tag:blogger.com,1999:blog-53134949089962779012024-03-19T01:14:40.934-07:00Abbey Physio LimerickAbbey Physio Limerickhttp://www.blogger.com/profile/04355351899636585517noreply@blogger.comBlogger9125tag:blogger.com,1999:blog-5313494908996277901.post-24725702570755724332017-05-24T11:02:00.001-07:002017-05-24T11:02:43.852-07:00<br />
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<span style="color: blue;"><b>REHAB CURE FOR WORK ABSENCE SAVES MILLIONS - IRISH EXAMINER</b></span><br />
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<a href="http://www.irishexaminer.com/ireland/health/rehab-cure-for-work-absence-saves-millions-135875.html" style="font-family: Calibri, sans-serif; font-size: 11pt;">http://www.irishexaminer.com/ireland/health/rehab-cure-for-work-absence-saves-millions-135875.html</a>Abbey Physio Limerickhttp://www.blogger.com/profile/04355351899636585517noreply@blogger.com0tag:blogger.com,1999:blog-5313494908996277901.post-52457757528872210022016-11-18T15:26:00.000-08:002016-11-18T15:26:18.088-08:00Painful Joints? Exercise may be the Answer <span style="text-align: justify;"><span style="font-size: 12pt;">It
can come on suddenly, your knee is painful after sitting or driving, or your
hips are stiff and it's painful to rise from a chair or climb the stairs. Life
becomes more difficult, you can no longer enjoy that long walk with the dog,
get out </span>hillwalking<span style="font-size: 12pt;"> at the weekend or stand watching a match. </span></span><br />
<span style="font-size: 12pt; text-align: justify;">Gardening becomes
a drag and every day you experience reminders of your aching joints, ageing
body and impending limitations. Do NOT avoid activity – get help and advice of
what exercise you CAN do to aid recovery.</span><br />
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<span style="font-size: 12.0pt; mso-bidi-font-family: Arial;">It
doesn’t have to be inevitable, that our shoulders, hips, knee, ankles, feet and
hands cause so much discomfort and misery. The right exercises prescribed by
your CHARTERED PHYSIOTHERAPIST will help subdue pain by: <o:p></o:p></span></div>
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<span style="font-size: 12pt;">Increasing muscle strength and flexibility of
soft tissues around the joint, increasing support for the painful joints.</span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-family: Arial; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Relieve stiffness by mobilising tendons,
muscles and ligaments, which shorten when not used. <b><span style="color: #323e4f; mso-themecolor: text2; mso-themeshade: 191;">MOVE
IT OR LOSE IT</span></b> is true. Increasing your joint motion, helps to polish
the joint surfaces and release the hardened swelling which can restrict joint
motion.<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-family: Arial; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Exercise helps to increase release of synovial
fluid into the joint, which is the lubrication fluid within the joint capsule.
Synovial fluid carries Oxygen or fuel into the joint and is the source of
energy for “well oiled” joints. <o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-family: Arial; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Exercises increases the production of
substances that dampen down pain. If not exercising, you are more aware of
every twinge and ache. Exercise releases the body’s own pain relieving
substances, endorphins, so that pain does not register so easily.<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-family: Arial; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Exercise is a necessary component of weight
control. Reducing weight helps to relieve pressure on weight-bearing joints,
particularly as we age. Hips, knees and ankles are particularly susceptible to
increased degeneration if too much weight increases pressure on the joints.<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-family: Arial; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Exercise has been found to increase hormone
release in the brain which improves our mood. Mental health benefits accrue
from regular exercise as when we are fitter, we feel happier!<o:p></o:p></span></div>
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<!--[endif]--><span style="font-size: 12pt;">Contact your </span><b style="font-size: 12pt;">Chartered Physiotherapist </b><span style="font-size: 12pt;">for an
individual consultation. We will assess your joint range of motion and muscle
strength and flexibility, we can determine your aerobic fitness level and we
will design a customised exercise programme just for you! Start now, exercise
your way out of pain and stiffness and enjoy all the </span>activities<span style="font-size: 12pt;"> you have
always loved.</span><br /></div>
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(061 417066) Call Abbey Physio Now</div>
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Abbey Physio Limerickhttp://www.blogger.com/profile/04355351899636585517noreply@blogger.com0tag:blogger.com,1999:blog-5313494908996277901.post-49363415404805292832016-11-15T14:49:00.000-08:002016-11-17T06:04:43.912-08:00Increasing blood flow to the Brain<div class="separator" style="clear: both; text-align: center;">
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EXERCISE TO INCREASE BLOOD FLOW<br />
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AEROBIC EXERCISE<br />
All aerobic exercise has positive effects on circulation and on health.<br />
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Modest exercise improves blood circulation to the brain in the older woman, 15% increase was found in one study.<br />
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Many studies indicate a connection between exercise and improvement in overall brain health.<br />
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Aerobic activities include swimming, cycling, brisk walking, dancing and sex, so find an activity that best suits your lifestyle and engage with enthusiasm.<br />
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WALK OFTEN <br />
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Short walks are beneficial in increasing circulation to the brain.<br />
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If you sit at work, use a timer to prompt you to get up and move, to ensure you walk regularly throughout the day.<br />
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Take the stairs in preference to the lift.<br />
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Park away from the workplace to build in a brisk walk twice daily.<br />
Get off the bus earlier than your stop, to insure you have a walk before and after work.<br />
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STRETCH OFTEN DAILY<br />
Helps prevent joint stiffness, reduces muscle tightness and improves blood circulation throughout the body.<br />
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Stretch hourly if you are sedentary at work.<br />
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Gentle stretches which increase blood flow to the brain include standing, bending forwards to touch knees, shins or toes.<br />
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In sitting, back supported on the floor. Stretch out legs on floor, bend forwards, slowly unfolding your spine, to touch knees, shins or toes. Do not exceed your “comfortable” stretch position. Do not do anything which increases pain or discomfort in your back or legs.<br />
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Interlink your fingers, bring palms together, bring both arms up over your head, turn arms to push palms upwards towards ceiling. Stretch x 20 seconds, lower slowly and repeat x 2.<br />
Both stretches can be performed every 2-3 hours throughout the day<br />
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YOGA<br />
Yoga incorporates breathing control and many poses encourage positioning of the head below heart.<br />
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Supported on back, lie on floor, rest legs up wall, bring buttocks to the wall.<br />
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Poses that stimulate blood flow to the brain include Plow Pose and Fish Pose. <br />
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USE BREATHING TO INCREASE BLOOD FLOW<br />
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BREATHE THROUGH THE NOSE<br />
Breathing deeply through nose, sinus cavities, oral cavities and upper lungs, with the diaphragm in the abdominal area, brings air and oxygen to the lower lungs where oxygenation of the blood circulation is greatest.<br />
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MEDITATE<br />
Slowing of breathing and heartbeat occurs during meditation. Deep conscious breathing even-paced, increases oxygen saturation in the blood.<br />
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Meditation lowers stress levels, increases ability to focus and strengthens the immune system.<br />
Sit comfortably, eyes closed, count deep belly breaths to 10, then start again. Focus attention on counting breaths when other thoughts enter, acknowledge and let them go. Resume counting breaths.<br />
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STOP SMOKING<br />
Nicotine decreases blood flow by restricting arteries.<br />
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Smoking is linked to strokes and brain aneurysm where weakness in blood vessel wall bulges and bursts, causing stroke.<br />
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E-cigarettes contain nicotine and are not recommended as a substitute, being still harmful to circulation to the brain.<br />
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CHANGE YOUR DIET <br />
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EAT CHOCOLATE! <br />
Chocolate has flavonoids, found in cocoa beans. Flavonoids are present in red wine, red grapes, apples and berries, also green or white tea.<br />
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Control calorie intake, monitor fat and sugar intake.<br />
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DRINK BEET JUICE<br />
Beets contain nitrates where are converted into nitrites which increase blood vessel diameters, increasing blood flow to the brain.<br />
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Nitrates are found in celery, cabbage and other green, leafy vegetables.<br />
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Eat fruit and vegetables high in nitrites for optimal brain functioning.<br />
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EAT “SUPERFOODS” IN YOUR DIET<br />
Superfoods are known for their high nutritional value. Nuts, seeds, blueberries and avocados.<br />
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Nuts: walnuts, pecans, almonds and cashews are excellent sources of Vitamin E. Decline in cognitive function is linked to deficits in Vitamin E.<br />
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Avocado are high in monounsaturated fat, which is linked to increased blood flow in the brain. Monounsaturated fat reduces bad cholesterol and lowers blood pressure.<br />
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<span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">Blueberries help protect the brain from oxidative
stress. Eating one cup of blueberries daily has been shown to increase
efficiency of brain functioning.<b><o:p></o:p></b></span></div>
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Consider Ginkgo Biloba supplements. It contains flavonoids and terpenoids. Flavonoids are plant-based antioxidants which protect nerves, heart muscle, blood vessels and retina from damage. Terpenoids improve blood flow by dilating blood vessels and reducing the stickiness (viscosity) of platelets.<br />
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Ginkgo is used to treat dementia, improve thinking, learning and memory (cognition). People have shown improvement in daily activity function, improved social behaviour and reduced feelings of depression.<br />
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It is known as the “brain herb”. Doses of 120 to 240 mg daily in divided doses containing 24-32% flavonoids and 6-12% terpenoids have been recommended in studies.<br />
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It can take 4-6 weeks for improvement to be evident. All herb supplements should only be taken with medical consultation as they can interact adversely with other medication, especially blood-thinning drugs. Always alert your doctor or dentist before surgery if you have taken a ginkgo supplement, due to increased risk of bleeding.<br />
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Abbey Physio Limerickhttp://www.blogger.com/profile/04355351899636585517noreply@blogger.com1tag:blogger.com,1999:blog-5313494908996277901.post-15954069600078735752016-11-08T12:32:00.002-08:002016-11-08T12:44:59.819-08:00<a href="http://www.abbeyphysio.ie/"><span style="font-size: x-large;">http://www.abbeyphysio.ie/</span></a>Abbey Physio Limerickhttp://www.blogger.com/profile/04355351899636585517noreply@blogger.com0tag:blogger.com,1999:blog-5313494908996277901.post-53589609879046571702016-11-08T10:45:00.003-08:002016-11-17T05:11:43.724-08:00Exercise Treats Cancer & Helps Prevent Recurrence<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
