Occupational Therapy News OTnews October 2019 | Page 48

FEATURE ACTIVITY towards individual weight loss goals. One participant commented: ‘Using the Fitbit gave me the motivation to do more activity and exercise, and to track and see my progress printed out on paper was very useful. The difficult part is not accessing ground leave as much and restricted movement – not having escorted community leave.’ Another added: ‘I reached 10,000 steps on a daily basis [and] I am walking around a lot more. My active minutes have improved, and I have started to eat healthier.’ While using an activity tracker enabled participants to measure and evaluate their activity levels, individual effort was still required to participate. One of the interesting findings from this initial group was the impact of staff annual leave; there was a marked reduction in the participants’ levels of activity when this occurred, suggesting that people relied on external motivation and the structure offered by planned sessions. One of the most concerning findings was how sedentary participants were, particularly at weekends when staffing levels are traditionally reduced. Secure environments are potentially obesogenic and to overcome this participation in physical activity requires a combination of staff support; access to facilities and considerable personal effort. As a result of the initial Fitbit group, increased exercise opportunities are being offered to all patients in the form of the ‘morning mile’, ‘midday mile’ and ‘going the extra mile’ walking sessions. Both staff and patients take part in the sessions, requiring approximately 30 laps of the unit sports hall to meet the requisite distance – although participants are advised to complete a distance they are comfortable with. The improved access to exercise recently culminated in a half marathon walk challenge, where 48 OTnews October 2019 a group of staff and patients completed a combined distance of 108 miles over the course of the day. Impressively, three patients completed the full distance after only starting the morning mile several months previously. Further work related to Fitbit use as a motivational tool will continue in an effort to overcome the physical health and obesity issues outlined earlier. Staff observed that the Fitbit model used did not have the functionality to provide real time feedback, therefore service users were dependant on staff to provide them with data summaries. Future projects will look at more sophisticated Fitbit models, while addressing security concerns. This would give service users more immediate feedback on step count, which might aid motivation. References Busche C and Leonard B (2004) ‘Association between atypical antipsychotic agents and type 2 diabetes: review of prospective clinical data’, British Journal of Psychiatry, 184 (suppl 47): s87-93 Diaz KM, Krupka DJ, Chang MJ, Peacock J, Ma Y, Goldsmith J, Schwartz JE and Davidson KW (2015) ‘Fitbit: an accurate and reliable device for wireless physical activity tracking’, International Journal of Cardiology, 15(185): 138–140 Haw C and Stubbs J (2011) ‘What are we doing about weight management in forensic psychiatry? A survey of forensic psychiatrists’, British Journal of Forensic Practice, 13(3): 183-190 Joukamaa M, Heliowara M, Knekt P, Raitasalo R and Lehtnen V (2001) ’Mental disorders and cause-specific mortality’, British Journal of Psychiatry, 179: 498-502 Oakley C, Mason F, Delmage E and Exworthy T (2013) ‘A right to be fat? A survey of weight management in medium secure units’, Journal of Forensic Psychiatry and Psychology, 24(2): 205-p214 Royal College of Occupational Therapists (2017) Occupational therapists’ use of occupation-focused practice in secure hospitals – practice guideline (2nd ed). Available at: https://www.rcot.co.uk/practice- resources/rcot-practice-guidelines/secure-hospitals [accessed 18 December 2018] Stubbs B and Rosenbaum S (2018) ‘Exercise Interventions in secure and forensic services’, in Stubbs B and Rosenbaum S (eds.) Exercise-based Interventions for mental illness. London: Academic Press, pp.209-214 Christopher Genter, specialist occupational therapist, Ravenswood House, and Anita Bowser, head of occupational therapy – specialised services. Email: [email protected] © GettyImages/PeopleImages