In The Thrive Clinic we work with a number of different clients, patients and friends. It is their experience and journey through The Thrive Clinic that makes what we do worthwhile and drive us to be better and do more. We interviewed one of our patients to find out more about their journey so far.
Q: What first made you come to The Thrive Clinic?
A: I was first introduced to Katie Stewart back in 2004. Katie had started the Beach Lifestyle Club in Cottesloe and I was a willing participant in one of her intensive 10 day Kickstart programmes. This programme changed my life. I went from being quite unfit to running 3kms in 10 days. I realised I was capable of so much more and thus began my journey with Katie. I joined her gym, lost 10kgs and went from strength to strength. Since then, Katie has seen me through my recovery from Breast Cancer and a double mastectomy and more recently a radical Hysterectomy where I had my ovaries, uterus and cervix removed. Post surgery Katie worked with me one on one to improve my pelvic and core strength and once I was strong enough I joined the Thrive Clinic as part of my recovery and rehabilitation. I had been thrown into sudden menopause and was suffering with anxiety, severe hot flushes and had gained a lot of weight. I was feeling fragile, weak and was losing my self confidence.
Q: What have been the benefits of the program for you?
A: The intensive cardio element of Thrive was intimidating at first. When you really push yourself, the 30 second bursts on the bike make you breathless and your heart. At first this was an uneasy feeling for me as these were the same feelings I had when I experience a hot flush or anxiety. However, after only a few sessions I began to reap the benefits and was able to adjust my approach to these sessions. Within a few weeks I noticed a dramatic decrease in the severity and frequency of my hot flushes. I also noticed a decrease in my anxiety. I felt my body gaining strength and stamina and I was sleeping better.
Q: What achievements have you made since starting the Thrive Clinic?
A: After 5 months of rehabilitation with Katie and attending regular Thrive Clinic sessions I was able to return to running and rejoined Katie’s RunFree programme. I am now training with Katie to run the New York Marathon this November. In a year and half Katie and her team have taken me from feeling despondent, fragile and weak to running my first half marathon at the Perth City to Surf this year and on to the New York Marathon this November. I have lost the weight I gained post surgery my anxiety and mood swings have been greatly reduced and I have gone from having sometime 7 to 10 hot flushes a day to 1 or 2. I have also gained better awareness of my body and can now target the correct muscle groups in my Thrive sessions to maintain and strengthen my pelvic and core area.
Q: What are your future health and wellbeing goals?
A: At the moment I’m working with the Thrive team to maintain my strength for running the marathon to give me the best possible chance of finishing the race strongly with no injury. After the marathon I will be working with the team to correct some postural issues I have as a result of my previous double mastectomy and reconstructive surgery.
Q: What do you enjoy about the Thrive Clinic Process and Protocol? (Connect, Observe, Prime, Play)
A: I love the Connect and Observe. This has taught me to really engage with my body and to perform the exercises correctly to get the most benefit. I love the Butterfly which begins each session. A moment to pause, be still and engage with my body. It really sets me up for the rest of the session.
Q: What keeps you motivated to adhere to your weekly sessions?
A: I love the relaxed feeling at the Thrive Clinic. The team are incredibly supportive and friendly. I feel like I am being welcomed with warm arms each time I walk through the door. The location and the rooms are informal and homely rather than being clinical. It is also great having a programme that is specifically targeted to your own personal needs and that is regularly adjusted as your body grows in strength and stamina. I also feel incredibly safe in this environment. I know that Katie and her team are extremely professional and knowledgeable as trained Exercise Physiologists and that they work in conjunction with your referring doctor or specialist constantly giving them feedback or seeking their advice.
Q: Any other comments?
A: I can’t recommend Thrive Clinic and the Exercise Therapist highly enough. It really has changed my life and been invaluable in my recovery and rehabilitation from very traumatic procedures. I’m turning 50 this December and feeling confident and strong. I’m no longer worried about my future or getting a little bit older. I feel I can now embrace my life with positivity and that anything is possible.
Natarsha Rawlins (Tarsh)
Osteoarthritis and Rheumatoid Arthritis
Knee and hip osteoarthritis represent two of the most common causes of disability in the world (Musemeci et al., 2014). Social, psychological and economical costs are involved with the condition and numerous consequences are experienced by the individual including pain, reduced range of motion, reduced functionality and ability to perform activities of daily living. Osteoarthritis generally requires long term therapeutic treatment that often involves lifestyle interventions (Krauss et al., 2016).
Rheumatoid arthritis affects 1% of the world’s population (Cooney et al., 2010). The inflammatory presentation and persistent episodes or flare ups result in pain and stiffness, leading to progressive joint deformities and loss of function. Secondly, chronic inflammation can result in an increased risk of secondary complications such as cardiovascular disease. Lifestyle interventions such as exercise as shown to improve function and reduce cardiovascular risk in patients with RA (Cooney et al., 2010).