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<span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">Cancer sufferers are less likely to exercise after
their diagnosis, which is of course understandable, due to the severe physical
effects of the disease, which can be devastating.<o:p></o:p></span></div>
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<span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">However recent research in Australia has indicated
regular exercise for cancer sufferers is highly beneficial in the following
ways:<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpFirst" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-GB" style="font-family: "wingdings"; font-size: 12.0pt;">§<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">increases the chances
of a remission of symptoms and cancer activity<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-GB" style="font-family: "wingdings"; font-size: 12.0pt;">§<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">supports the body’s
immune system which helps fight cancer and <o:p></o:p></span></div>
<div class="MsoListParagraphCxSpLast" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-GB" style="font-family: "wingdings"; font-size: 12.0pt;">§<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">improves the general
quality of life of someone who has had cancer.<o:p></o:p></span></div>
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<b><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">MUSCLE MASS</span></b><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;"><o:p></o:p></span></div>
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<span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">Resistance exercise, dynamic and aerobic <b><i>training
prior to</i> </b>and <b><i>during cancer treatment</i>, </b>has been
shown to:<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpFirst" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 72.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l1 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-GB" style="font-family: "wingdings"; font-size: 12.0pt;">§<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">aid cancer recovery
by helping to maintain muscle mass and body strength<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpLast" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 72.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l1 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-GB" style="font-family: "wingdings"; font-size: 12.0pt;">§<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">thereby maintaining
higher functional levels during and after the cancer episode.</span></div>
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<span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">A Canadian study of bowel cancer sufferers found that:<o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="EN-GB" style="font-family: "wingdings"; font-size: 12.0pt;">§<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">81% of the
prehabilitated group, who did regular exercise <b>before </b>treatment, recovered their basic walking ability within 12
weeks and were able to walk further distances post-operatively.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpLast" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 72.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l1 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-GB" style="font-family: "wingdings"; font-size: 12.0pt;">§<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">Only 40% of the
control group, who did not participate in the prehabilitation, achieved the
goal of walking ability by 12 weeks. Distance walked was less. <o:p></o:p></span></div>
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<b><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">BONE DENSITY AND
STRENGTH <o:p></o:p></span></b></div>
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<span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">Prostrate cancer treatment depletes testosterone
supply which reduces bone density and increases risk of osteoporosis. This
increases the risk of bone fractures whether occurring spontaneously or as a
result of a minor impact or fall. <o:p></o:p></span></div>
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<span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">Research in Perth indicated dynamic training,
including jumping exercises, will reduce loss of bone density and risk of developing
brittle bones.<o:p></o:p></span></div>
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<span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">Some participants experienced <i>increase in bone density</i> as a result of the exercise programme.<o:p></o:p></span><br />
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<b><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">OXYGENATED BLOOD
FLOW</span></b></div>
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<span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">Regular exercise increases oxygen-rich blood flow
through the body, reducing the hypoxic state around tumours, where cancer cells
exist in a minimal oxygen microcosm.<o:p></o:p></span><br />
<span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;"><br /></span>
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</v:imagedata></v:shape></span><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;"><o:p></o:p></span></div>
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<span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;"><br /></span>
<span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">Cancers are more aggressive and resistant to treatment
where oxygen is lacking. Exercise improves the effectiveness of cancer
treatments which rely on oxygen-rich blood vessels travelling to cancer cells.<o:p></o:p></span></div>
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<b><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;"> </span></b><b><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;"> </span></b><b><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;"> </span></b></div>
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<b><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">PREVENTION <o:p></o:p></span></b></div>
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<i><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">Lack of physical
exercise is the 2nd Highest Contributor to Cancer incidence in Australia</span></i><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">.<o:p></o:p></span></div>
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<span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">First cause is tobacco smoking. <o:p></o:p></span></div>
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<span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">A 2010 study indicated that a significant number of
bowel, breast and endometrial cancer cases are associated with lack of regular
exercise. Regular exercise reduces
insulin production. Excess Insulin is associated with obesity and cancer.<a href="https://www.blogger.com/null" name="_GoBack"></a><o:p></o:p></span></div>
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<i><span lang="EN-GB" style="font-size: 18.0pt;">30
minutes of rigorous exercise or one hour of moderate exercise daily is
recommended to increase the ability to prevent Cancer. <span style="color: red;"><o:p></o:p></span></span></i></div>
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</v:imagedata></v:shape></span></i><i><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;"><o:p></o:p></span></i></div>
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<b><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;"><span style="font-size: 12pt;">PHYSICAL </span>ACTIVITY<span style="font-size: 12pt;"> GUIDELINES : Adults aged 18-64 years</span></span></b><i><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;"><o:p></o:p></span></i></div>
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<span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">Doing any physical activity is better than doing none.
If you do no exercise, start slowly and build up gradually to the recommended
amount. <o:p></o:p></span></div>
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<span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">Be active on most days, preferably <i>every day.</i></span><span lang="EN-GB"> </span><b><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;"><o:p></o:p></span></b><br />
<span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;"><i><br /></i></span>
<span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;"><i><br /></i></span>
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</v:imagedata></v:shape> <b><span style="font-size: 12.0pt; mso-fareast-language: EN-IE; mso-no-proof: yes;"><v:shape alt="Image result for exercise to prevent cancer recurrence" id="Picture_x0020_16" o:spid="_x0000_i1026" style="height: 135pt; mso-wrap-style: square; visibility: visible; width: 180pt;" type="#_x0000_t75">
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgd6kp8hLUIAY5fvTcTtXX1a_h3tVI04qXHGNSmkuSxiBKehxxOuyn8J-bQcUhydOPEqxO8rr3a7-nVm8N-Mu6Y3mmqlYyr4jCNZWWYAtodlbbv7Is5cEWNdp6nsd0zE_KRuPdeEmyemBI/s1600/couple+2.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgd6kp8hLUIAY5fvTcTtXX1a_h3tVI04qXHGNSmkuSxiBKehxxOuyn8J-bQcUhydOPEqxO8rr3a7-nVm8N-Mu6Y3mmqlYyr4jCNZWWYAtodlbbv7Is5cEWNdp6nsd0zE_KRuPdeEmyemBI/s320/couple+2.jpg" width="204" /></a></div>
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</v:imagedata></v:shape><b><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;"><o:p></o:p></span></b></div>
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<!--[if !supportLists]--><span lang="EN-GB" style="font-family: "wingdings"; font-size: 12.0pt;">§<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">You need to
accumulate 2 ½ - 5 hours of moderate intensity exercise each week <b>or </b>1 ¼
to 2 ½ hours of vigorous intensity physical activity every week.<b><o:p></o:p></b></span></div>
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<div class="MsoListParagraphCxSpLast" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 72.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l2 level1 lfo3; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-GB" style="font-family: "wingdings"; font-size: 12.0pt;">§<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">Do muscle
strengthening exercise on at least 2 days every week, e.g. weight training, resistance
training, weight bearing poses in yoga.<b><o:p></o:p></b></span><br />
<span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;"><br /></span>
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Abbey Physio Limerickhttp://www.blogger.com/profile/04355351899636585517noreply@blogger.com0tag:blogger.com,1999:blog-5313494908996277901.post-72547319646354498912016-11-08T10:26:00.000-08:002016-11-17T05:28:14.660-08:00Physiotherapy enables people to STAY IN or RETURN TO WORK<div class="separator" style="clear: both; text-align: center;">
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<b><span style="color: #2e2e3b; font-family: "arial" , "sans-serif"; font-size: 13.5pt;">The UK challenge:<br />
health, work and austerity<o:p></o:p></span></b></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEioOTde_sQqW1FrZT2qmkREmi6jLcHdviBSHmaSc94JK9_kxbnGzurjvdQTBkrMNFUh03bvXXgDvI8hrVLTN_iKgozQd8vhoNcR_zoqmf2YhTyZlr3v-h4q4ZSlt2YykexK-fB6aO9aq0k/s1600/40%2525.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="201" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEioOTde_sQqW1FrZT2qmkREmi6jLcHdviBSHmaSc94JK9_kxbnGzurjvdQTBkrMNFUh03bvXXgDvI8hrVLTN_iKgozQd8vhoNcR_zoqmf2YhTyZlr3v-h4q4ZSlt2YykexK-fB6aO9aq0k/s400/40%2525.jpg" width="400" /></a></div>
<span style="color: #555555; font-family: "arial" , sans-serif; font-size: 10.5pt;"><br /></span>
<span style="color: #555555; font-family: "arial" , sans-serif; font-size: 10.5pt;">At a time when the NHS is serving a growing and
ageing population, the UK government estimates the need for £22 billion in NHS
savings by 2020/21</span><sup style="color: #555555; font-family: arial, sans-serif;">(3)</sup><span style="color: #555555; font-family: "arial" , sans-serif; font-size: 10.5pt;">. Yet public expectation remains that access to
ever improving treatment should be available to all. So the drive to reduce the
welfare bill and to have people in</span></div>
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<span style="color: #555555; font-family: "arial" , "sans-serif"; font-size: 10.5pt;">
productive work remains a government priority.<sup>(4) </sup>There is clearly a
pressing need for best value and productivity in healthcare.<o:p></o:p></span></div>
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<span style="color: #555555; font-family: "arial" , "sans-serif"; font-size: 10.5pt;">Musculoskeletal disorders (MSDs), from short term
back pain to complex, long term conditions such as rheumatoid arthritis, are
the main reason for people being off work. These conditions can also link to
mental health conditions such as anxiety and depression, which are associated
with stress and are responsible for the most working days lost in the UK.
