to the
volume — frequency, intensity and duration — of participation, which will
bring about physiological and/or psychosocial improvements.
The term `Green Exercise' was first coined at the University of Essex to
describe physical activity undertaken in `green' surroundings. Essex
research demonstrates and quantifies the associated benefits to health and
well-being. This research has stimulated changes to the policies and
practices of health and environmental organisations, and has also been
used in the private sector to support a consumer engagement campaign. Most
notably, the mental health charity Mind used the findings of Essex
research as part of a successful Big Lottery bid. This led to Ecominds,
a £7.5M, 5 year programme supporting 130 environmental projects
nationwide, which have improved the mental health of participants via
green activity engagement.
High intensity training: Impact can be evidenced on multiple levels
ranging from adding to the
public debate on exercise duration and providing information to the sports
industry. This includes
publication of the findings/applied recommendations of this research in
lay magazines (e.g. Men's
Health), books (e.g. The High Intensity Workout Dundee University Press
2012) and television
shows (e.g. Horizon). In addition, the research has informed coaches (ice
hockey and rugby union)
and people working in the fitness industry (personnel trainers), and has
contributed to the debate
on exercise for health (Scottish Government).
Research undertaken at the Centre for Physical Activity and Health
Research within the Sport and Exercise Sciences Research Institute has
directly contributed to changes in public policy surrounding the health
benefits of exercise and has informed the development of international and
national physical activity guidelines.
It is important that valid outcome measures are used to assess clinical
services and interventions to demonstrate that services are effective.
Additionally, outcomes of interventions need to be meaningful to the
patients reporting them, as this adds value to the outcome of trials over
and above the statistically significant difference derived mathematically.
Singh and colleagues explored the minimum clinically important
difference of the incremental shuttle walking test for individuals with
chronic respiratory disease. As a result of Singh's research, this
threshold is now included in international guidelines for pulmonary
rehabilitation and has also been introduced into research and practice
among people attending cardiac rehabilitation over the last 5 years.