Treatment Options Using Exercise as Medicine for Osteoarthritis and Rheumatoid Arthritis
Exercise is used as a lifestyle intervention to reduce the effects of rheumatoid and osteoarthritis. Physical exercises are recommended as the first line of treatment to reduce risk factors such as overweight, obesity and joint tissue inflammation. Physical activity has been recognised as an effective, economical and accessible tool to everyone in the treatment and prevention of osteoarthritis. Exercise also leads to a reduction in pain and an increase in physical functioning.
Supervised exercise sessions completed three times a week with a focus on aerobic capacity, quadriceps strengthening and lower extremity performance indicate the greatest reduction in pain and most significant improvements in functionality (Juhl et al., 2014).
There is strong evidence that supports the short-term efficacy of joint specific exercise programs with respect to pain reduction and increase of functionality in subjects with knee and hip osteoarthritis (Krauss et al., 2016). Research supports positive knee and hip osteoarthritis outcomes of regular exercise engagement. Such improvement includes, increased health related quality of life, reduced pain and physical function at mid and long-term assessments, and greater self-efficacy and physical activity levels. These improvements allow surgery to be delayed, or prevent replacement surgery completely. Exercise is also known to be an efficient intervention with regards to personal and social costs when directly compared with surgical interventions (Krauss et al., 2016).
As supported by research, three supervised exercise sessions per week for at least eight weeks results in improvements in perceived pain, functionality, quadriceps strength and aerobic fitness when directly compared to non-exercise control groups of the same patient demographics. Patients completing regular exercise observe reductions in depressive symptoms, weight and other risk factors contributing to potential comorbidities (Krauss et al., 2016).
So how do I use exercise as medicine to reduce my symptoms of arthritis?
At The Exercise Therapist we prescribe exercise as medicine for patients with osteoarthritis and rheumatoid arthritis. The difference in our management of these clients is evident during episodes or flare ups. For patients experiencing a RA flare up, they experience a significant impact on joint function and therefore in these episodes we reduce the amount of loading and impact on these joints during exercise. However, a flare up or episode of agitation in patients with osteoarthritis, there is significantly less impact on the affected nerve, and the joint is still able to be loaded.
The Thrive Clinic follows a four stage exercise prescription model to ensure all patients are thriving. Following a comprehensive global postural musculoskeletal screening, where anomalies and weaknesses are identified, an individualised functional strength and conditioning program will be prescribed. The program will be based on four key postural aspects: postural mobility, trunk conditioning, VMO and glute med coordination and activation, and scapulohumeral rhythm. Note, although thoracic and upper mobility may not have any direct operative link, full body biomechanics and postural orientations have a large impact on re-injury predisposition and global post-operative recovery. Patients that have followed this procedure in a supervised domain have seen improvements in functionality, strength and confidence in their own ability.
Your GP will assess your eligibility for a Chronic Disease Management (CDM) Referral. These allocated CDM sessions will be used for initial and follow-up assessments and reviews.
We offer eight or twelve week programs where patients attend The Thrive Clinic two or three sessions a week. Patients complete their specific exercise program in a supervised setting where technique and feedback is provided. Reviews are completed every four-weeks, allowing not only the individual but the GP to monitor their progress. If covered by Exercise Physiology, patients may receive up to $150 back from their private health fund at the completion of their program.
Juhl, C., Christensen, R., Roose, E.M., Zhang, W. & Lund, H. (2014). Impact of exercise type and dose on pain and disability in knee osteoarthritis. Arthritis and Rheumatology, 66(3), 622-636. doi: 10.1002/art.38290
Cooney, J., et al. (2010). Benefits of exercise in rheumatoid arthritis. Journal of Aging Research, 2011. doi:10.4061/2011/681640
Krauss, I., Mueller, G., Haupt, G., Steinhiber, B., Janssen, P., Jentner, N., Martus, P. (2016). Effectiveness and efficiency of an 11-week exercise intervention for patients with hip or knee osteoarthritis: A protocol for a controlled study in the context of health services research. BMC Public Health, 16(367), 1-16. doi: 10.1186/s12889-016-3030-0
Musumeci, G., Loreto, C., Imbesi, R., Trovato, F.M., Di Giunta, A., Lombardo, C., Castorina, S. & Castrogiocanni, P. (2014). Advantages of exercise in rehabilitation, treatment and prevention of altered morphological features in knee osteoarthritis. A narrative review. Histology and Histopathology, 29(6), 707-719. doi: 10.14670/HH-29.707