Psychosocial factors such as workplace culture can in turn impact on the
development of MSDs.<sup>(5)</sup><o:p></o:p></span></div>
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<b><span style="color: #444444; font-family: "arial" , "sans-serif"; font-size: 10.5pt;">Benefits of early referral to physiotherapy for work</span></b><span style="color: #444444; font-family: "arial" , "sans-serif"; font-size: 10.5pt;"><o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="color: #444444; font-family: "wingdings"; font-size: 10.0pt;">§<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><b><span style="color: #444444; font-family: "arial" , "sans-serif"; font-size: 10.5pt;">Economic savings</span></b><span style="color: #444444; font-family: "arial" , "sans-serif"; font-size: 10.5pt;"> to the UK<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="color: #444444; font-family: "wingdings"; font-size: 10.0pt;">§<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><b><span style="color: #444444; font-family: "arial" , "sans-serif"; font-size: 10.5pt;">Prevention of MSDs</span></b><span style="color: #444444; font-family: "arial" , "sans-serif"; font-size: 10.5pt;"> and work-related
exacerbation of other conditions<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="color: #444444; font-family: "wingdings"; font-size: 10.0pt;">§<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><b><span style="color: #444444; font-family: "arial" , "sans-serif"; font-size: 10.5pt;">Clinical
effectiveness</span></b><span style="color: #444444; font-family: "arial" , "sans-serif"; font-size: 10.5pt;"> in the treatment of MSDs and other conditions affecting workers<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="color: #444444; font-family: "wingdings"; font-size: 10.0pt;">§<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><b><span style="color: #444444; font-family: "arial" , "sans-serif"; font-size: 10.5pt;">High levels</span></b><span style="color: #444444; font-family: "arial" , "sans-serif"; font-size: 10.5pt;"> of staff satisfaction<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="color: #444444; font-family: "wingdings"; font-size: 10.0pt;">§<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span style="color: #444444; font-family: "arial" , "sans-serif"; font-size: 10.5pt;">'<b>Healthy
conversations</b>' that support behaviour change<o:p></o:p></span></div>
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<b><span style="color: #2e2e3b; font-family: "arial" , "sans-serif"; font-size: 13.5pt;">Early access to physiotherapy enables
people to work<o:p></o:p></span></b></div>
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<span style="color: #2e2e3b; font-family: "arial" , sans-serif; font-size: large;"><b>SICKNESS ABSENCE FROM WORK </b></span></div>
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<span style="color: #2e2e3b; font-family: "arial" , sans-serif; font-size: large;"><b>CURRENTLY </b></span><b style="color: #2e2e3b; font-family: Arial, sans-serif; font-size: x-large;">COSTS THE UK</b></div>
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<b style="color: #2e2e3b; font-family: Arial, sans-serif;"><span style="font-size: large;">£14.3 BILLION</span></b></div>
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<span style="color: #555555; font-family: "arial" , sans-serif; font-size: 10.5pt;">Physiotherapy can help. It is a regulated,
clinically and economically cost-effective profession.</span></div>
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<span style="color: #555555; font-family: "arial" , "sans-serif"; font-size: 10.5pt;">Physiotherapists are autonomous practitioners, with
the skills to accept referrals directly.<sup>(6)</sup><o:p></o:p></span></div>
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<span style="color: #555555; font-family: "arial" , "sans-serif"; font-size: 10.5pt;">They assess, diagnose, advise and treat people in
many clinical and non-clinical settings, both inside and outside of the NHS.
They are experts in the prevention and treatment of MSDs and of other conditions
affecting people of working age, such as cancer, cardiac, respiratory and
neurological conditions.<sup>(8)</sup><o:p></o:p></span></div>
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<span style="color: #555555; font-family: "arial" , "sans-serif"; font-size: 10.5pt;">According to Macmillan, there are currently over
750,000 people of working age living with cancer and it is predicted that there
will be 17million people living with arthritis and 3 million with cancer by
2030.<sup>(9)</sup><o:p></o:p></span></div>
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<b><span style="color: #2e2e3b; font-family: "arial" , "sans-serif"; font-size: 13.5pt;"> </span></b><b><span style="color: #2e2e3b; font-family: "arial" , "sans-serif"; font-size: 13.5pt;">Work advice from physiotherapists</span></b></div>
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<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgsYvZhv1gpfStf8dABacWwuHOYlWPbhyhGKFMYqnwOE8DzkvLFJ4ilRC5za96xFD2LBhsUNgixpzal9FJykmOKlYXsYOWFuhbogHAkxynt020aebTq0hYDEFQ2lMAjAiYgWEQgCsZvxoo/s1600/sickness.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="201" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgsYvZhv1gpfStf8dABacWwuHOYlWPbhyhGKFMYqnwOE8DzkvLFJ4ilRC5za96xFD2LBhsUNgixpzal9FJykmOKlYXsYOWFuhbogHAkxynt020aebTq0hYDEFQ2lMAjAiYgWEQgCsZvxoo/s400/sickness.jpg" width="400" /></a></div>
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<span style="color: #555555; font-family: "arial" , "sans-serif"; font-size: 10.5pt;"><br /></span>
<span style="color: #555555; font-family: "arial" , "sans-serif"; font-size: 10.5pt;">All physiotherapists can give advice to help people
to prevent problems related to their work. They advise employees, enabling
conversations with line managers, and liaise with other health care
professionals, family and carers as needed. Where a problem or health condition
already exists they work with people to achieve optimal function and mobility -
with work an important treatment outcome.<o:p></o:p></span></div>
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<span style="color: #555555; font-family: "arial" , "sans-serif"; font-size: 10.5pt;">Physiotherapists add further value in supporting
the public’s overall health. For instance, they can give specific advice about
physical activity levels based on an individual’s clinical physiotherapy
assessment. This can help people address concerns such as obesity, leading them
to better overall health and promoting self-management of their condition.<o:p></o:p></span></div>
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<span style="color: #555555; font-family: "arial" , "sans-serif"; font-size: 10.5pt;">Within the workplace, physiotherapists specialising
in occupational health and ergonomics can provide targeted support in response
to the needs of staff and their roles, as well as the business needs of
employers.<sup>(10)</sup> They liaise with line managers and others to promote
workplace health and minimise sickness absence.<o:p></o:p></span></div>
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<span style="color: #555555; font-family: "arial" , "sans-serif"; font-size: 10.5pt;"> </span><span style="color: #555555; font-family: "arial" , sans-serif; font-size: 10.5pt;">The NHS itself, the UK’s largest employer, has a
high rate of sickness absence due to MSDs, costing around £400m per year.</span><sup style="color: #555555; font-family: Arial, sans-serif;">(11)</sup><span style="color: #555555; font-family: "arial" , sans-serif; font-size: 10.5pt;">
Early access to physiotherapy is now included in government measures. For
instance, as part of the work generated by the Five Year Forward View aimed at
reducing sickness absence in NHS workers.</span><sup style="color: #555555; font-family: Arial, sans-serif;">(12)</sup></div>
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<b><span style="color: #2e2e3b; font-family: "arial" , "sans-serif"; font-size: 13.5pt;">Case studies<o:p></o:p></span></b></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiToCFFdBZVQrjLY-QOi1zavOKpKj-JcjmpEHcdetCRYTmNXpwA0tXTcv6898I2XrJoW7a8g3MUDr-ndQ3B2ffnoVVFN-6HtjpoaYyj0vvxTpfosBFdl9iUJkLlR8O9nD7UZ_D6s6scXFw/s1600/2018.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="201" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiToCFFdBZVQrjLY-QOi1zavOKpKj-JcjmpEHcdetCRYTmNXpwA0tXTcv6898I2XrJoW7a8g3MUDr-ndQ3B2ffnoVVFN-6HtjpoaYyj0vvxTpfosBFdl9iUJkLlR8O9nD7UZ_D6s6scXFw/s400/2018.jpg" width="400" /></a></div>
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<b><span style="color: #222222; font-family: "arial" , "sans-serif"; font-size: 13.5pt;">41,000 working days
saved<o:p></o:p></span></b></div>
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<b><span style="color: #555555; font-family: "arial" , "sans-serif"; font-size: 10.5pt;">John Lewis</span></b><span style="color: #555555; font-family: "arial" , "sans-serif"; font-size: 10.5pt;"> partners (staff)
reporting an injury receive a triage call from Physio Med within four hours,
and initial assessment from a chartered physiotherapist within three days.
2,324 partners engaged with the service over 12 months. JLP estimates it saved
41,010 working days, saving £2,676,000<o:p></o:p></span></div>
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<b><span style="color: #222222; font-family: "arial" , "sans-serif"; font-size: 13.5pt;">93% improvement<o:p></o:p></span></b></div>
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<span style="color: #555555; font-family: "arial" , "sans-serif"; font-size: 10.5pt;">The <b>Royal Free London NHS Trust</b> provides a
physio-led health and work centre for staff with self-referral to
physiotherapy, workplace and ergonomic assessments and health and wellbeing
advice. 89% were recommended fit to stay or return to work; data shows 93%
improvement in spinal, upper and lower limb disorders.<o:p></o:p></span></div>
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<b><span style="color: #222222; font-family: "arial" , "sans-serif"; font-size: 13.5pt;"> </span></b><b><span style="color: #222222; font-family: "arial" , "sans-serif"; font-size: 13.5pt;">Worst to best</span></b></div>
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<b><span style="color: #555555; font-family: "arial" , "sans-serif"; font-size: 10.5pt;">NHS Lanarkshire</span></b><span style="color: #555555; font-family: "arial" , "sans-serif"; font-size: 10.5pt;"> put in place a
‘self-referral to support’ service, including physiotherapy, from day one of
sickness absence. They moved from being the worst, to among the bestperforming
Health Boards in mainland Scotland.<o:p></o:p></span></div>
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<b><span style="color: #222222; font-family: "arial" , "sans-serif"; font-size: 13.5pt;">Increased
confidence for managers<o:p></o:p></span></b></div>
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<span style="color: #555555; font-family: "arial" , "sans-serif"; font-size: 10.5pt;">79% of staff using the Physio Plus self-referral
physiotherapy service at <b>Sheffield NHS Hospitals Trust</b> report it
prevented them having to take time off work. 69% of those off work said it
helped them return more quickly. Staff and managers said it increased their
confidence in dealing with sickness absence.<o:p></o:p></span></div>
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<b><span style="color: #222222; font-family: "arial" , "sans-serif"; font-size: 13.5pt;">High return on
investment<o:p></o:p></span></b></div>
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<span style="color: #555555; font-family: "arial" , "sans-serif"; font-size: 10.5pt;">100 <b>London Fire Brigade</b> staff with chronic
musculoskeletal conditions followed a programme provided by Crystal Palace
Physio Group including work-specific exercises. There was an 85% reduction in
time off work, and £27 return on every £1 spent.<o:p></o:p></span></div>
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<b><span style="color: #222222; font-family: "arial" , "sans-serif"; font-size: 13.5pt;">Staff self-referral<o:p></o:p></span></b></div>
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<span style="color: #555555; font-family: "arial" , "sans-serif"; font-size: 10.5pt;">Powys physiotherapy service responded to data from
the health and wellbeing team demonstrating MSK conditions were in the top
three reasons for sickness absence at <b>Powys Teaching Health Board</b>. Staff
now fast-track themselves into the service for assessment, self-help advice and
management of their condition.<o:p></o:p></span></div>
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<b><span style="color: #2e2e3b; font-family: "arial" , "sans-serif"; font-size: 13.5pt;">Summary<o:p></o:p></span></b></div>
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<span style="color: #555555; font-family: "arial" , "sans-serif"; font-size: 10.5pt;">Referral to physiotherapy can help people to work.
For those already in work, physiotherapists can help to prevent sickness
absence in the first place, and facilitate sustainable return to work following
sickness absence. For those not working, physiotherapy can enable individuals
to take opportunities to work. Early access to physiotherapy benefits
individuals, workplaces and the economy.<o:p></o:p></span></div>
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<b><span style="color: #2e2e3b; font-family: "arial" , "sans-serif"; font-size: 13.5pt;">References<o:p></o:p></span></b></div>
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<!--[if !supportLists]--><span style="color: #555555; font-family: "arial" , "sans-serif"; font-size: 10.5pt;">1.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span style="color: #555555; font-family: "arial" , "sans-serif"; font-size: 10.5pt;">Waddell G, Burton
KA. Is work good for your health and well-being? Norwich: TSO; 2006. </span><a href="https://www.gov.uk/government/publications/is-work-good-for-your-health-and-well-being" title="https://www.gov.uk/government/publications/is-work-good-for-your-health-and-well-being"><span style="color: #3554ae; font-family: "times new roman" , "serif"; font-size: 10.5pt; text-decoration: none;">https://www.gov.uk/government/publications/is-work-good-for-your-health-...</span></a><span style="color: #555555; font-family: "arial" , "sans-serif"; font-size: 10.5pt;"><o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="color: #555555; font-family: "arial" , "sans-serif"; font-size: 10.5pt;">2.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span style="color: #555555; font-family: "arial" , "sans-serif"; font-size: 10.5pt;">Black C, Frost D.
Health at work: an independent review of sickness absence. Norwich: TSO;<br />
</span><a href="https://www.gov.uk/government/publications/review-of-the-sickness-absence-system-in-great-britain" title="https://www.gov.uk/government/publications/review-of-the-sickness-absence-system-in-great-britain"><span style="color: #3554ae; font-family: "times new roman" , "serif"; font-size: 10.5pt; text-decoration: none;">https://www.gov.uk/government/publications/review-of-the-sickness-absenc...</span></a><span style="color: #555555; font-family: "arial" , "sans-serif"; font-size: 10.5pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 8.55pt; margin-left: 22.5pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo2; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: #555555; font-family: "arial" , "sans-serif"; font-size: 10.5pt;">3.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span style="color: #555555; font-family: "arial" , "sans-serif"; font-size: 10.5pt;">HM Treasury.
Spending review and autumn statement 2015. Norwich: TSO; 2015.<br />
</span><a href="https://www.gov.uk/government/publications/spending-review-and-autumn-statement-" title="https://www.gov.uk/government/publications/spending-review-and-autumn-statement-"><span style="color: #3554ae; font-family: "times new roman" , "serif"; font-size: 10.5pt; text-decoration: none;">https://www.gov.uk/government/publications/spending-review-and-autumn-st...</span></a><span style="color: #555555; font-family: "arial" , "sans-serif"; font-size: 10.5pt;"><br />
2015-documents<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 8.55pt; margin-left: 22.5pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo2; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: #555555; font-family: "arial" , "sans-serif"; font-size: 10.5pt;">4.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span style="color: #555555; font-family: "arial" , "sans-serif"; font-size: 10.5pt;">Department of Work
and Pensions. Fitness for work: the Government response to ‘Health at work – an
independent review of sickness absence’. London: Department of Work and
Pensions; 2013. </span><a href="https://www.gov.uk/government/publications/government-response-to-" title="https://www.gov.uk/government/publications/government-response-to-"><span style="color: #3554ae; font-family: "times new roman" , "serif"; font-size: 10.5pt; text-decoration: none;">https://www.gov.uk/government/publications/government-response-to-</span></a><span style="color: #555555; font-family: "arial" , "sans-serif"; font-size: 10.5pt;"><br />
the-review-of-the-sickness-absence-system-in-great-britain<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="color: #555555; font-family: "arial" , "sans-serif"; font-size: 10.5pt;">5.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span style="color: #555555; font-family: "arial" , "sans-serif"; font-size: 10.5pt;">National Institute
for Health and Care Excellence. Workplace health: management practices London:
National Institute for Health and Care Excellence; 2015.<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 8.55pt; margin-left: 22.5pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo2; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: #555555; font-family: "arial" , "sans-serif"; font-size: 10.5pt;">6.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span style="color: #555555; font-family: "arial" , "sans-serif"; font-size: 10.5pt;">The Chartered
Society of Physiotherapy. Self referral. 2015. </span><a href="http://www.csp.org.uk/professional-union/practice/self-referral" title="http://www.csp.org.uk/professional-union/practice/self-referral"><span style="color: #3554ae; font-family: "times new roman" , "serif"; font-size: 10.5pt; text-decoration: none;">http://www.csp.org.uk/professional-union/practice/self-referral</span></a><span style="color: #555555; font-family: "arial" , "sans-serif"; font-size: 10.5pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 8.55pt; margin-left: 22.5pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo2; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: #555555; font-family: "arial" , "sans-serif"; font-size: 10.5pt;">7.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span style="color: #555555; font-family: "arial" , "sans-serif"; font-size: 10.5pt;">Health and Safety
Executive. Work Related Musculoskeletal Disorder Statistics (WRMSDs) in Great
Britain 2014/15. London: Health and Safety Executive; 2015. </span><a href="http://www.hse.gov.uk/statistics/causdis/musculoskeletal/index.htm" title="http://www.hse.gov.uk/statistics/causdis/musculoskeletal/index.htm"><span style="color: #3554ae; font-family: "times new roman" , "serif"; font-size: 10.5pt; text-decoration: none;">http://www.hse.gov.uk/statistics/causdis/musculoskeletal/index.htm</span></a><span style="color: #555555; font-family: "arial" , "sans-serif"; font-size: 10.5pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 8.55pt; margin-left: 22.5pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo2; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: #555555; font-family: "arial" , "sans-serif"; font-size: 10.5pt;">8.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span style="color: #555555; font-family: "arial" , "sans-serif"; font-size: 10.5pt;">The Chartered
Society of Physiotherapy. Physiotherapy works - the evidence. </span><a href="http://www.csp.org.uk/professional-union/practice/your-business/evidence-base/physiotherapy-works" title="http://www.csp.org.uk/professional-union/practice/your-business/evidence-base/physiotherapy-works"><span style="color: #3554ae; font-family: "times new roman" , "serif"; font-size: 10.5pt; text-decoration: none;">http://www.csp.org.uk/professional-union/practice/your-business/evidence...</span></a><span style="color: #555555; font-family: "arial" , "sans-serif"; font-size: 10.5pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 8.55pt; margin-left: 22.5pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo2; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: #555555; font-family: "arial" , "sans-serif"; font-size: 10.5pt;">9.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span style="color: #555555; font-family: "arial" , "sans-serif"; font-size: 10.5pt;">The Kings Fund.
Disease and Disability. </span><a href="http://www.kingsfund.org.uk/time-to-think-differently/trends/disease-and-disability" title="http://www.kingsfund.org.uk/time-to-think-differently/trends/disease-and-disability"><span style="color: #3554ae; font-family: "times new roman" , "serif"; font-size: 10.5pt; text-decoration: none;">http://www.kingsfund.org.uk/time-to-think-differently/trends/disease-and...</span></a><span style="color: #555555; font-family: "arial" , "sans-serif"; font-size: 10.5pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 8.55pt; margin-left: 22.5pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo2; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: #555555; font-family: "arial" , "sans-serif"; font-size: 10.5pt;">10.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span style="color: #555555; font-family: "arial" , "sans-serif"; font-size: 10.5pt;">The Chartered
Society of Physiotherapy. Association of Chartered Physiotherapists in
Occupational Health and Ergonomics. 2015. </span><a href="http://www.acpohe.org.uk/" title="http://www.acpohe.org.uk/"><span style="color: #3554ae; font-family: "times new roman" , "serif"; font-size: 10.5pt; text-decoration: none;">http://www.acpohe.org.uk/</span></a><span style="color: #555555; font-family: "arial" , "sans-serif"; font-size: 10.5pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 8.55pt; margin-left: 22.5pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo2; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: #555555; font-family: "arial" , "sans-serif"; font-size: 10.5pt;">11.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span style="color: #555555; font-family: "arial" , "sans-serif"; font-size: 10.5pt;">The Royal College
of Physicians. Work and wellbeing in the NHS: why staff health matters to
patient care. London: Royal College of Physicians; 2015. </span><a href="https://www.rcplondon.ac.uk/guidelines-policy/work-and-wellbeing-nhs-why-staff-health-matters-patient-care" title="https://www.rcplondon.ac.uk/guidelines-policy/work-and-wellbeing-nhs-why-staff-health-matters-patient-care"><span style="color: #3554ae; font-family: "times new roman" , "serif"; font-size: 10.5pt; text-decoration: none;">https://www.rcplondon.ac.uk/guidelines-policy/work-and-wellbeing-nhs-why...</span></a><span style="color: #555555; font-family: "arial" , "sans-serif"; font-size: 10.5pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 8.55pt; margin-left: 22.5pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo2; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: #555555; font-family: "arial" , "sans-serif"; font-size: 10.5pt;">12.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span style="color: #555555; font-family: "arial" , "sans-serif"; font-size: 10.5pt;">NHS England. Five
Year Forward View. London: NHS England; 2014. </span><a href="https://www.england.nhs.uk/ourwork/futurenhs/" title="https://www.england.nhs.uk/ourwork/futurenhs/"><span style="color: #3554ae; font-family: "times new roman" , "serif"; font-size: 10.5pt; text-decoration: none;">https://www.england.nhs.uk/ourwork/futurenhs/</span></a><span style="color: #555555; font-family: "arial" , "sans-serif"; font-size: 10.5pt;"><o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 8.55pt; margin-left: 22.5pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo2; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: #555555; font-family: "arial" , "sans-serif"; font-size: 10.5pt;">13.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span style="color: #555555; font-family: "arial" , "sans-serif"; font-size: 10.5pt;">The Kings Fund.
Long term conditions and multi morbidity. </span><a href="http://www.kingsfund.org.uk/time-to-think-differently/trends/disease-and-disability/long-term-conditions-multi-morbidity" title="http://www.kingsfund.org.uk/time-to-think-differently/trends/disease-and-disability/long-term-conditions-multi-morbidity"><span style="color: #3554ae; font-family: "times new roman" , "serif"; font-size: 10.5pt; text-decoration: none;">http://www.kingsfund.org.uk/time-to-think-differently/trends/disease-and...</span></a><span style="color: #555555; font-family: "arial" , "sans-serif"; font-size: 10.5pt;"><o:p></o:p></span></div>
Abbey Physio Limerickhttp://www.blogger.com/profile/04355351899636585517noreply@blogger.com0tag:blogger.com,1999:blog-5313494908996277901.post-1855068593496750242016-11-08T09:54:00.003-08:002016-11-08T09:54:39.642-08:00Physiotherapy Works - Easy & Early Access<div style="background: white; line-height: 16.3pt;">
<span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt;">The benefits of early
appropriate access to Physiotherapists for patients with musculoskeletal
disorders is no longer disputed. Research evidence is overwhelming in
confirming it is both clinically and cost effective for patients to consult a
Chartered Physiotherapist with their back neck or limb complaints. Patients can
self-refer in most places in Scotland and two-thirds of <a href="https://www.blogger.com/null" name="_GoBack"></a>Wales,
but only three of 10 CCGs in England offer that option in any form and there is
one pilot scheme in Northern Ireland.<o:p></o:p></span></div>
<div style="background: white; line-height: 16.3pt;">
<span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt;">However, with primary care
under enormous pressure and seeking new models of care that put patients in
control, the case for making physiotherapists <b>the first point of contact for back, neck, limb problems</b> - whether
working alongside GPs or in more traditional outpatient settings – has never
been stronger<o:p></o:p></span></div>
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<br /></div>
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<b><span style="color: #222222; font-family: "Arial","sans-serif"; font-size: 13.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Creating capacity<o:p></o:p></span></b></div>
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<!--[if !supportLists]--><span style="color: #555555; font-family: Wingdings; font-size: 10.0pt; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 10.5pt; mso-fareast-font-family: Wingdings; mso-fareast-language: EN-IE;">§<span style="font-family: "Times New Roman"; font-size: 7pt; font-stretch: normal; font-variant-numeric: normal; line-height: normal;"> </span></span><!--[endif]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Giving patients the
choice to be assessed by a physiotherapist as their first point of contact
frees up GPs for other often more acute cases<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="color: #555555; font-family: Wingdings; font-size: 10.0pt; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 10.5pt; mso-fareast-font-family: Wingdings; mso-fareast-language: EN-IE;">§<span style="font-family: "Times New Roman"; font-size: 7pt; font-stretch: normal; font-variant-numeric: normal; line-height: normal;"> </span></span><!--[endif]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Musculoskeletal
conditions alone account for up to 30% of consultations in GP surgeries each
year – more than 100 million appointments.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="color: #555555; font-family: Wingdings; font-size: 10.0pt; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 10.5pt; mso-fareast-font-family: Wingdings; mso-fareast-language: EN-IE;">§<span style="font-family: "Times New Roman"; font-size: 7pt; font-stretch: normal; font-variant-numeric: normal; line-height: normal;"> </span></span><!--[endif]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">When other
conditions, such as frailty and women’s health, are taken into consideration,
the potential impact for the HSE and all public health services is enormous<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 12.85pt; margin-left: 0cm; margin-right: 0cm; margin-top: 18.0pt; mso-outline-level: 3;">
<b><span style="color: #222222; font-family: "Arial","sans-serif"; font-size: 13.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Saving money<o:p></o:p></span></b></div>
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<!--[if !supportLists]--><span style="color: #555555; font-family: Wingdings; font-size: 10.0pt; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 10.5pt; mso-fareast-font-family: Wingdings; mso-fareast-language: EN-IE;">§<span style="font-family: "Times New Roman"; font-size: 7pt; font-stretch: normal; font-variant-numeric: normal; line-height: normal;"> </span></span><!--[endif]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Self-referral for
an MSK problem cuts costs for the NHS by an average of £33 per patient<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 8.55pt; margin-left: 20.25pt; margin-right: 0cm; margin-top: 0cm; mso-list: l2 level1 lfo2; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: #555555; font-family: Wingdings; font-size: 10.0pt; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 10.5pt; mso-fareast-font-family: Wingdings; mso-fareast-language: EN-IE;">§<span style="font-family: "Times New Roman"; font-size: 7pt; font-stretch: normal; font-variant-numeric: normal; line-height: normal;"> </span></span><!--[endif]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">This represents a
saving of up to 25%<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="color: #555555; font-family: Wingdings; font-size: 10.0pt; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 10.5pt; mso-fareast-font-family: Wingdings; mso-fareast-language: EN-IE;">§<span style="font-family: "Times New Roman"; font-size: 7pt; font-stretch: normal; font-variant-numeric: normal; line-height: normal;"> </span></span><!--[endif]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Savings also come
through fewer investigations, such as scans and x-rays, and lower levels of
prescribing<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 8.55pt;">
<span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;"> </span><b><span style="color: #222222; font-family: "Arial","sans-serif"; font-size: 13.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Improving patient
outcomes</span></b></div>
<div class="MsoNormal" style="background: whitesmoke; line-height: 16.3pt;">
<span style="color: #444444; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">In Torbay, North
Devon, introducing self-referral <b>cut waiting times</b> from 10 weeks to
within three days for <b>90%</b> of patients with musculoskeletal complaints<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 8.55pt; margin-left: 20.25pt; margin-right: 0cm; margin-top: 0cm; mso-list: l4 level1 lfo3; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: #555555; font-family: Wingdings; font-size: 10.0pt; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 10.5pt; mso-fareast-font-family: Wingdings; mso-fareast-language: EN-IE;">§<span style="font-family: "Times New Roman"; font-size: 7pt; font-stretch: normal; font-variant-numeric: normal; line-height: normal;"> </span></span><!--[endif]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Self-referral helps
prevent acute problems from becoming chronic and reduces long-term pain and
disability<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 8.55pt; margin-left: 20.25pt; margin-right: 0cm; margin-top: 0cm; mso-list: l4 level1 lfo3; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: #555555; font-family: Wingdings; font-size: 10.0pt; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 10.5pt; mso-fareast-font-family: Wingdings; mso-fareast-language: EN-IE;">§<span style="font-family: "Times New Roman"; font-size: 7pt; font-stretch: normal; font-variant-numeric: normal; line-height: normal;"> </span></span><!--[endif]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">It reduces the time
people are off sick from work<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 8.55pt; margin-left: 20.25pt; margin-right: 0cm; margin-top: 0cm; mso-list: l4 level1 lfo3; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: #555555; font-family: Wingdings; font-size: 10.0pt; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 10.5pt; mso-fareast-font-family: Wingdings; mso-fareast-language: EN-IE;">§<span style="font-family: "Times New Roman"; font-size: 7pt; font-stretch: normal; font-variant-numeric: normal; line-height: normal;"> </span></span><!--[endif]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">It is also shown to
reduce waiting times and improve patient satisfaction<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 12.85pt; mso-margin-top-alt: auto;">
<b><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Putting patients in control</span></b><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;"><o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 8.55pt; margin-left: 20.25pt; margin-right: 0cm; margin-top: 0cm; mso-list: l3 level1 lfo4; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: #555555; font-family: Wingdings; font-size: 10.0pt; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 10.5pt; mso-fareast-font-family: Wingdings; mso-fareast-language: EN-IE;">§<span style="font-family: "Times New Roman"; font-size: 7pt; font-stretch: normal; font-variant-numeric: normal; line-height: normal;"> </span></span><!--[endif]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Self-referral is an
important route into advice and treatment for the growing numbers of people
with at least one long-term condition<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 8.55pt; margin-left: 20.25pt; margin-right: 0cm; margin-top: 0cm; mso-list: l3 level1 lfo4; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: #555555; font-family: Wingdings; font-size: 10.0pt; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 10.5pt; mso-fareast-font-family: Wingdings; mso-fareast-language: EN-IE;">§<span style="font-family: "Times New Roman"; font-size: 7pt; font-stretch: normal; font-variant-numeric: normal; line-height: normal;"> </span></span><!--[endif]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">It enables
individuals to feel confident to more effectively manage their own condition
and live independently<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 8.55pt; margin-left: 20.25pt; margin-right: 0cm; margin-top: 0cm; mso-list: l3 level1 lfo4; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: #555555; font-family: Wingdings; font-size: 10.0pt; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 10.5pt; mso-fareast-font-family: Wingdings; mso-fareast-language: EN-IE;">§<span style="font-family: "Times New Roman"; font-size: 7pt; font-stretch: normal; font-variant-numeric: normal; line-height: normal;"> </span></span><!--[endif]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Giving patients the
responsibility for their own referral is shown to cut did-not-attend rates and
improve adherence to treatment plans<o:p></o:p></span></div>
<div style="background: white; border-bottom: dotted #C8C8C8 1.0pt; border-left: none; border-right: none; border-top: solid #FDBF14 2.25pt; mso-border-bottom-alt: dotted #C8C8C8 .75pt; mso-border-top-alt: solid #FDBF14 2.25pt; mso-element: para-border-div; padding: 7.0pt 0cm 10.0pt 0cm;">
<div class="MsoNormal" style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; border: none; line-height: 16.3pt; margin: 26.65pt 0cm 10pt; padding: 0cm;">
<b><span style="color: #2e2e3b; font-family: "Arial","sans-serif"; font-size: 13.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Putting self-referral into practice<o:p></o:p></span></b></div>
</div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 12.85pt; margin-left: 0cm; margin-right: 0cm; margin-top: 18.0pt; mso-outline-level: 3;">
<b><span style="color: #222222; font-family: "Arial","sans-serif"; font-size: 13.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Working alongside
GPs<o:p></o:p></span></b></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 12.85pt; mso-margin-top-alt: auto;">
<span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">In West Wakefield physiotherapists are the first
point of contact for patients with musculoskeletal pain and dysfunction.<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 12.85pt; mso-margin-top-alt: auto;">
<span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">The service, which has been running since late 2014
following a successful pilot, has expanded to six GP practices in West
Wakefield and receives on average 900 referrals a month.<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 12.85pt; mso-margin-top-alt: auto;">
<span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">By upskilling reception staff to identify
appropriate patients to be seen by physiotherapists, significant GP time has
been saved.<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 12.85pt; margin-left: 0cm; margin-right: 0cm; margin-top: 18.0pt; mso-outline-level: 3;">
<b><span style="color: #222222; font-family: "Arial","sans-serif"; font-size: 13.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;"><br /></span></b></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 12.85pt; margin-left: 0cm; margin-right: 0cm; margin-top: 18.0pt; mso-outline-level: 3;">
<b><span style="color: #222222; font-family: "Arial","sans-serif"; font-size: 13.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">The GP's view</span></b></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 12.85pt; mso-margin-top-alt: auto;">
<span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Self-referral was rolled out across the Plymouth
area in February 2015 after a successful trial.<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 12.85pt; mso-margin-top-alt: auto;">
<span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Dr Gary Lenden, a GP from Plymouth and Clinical
Lead for the Western locality of Northern, Eastern and Western Devon Clinical
Commissioning Group, said:<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 12.85pt; mso-margin-top-alt: auto;">
<span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">'Being able to self-refer makes patients feel
empowered, because they have the chance to say exactly what symptoms they are
experiencing and how it is affecting them.<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 12.85pt; mso-margin-top-alt: auto;">
<span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">'It also means people can be seen quicker, which is
more convenient for them and prevents chronic issues developing.<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 12.85pt; mso-margin-top-alt: auto;">
<span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">'Hopefully this will reduce the need for
prescriptions and expensive diagnostic tests. Allowing patients to self-refer
also reduces the overall musculoskeletal workload for GP practices, which frees
up appointment slots in busy clinics.'<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 12.85pt; margin-left: 0cm; margin-right: 0cm; margin-top: 18.0pt; mso-outline-level: 3;">
<b><span style="color: #222222; font-family: "Arial","sans-serif"; font-size: 13.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">The rapid access
service<o:p></o:p></span></b></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 12.85pt; mso-margin-top-alt: auto;">
<span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Patients refering themselves by telephone in the
Torbay and Southern Devon Health and Care NHS Trust are offered an appointment
with a physiotherapist within 72 hours.<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 12.85pt; mso-margin-top-alt: auto;">
<span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">The waiting time prior to the introduction of
rapid-access/self–referral was up to 10 weeks. The service cut DNAs by at least
70% and reduced the number of follow-up appointments by more than 18%.<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 12.85pt; mso-margin-top-alt: auto;">
<span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">The drop-in clinic<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 12.85pt; mso-margin-top-alt: auto;">
<span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Abertawe Bro Morgannwg University Health Board set
up a walk-in clinic in November 2009 for immediate, face-to-face
musculoskeletal assessment and advice.<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 12.85pt; mso-margin-top-alt: auto;">
<span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">The service runs for two hours each weekday morning
and has led to a significant reduction in the volume of follow-up appointments
and an overall patient satisfaction rating of 9.6 out of 10.<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 12.85pt; mso-margin-top-alt: auto;">
<span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">A ‘Physio Direct’ telephone service has since been
established alongside the clinic for an hour a day to provide early advice and
management for people with MSK problems.<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 12.85pt; margin-left: 0cm; margin-right: 0cm; margin-top: 18.0pt; mso-outline-level: 3;">
<br /></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 12.85pt; margin-left: 0cm; margin-right: 0cm; margin-top: 18.0pt; mso-outline-level: 3;">
<b><span style="color: #222222; font-family: "Arial","sans-serif"; font-size: 13.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Telephone triage</span></b></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 12.85pt; mso-margin-top-alt: auto;">
<span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Self-referral is long–established in Scotland and
all health boards offer either a full or partial service.<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 12.85pt; mso-margin-top-alt: auto;">
<span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Telephone triage is central to that, although many
patients can also access services electronically.<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 12.85pt; mso-margin-top-alt: auto;">
<span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">NHS Tayside trialled the Musculoskeletal Advice and
Triage Service (MATS), offering a telephone assessment by a physiotherapist to
patients diverted from the national NHS 24 helpline.<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 12.85pt; mso-margin-top-alt: auto;">
<span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">By cutting the number of face-to-face follow-up
appointments needed, the 39-week trial is estimated<br />
to have saved the equivalent of 182 working days for the service.<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 12.85pt; mso-margin-top-alt: auto;">
<span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">It halved waiting times and achieved high patient
satisfaction levels.<o:p></o:p></span></div>
<div style="background: white; border-bottom: dotted #C8C8C8 1.0pt; border-left: none; border-right: none; border-top: solid #FDBF14 2.25pt; mso-border-bottom-alt: dotted #C8C8C8 .75pt; mso-border-top-alt: solid #FDBF14 2.25pt; mso-element: para-border-div; padding: 7.0pt 0cm 10.0pt 0cm;">
<div class="MsoNormal" style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; border: none; line-height: 16.3pt; margin: 26.65pt 0cm 10pt; padding: 0cm;">
<b><span style="color: #2e2e3b; font-family: "Arial","sans-serif"; font-size: 13.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Mythbusters<o:p></o:p></span></b></div>
</div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 12.85pt; margin-left: 0cm; margin-right: 0cm; margin-top: 18.0pt; mso-outline-level: 3;">
<b><span style="color: #222222; font-family: "Arial","sans-serif"; font-size: 13.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Won’t self-referral
lead to a surge in referrals?<o:p></o:p></span></b></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 12.85pt; mso-margin-top-alt: auto;">
<span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">No. The evidence shows that unless there was a
previously unmet need in the area, referrals do not increase significantly in
the early stages of implementation and later level off.<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 12.85pt; mso-margin-top-alt: auto;">
<span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Indeed, self-referrers are shown to need fewer
appointments so activity levels can actually reduce.<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 12.85pt; mso-margin-top-alt: auto;">
<span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">A rise in referrals can also reduce demand in the
longer-term if patients with minor problems seek treatment sooner before they
can become chronic.<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 12.85pt; margin-left: 0cm; margin-right: 0cm; margin-top: 18.0pt; mso-outline-level: 3;">
<b><span style="color: #222222; font-family: "Arial","sans-serif"; font-size: 13.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;"> </span></b><b><span style="color: #222222; font-family: "Arial","sans-serif"; font-size: 13.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Aren’t there safety
concerns?</span></b></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 12.85pt; mso-margin-top-alt: auto;">
<span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">No. Physiotherapists complete extensive training to
identify red flags and would always refer a patient back to a GP if they had
concerns.<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 12.85pt; mso-margin-top-alt: auto;">
<span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Low numbers of complaints about physiotherapists to
their regulator, the Health and Care Professions Council, demonstrate their
high level of professionalism.<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 12.85pt; mso-margin-top-alt: auto;">
<span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Self-referral has also been the primary route in to
private treatment for decades, further demonstrating the safe, effective nature
of the model.<o:p></o:p></span></div>
<div style="background: white; border-bottom: dotted #C8C8C8 1.0pt; border-left: none; border-right: none; border-top: solid #FDBF14 2.25pt; mso-border-bottom-alt: dotted #C8C8C8 .75pt; mso-border-top-alt: solid #FDBF14 2.25pt; mso-element: para-border-div; padding: 7.0pt 0cm 10.0pt 0cm;">
<div class="MsoNormal" style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; border: none; line-height: 16.3pt; margin: 26.65pt 0cm 10pt; padding: 0cm;">
<b><span style="color: #2e2e3b; font-family: "Arial","sans-serif"; font-size: 13.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">The patient voice<o:p></o:p></span></b></div>
</div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 12.85pt; mso-margin-top-alt: auto;">
<span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Patient satisfaction was recorded as high during
the Department of Health’s pilot scheme in England and feedback was positive.<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 12.85pt; mso-margin-top-alt: auto;">
<span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">'"Cost-effective in terms of my time and
commitments.'<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 12.85pt; mso-margin-top-alt: auto;">
<span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">'I was pleased at the speed with which my
self-referral was dealt with.'<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 12.85pt; mso-margin-top-alt: auto;">
<span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">'Constructive advice for self-help and management
for living with arthritis.'<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 12.85pt; mso-margin-top-alt: auto;">
<span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">'In-depth consultation in a relaxed and unhurried
way.'<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 12.85pt; mso-margin-top-alt: auto;">
<span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">'This service should continue to be offered for all
patients.'<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 12.85pt; mso-margin-top-alt: auto;">
<span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">'Most appreciative of my 'personal exercise
programme' given to me and explained.'<o:p></o:p></span></div>
<div style="background: white; border-bottom: dotted #C8C8C8 1.0pt; border-left: none; border-right: none; border-top: solid #FDBF14 2.25pt; mso-border-bottom-alt: dotted #C8C8C8 .75pt; mso-border-top-alt: solid #FDBF14 2.25pt; mso-element: para-border-div; padding: 7.0pt 0cm 10.0pt 0cm;">
<div class="MsoNormal" style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; border: none; line-height: 16.3pt; margin: 26.65pt 0cm 10pt; padding: 0cm;">
<b><span style="color: #2e2e3b; font-family: "Arial","sans-serif"; font-size: 13.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Recommendations for implementing
self-referral<o:p></o:p></span></b></div>
</div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 12.85pt; mso-margin-top-alt: auto;">
<b><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Understand</span></b><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;"> existing referral
patterns from local GPs<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 12.85pt; mso-margin-top-alt: auto;">
<b><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Establish</span></b><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;"> baseline data for
activity, cost and outcomes<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 12.85pt; mso-margin-top-alt: auto;">
<b><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Reduce</span></b><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;"> waiting lists in
preparation for direct access<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 12.85pt; mso-margin-top-alt: auto;">
<b><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Ensure</span></b><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;"> all staff in the
pathway understand and support the self referral scheme<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 12.85pt; mso-margin-top-alt: auto;">
<b><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Identify</span></b><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;"> appropriate
opportunities to signpost to self referral<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 12.0pt; mso-margin-top-alt: auto;">
<b><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Engage</span></b><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;"> with development
and design with online referral systems to allow self referral<o:p></o:p></span></div>
<div style="background: white; border-bottom: dotted #C8C8C8 1.0pt; border-left: none; border-right: none; border-top: solid #FDBF14 2.25pt; mso-border-bottom-alt: dotted #C8C8C8 .75pt; mso-border-top-alt: solid #FDBF14 2.25pt; mso-element: para-border-div; padding: 7.0pt 0cm 10.0pt 0cm;">
<div class="MsoNormal" style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; border: none; line-height: 16.3pt; margin: 26.65pt 0cm 10pt; padding: 0cm;">
<b><span style="color: #2e2e3b; font-family: "Arial","sans-serif"; font-size: 13.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">References<o:p></o:p></span></b></div>
</div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 8.55pt; margin-left: 22.5pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo5; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: Arial; mso-fareast-language: EN-IE;">1.<span style="font-family: "Times New Roman"; font-size: 7pt; font-stretch: normal; font-variant-numeric: normal; line-height: normal;"> </span></span><!--[endif]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">The Chartered
Society of Physiotherapy, Freedom of Information Audit, 2014<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 8.55pt; margin-left: 22.5pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo5; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: Arial; mso-fareast-language: EN-IE;">2.<span style="font-family: "Times New Roman"; font-size: 7pt; font-stretch: normal; font-variant-numeric: normal; line-height: normal;"> </span></span><!--[endif]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">British Orthopaedic
Association. Getting it right first time (GIRFT): improving the Quality of
Orthopaedic Care within the National Health Service in England. London: British
Orthopaedic Association; 2015. URL: </span><a href="http://www.gettingitrightfirsttime.com/report" target="_blank" title="Getting it right first time report (external link)"><span style="color: #3554ae; font-family: "Times New Roman","serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE; text-decoration: none; text-underline: none;">www.gettingitrightfirsttime.com/report</span></a><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;"><o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 8.55pt; margin-left: 22.5pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo5; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: Arial; mso-fareast-language: EN-IE;">3.<span style="font-family: "Times New Roman"; font-size: 7pt; font-stretch: normal; font-variant-numeric: normal; line-height: normal;"> </span></span><!--[endif]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">The Chartered
Society of Physiotherapy. Musculoskeletal physiotherapy: patient self-referral.
London: The Chartered Society of Physiotherapy; 2012. URL: </span><a href="https://www.nice.org.uk/sav%3Cbr%20/%3EingsAndProductivityAndLocalPracticeResource?ci=http%3a%2f%3cbr%20/%3e%2farms.evidence.nhs.uk%2fresources%2fQIPP%2f29492%3f%3cbr%20/%3eniceorg%3dtrue" target="_blank" title="NICE website (external link)"><span style="color: #3554ae; font-family: "Times New Roman","serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE; text-decoration: none; text-underline: none;">www.nice.org.uk</span></a><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;"><o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 8.55pt; margin-left: 22.5pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo5; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: Arial; mso-fareast-language: EN-IE;">4.<span style="font-family: "Times New Roman"; font-size: 7pt; font-stretch: normal; font-variant-numeric: normal; line-height: normal;"> </span></span><!--[endif]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Holdsworth L,
Webster V, McFadyen A. What are the costs to NHS Scotland of self-referral to
physiotherapy? Results of a national trial. Physiotherapy. 2007;93(1):3-11<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 8.55pt; margin-left: 22.5pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo5; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: Arial; mso-fareast-language: EN-IE;">5.<span style="font-family: "Times New Roman"; font-size: 7pt; font-stretch: normal; font-variant-numeric: normal; line-height: normal;"> </span></span><!--[endif]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Department of
Health. The musculoskeletal services framework : a joint responsibility: doing
it differently. London: Department of Health; 2006. URL: </span><a href="https://www.blogger.com/blogger.g?blogID=5313494908996277901" target="_blank" title="National Archives website (external link)"><span style="color: #3554ae; font-family: "Times New Roman","serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE; text-decoration: none; text-underline: none;">webarchive.nationalarchives.gov.uk</span></a><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;"><o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 8.55pt; margin-left: 22.5pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo5; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: Arial; mso-fareast-language: EN-IE;">6.<span style="font-family: "Times New Roman"; font-size: 7pt; font-stretch: normal; font-variant-numeric: normal; line-height: normal;"> </span></span><!--[endif]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Nordeman L, Nilsson
B, Möller M, et al. Early access to physical therapy treatment for subacute low
back pain in primary health care. Clinical Journal of Pain. 2006;22(6):505-11<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 8.55pt; margin-left: 22.5pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo5; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: Arial; mso-fareast-language: EN-IE;">7.<span style="font-family: "Times New Roman"; font-size: 7pt; font-stretch: normal; font-variant-numeric: normal; line-height: normal;"> </span></span><!--[endif]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Department of
Health. Self-referral pilots to musculoskeletal physiotherapy and the
implications for improving access to other AHP services. London: Department of
Health; 2008. URLs: </span><a href="http://webarchive.nationalarchives.gov.uk/20100202100434/" title="National Archives website (external link)"><span style="color: #3554ae; font-family: "Times New Roman","serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE; text-decoration: none; text-underline: none;">webarchive.nationalarchives.gov.uk</span></a><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;"><br />
</span><a href="http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/%3Cbr%20/%3EPublicationsPolicyAndGuidance/DH_089516" target="_blank" title="DH website (external link)"><span style="color: #3554ae; font-family: "Times New Roman","serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE; text-decoration: none; text-underline: none;">webarchive.nationalarchives.gov.uk</span></a><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;"><o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 8.55pt; margin-left: 22.5pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo5; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: Arial; mso-fareast-language: EN-IE;">8.<span style="font-family: "Times New Roman"; font-size: 7pt; font-stretch: normal; font-variant-numeric: normal; line-height: normal;"> </span></span><!--[endif]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Torbay and Southern
Devon Health and Care NHS Trust. Information supplied to CSP<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 8.55pt; margin-left: 22.5pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo5; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: Arial; mso-fareast-language: EN-IE;">9.<span style="font-family: "Times New Roman"; font-size: 7pt; font-stretch: normal; font-variant-numeric: normal; line-height: normal;"> </span></span><!--[endif]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">West Wakefield
Health and Wellbeing. Information supplied to CSP<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 8.55pt; margin-left: 22.5pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo5; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: Arial; mso-fareast-language: EN-IE;">10.<span style="font-family: "Times New Roman"; font-size: 7pt; font-stretch: normal; font-variant-numeric: normal; line-height: normal;"> </span></span><!--[endif]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">NHS Tayside.
Information supplied to CSP<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 8.55pt; margin-left: 22.5pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo5; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: Arial; mso-fareast-language: EN-IE;">11.<span style="font-family: "Times New Roman"; font-size: 7pt; font-stretch: normal; font-variant-numeric: normal; line-height: normal;"> </span></span><!--[endif]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Abertawe Bro
Morgannwg University Health Board. Information supplied to CSP<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 8.55pt; margin-left: 22.5pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo5; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: Arial; mso-fareast-language: EN-IE;">12.<span style="font-family: "Times New Roman"; font-size: 7pt; font-stretch: normal; font-variant-numeric: normal; line-height: normal;"> </span></span><!--[endif]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Northern, Eastern
and Western Devon Clinical Commissioning Group. Information supplied to CSP<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 8.55pt; margin-left: 22.5pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo5; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: Arial; mso-fareast-language: EN-IE;">13.<span style="font-family: "Times New Roman"; font-size: 7pt; font-stretch: normal; font-variant-numeric: normal; line-height: normal;"> </span></span><!--[endif]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">NHS London. Allied
Health Professions MSK toolkit. 2012. ‘A significant saving to patients was
experienced as they attended far fewer appointments which resulted in lower
personal cost and less inconvenience’. MSK framework Assessment/Diagnosis p.28.
URL: </span><a href="http://www.nras.org.uk/data/files/For%20professionals/MSK%20%3Cbr%20/%3Etoolkit.pdf" target="_blank" title="NRAS website (external link)"><span style="color: #3554ae; font-family: "Times New Roman","serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE; text-decoration: none; text-underline: none;">www.nras.org.uk</span></a><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;"><o:p></o:p></span></div>
<br />
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<!--[if !supportLists]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: Arial; mso-fareast-language: EN-IE;">14.<span style="font-family: "Times New Roman"; font-size: 7pt; font-stretch: normal; font-variant-numeric: normal; line-height: normal;"> </span></span><!--[endif]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">The Chartered
Society of Physiotherapy. What is physiotherapy? The Chartered Society of
Physiotherapy URL: </span><a href="http://www.csp.org.uk/your-health/what-physiotherapy" title="What is<br />
physiotherapy?"><span style="color: #3554ae; font-family: "Times New Roman","serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE; text-decoration: none; text-underline: none;">www.csp.org.uk</span></a><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;"><o:p></o:p></span></div>
Abbey Physio Limerickhttp://www.blogger.com/profile/04355351899636585517noreply@blogger.com0tag:blogger.com,1999:blog-5313494908996277901.post-6525558961366030552016-11-08T09:22:00.000-08:002016-11-08T09:22:53.127-08:00Physiotherapy works: Falls and frailty<div class="MsoNormal">
<span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; line-height: 107%;">As we age, we begin to notice changes,
small at first, a little joint stiffness maybe, hips and knees or shoulders can
be culprits. Or our balance starts to become less reliable. It may be time to
consult your Chartered Physiotherapist. Physiotherapy treatment and
rehabilitation reduces falls, addresses frailty and restores independence. It
helps maintain our strength, flexibility, balance and function if we are ageing
well and want to stay active and independent for our life time. <o:p></o:p></span></div>
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<b><span style="color: #2e2e3b; font-family: "Arial","sans-serif"; font-size: 13.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Risks of a fall<o:p></o:p></span></b></div>
</div>
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<b><span style="color: #444444; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Half of people who
have a fall will fall again within the next 12 months</span></b><a href="https://www.blogger.com/null" name="_GoBack"></a><span style="color: #444444; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;"><o:p></o:p></span></div>
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<span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">A fall is an event that results in a person coming
to rest unintentionally on the ground or floor or other lower level.<sup>(1)</sup>
Over 400 risk factors leading to falling have been identified including <br />
lack of physical activity resulting in loss of muscle tone, decreased bone
mass, poor balance, and reduced flexibility; impaired vision, medications,
disease including Parkinson’s, dementia, stroke and arthritis, surgery, and
environmental hazards. The risk of falls and associated complications rise
steadily with age and can be a marker of increasing frailty. Frailty is not
clearly defined but is widely accepted to include a combination of weight loss,
fatigue, reduced grip strength, diminished physical activity or slowed gait
associated with increased risk of falls, hospitalisation, loss of mobility and
independence, increasing disability and death.<sup>(2)</sup><o:p></o:p></span></div>
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<b><span style="color: #2e2e3b; font-family: "Arial","sans-serif"; font-size: 13.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Size of the problem<o:p></o:p></span></b></div>
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<b><span style="color: #444444; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Cost of the
problem:<br />
</span></b><span style="color: #444444; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Cost to the NHS of falls is estimated at £2.3 billion per year.<sup>(14)</sup><o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="color: #555555; font-family: Wingdings; font-size: 10.0pt; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 10.5pt; mso-fareast-font-family: Wingdings; mso-fareast-language: EN-IE;">§<span style="font-family: "Times New Roman"; font-size: 7pt; font-stretch: normal; font-variant-numeric: normal; line-height: normal;"> </span></span><!--[endif]--><b><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">1 in 3</span></b><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;"> people aged over
65 will fall every year<sup>(10)</sup> equating to more than<b> 3 million</b>
falls per year.The rate increases to nearly 1 in 2 for community dwelling
adults over 80<sup>(11)</sup><o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="color: #555555; font-family: Wingdings; font-size: 10.0pt; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 10.5pt; mso-fareast-font-family: Wingdings; mso-fareast-language: EN-IE;">§<span style="font-family: "Times New Roman"; font-size: 7pt; font-stretch: normal; font-variant-numeric: normal; line-height: normal;"> </span></span><!--[endif]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Half of people who
fall<b> will fall again</b> in the next 12 months<sup>(12, 13)</sup><o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="color: #555555; font-family: Wingdings; font-size: 10.0pt; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 10.5pt; mso-fareast-font-family: Wingdings; mso-fareast-language: EN-IE;">§<span style="font-family: "Times New Roman"; font-size: 7pt; font-stretch: normal; font-variant-numeric: normal; line-height: normal;"> </span></span><!--[endif]--><b><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">10-25%</span></b><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;"> of fallers will
sustain a serious injury<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="color: #555555; font-family: Wingdings; font-size: 10.0pt; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 10.5pt; mso-fareast-font-family: Wingdings; mso-fareast-language: EN-IE;">§<span style="font-family: "Times New Roman"; font-size: 7pt; font-stretch: normal; font-variant-numeric: normal; line-height: normal;"> </span></span><!--[endif]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Injury due to falls
is leading cause of mortality in people aged<b> over 75</b> in UK<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 8.55pt; margin-left: 20.25pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: #555555; font-family: Wingdings; font-size: 10.0pt; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 10.5pt; mso-fareast-font-family: Wingdings; mso-fareast-language: EN-IE;">§<span style="font-family: "Times New Roman"; font-size: 7pt; font-stretch: normal; font-variant-numeric: normal; line-height: normal;"> </span></span><!--[endif]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Recurrent falls are
associated with increased mortality, increased hospitalisation and higher rates
of long term care.<o:p></o:p></span></div>
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<b><span style="color: #2e2e3b; font-family: "Arial","sans-serif"; font-size: 13.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Physiotherapy<o:p></o:p></span></b></div>
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<b><span style="color: #222222; font-family: "Arial","sans-serif"; font-size: 12.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">The cost of falls<o:p></o:p></span></b></div>
<div class="MsoNormal" style="background: whitesmoke; line-height: 16.3pt; margin-bottom: 12.0pt;">
<span style="color: #444444; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Falls cost the NHS £4.6 million every day yet every £1 spent on
physiotherapy could save £1.50 across the whole pathway<o:p></o:p></span></div>
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<a href="http://www.csp.org.uk/professional-union/practice/your-business/evidence-base/cost-falls"><span style="color: #3554ae; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE; text-decoration: none; text-underline: none;">Find and share the figures for your locality</span></a><span style="color: #444444; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;"><o:p></o:p></span></div>
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<span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Physiotherapists work with older adults in
interdisciplinary teams and with other agencies in community, hospital and care
settings often as an integral part of local falls care pathways. They have
specialist skills in assessment and re-ablement and provide evidence based
exercise, education and advice programmes aimed to prevent falls, improve
balance, increase self confidence, reduce fear of falling and promote active
and healthy lifestyles. Physiotherapy led group exercise programmes have been
shown to be effective and to reduce falls by 29% and the risk of falling by 15%
and individual exercise programmes by 32% and 22% respectively.<sup>(3)</sup>
Community based falls prevention programmes targeting older adults particularly
older women, can be highly cost effective with the value of benefits from
reduced hospital admission significantly exceeding cost of intervention.<sup>(4)</sup>
For community living older adults tailored exercise programmes delivered as
part of a multidisciplinary co-ordinated intervention reduced the rate of falls
by 31% and the risk of falling by 27%.<sup>(5)</sup><o:p></o:p></span></div>
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<b><span style="color: #222222; font-family: "Arial","sans-serif"; font-size: 12.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">More on falls, fractures and physiotherapy:<o:p></o:p></span></b></div>
<div class="MsoNormal" style="background: whitesmoke; line-height: 16.3pt;">
<a href="http://www.csp.org.uk/your-health/conditions/falls-fragility-fractures"><span style="color: #3554ae; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE; text-decoration: none; text-underline: none;">Falls and fragility fractures information aimed at
patients and carers</span></a><span style="color: #444444; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;"><o:p></o:p></span></div>
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<span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Programmes delivering 50+ hours of exercise have
been shown to be more effective (23% reduction in rate of falls) than those
with less than 50 hours (7% reduction) and programmes of 2 hours per week for 6
months are recommended.<sup>(3, 6)</sup> Up to half of non-injured fallers are
unable to get up following a fall; physiotherapists teach people how to get up
from the ground safely, reducing the risks associated with long lies including
pressure sores, hospital admission and moving into long term care.<sup>(7)</sup>
Physiotherapists lead falls clinics providing comprehensive assessment,
identifying underlying pathologies (such as osteoporosis), signposting to other
specialist services and offering individual advice and support.<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 12.85pt; mso-margin-top-alt: auto;">
<span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">There is a need for more research into frailty but
two systematic reviews suggested that physiotherapy had a positive effect
sustained for 12 months in reducing disability in older adults with moderate
frailty.<sup>(8, 9)</sup><o:p></o:p></span></div>
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<b><span style="color: #2e2e3b; font-family: "Arial","sans-serif"; font-size: 13.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Case study<o:p></o:p></span></b></div>
</div>
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<span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">The Westminster Falls Service offers multifactorial
risks assessment and targeted intervention for clients referred following a
fall or who are at risk of falling. After assessment clients are stratified to
receive either 1:1 physiotherapy and/or attend a 12 week strength and balance
programme designed to increase physical capability and confidence, improve
balance, and reduce fear of falling. On completion of the programme clients
continue evidence based falls prevention exercise via ‘Steady and Stable’
classes in partnership with a voluntary organisation. The falls pathway enables
clients to reach the recommended 50+ hours of strength and balance required to
prevent falls in the long term. High risk clients are also reviewed by
telephone.<br />
<br />
Clients followed up a year post discharge reported a 60% reduction of falls,
55% fewer fractures, 92% fewer A&E admissions, and a 80% reduction in GP
appointments compared to the year prior to intervention.<o:p></o:p></span></div>
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<b><span style="color: #2e2e3b; font-family: "Arial","sans-serif"; font-size: 13.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">References<o:p></o:p></span></b></div>
</div>
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<!--[if !supportLists]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: Arial; mso-fareast-language: EN-IE;">1.<span style="font-family: "Times New Roman"; font-size: 7pt; font-stretch: normal; font-variant-numeric: normal; line-height: normal;"> </span></span><!--[endif]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">World Health
Organisation. WHO Global Report on Falls Prevention in Older Age. Geneva: World
Health Organisation; 2007. </span><a href="http://www.who.int/ageing/publications/Falls_prevention7March.pdf" title="http://www.who.int/ageing/publications/Falls_prevention7March.pdf"><span style="color: #3554ae; font-family: "Times New Roman","serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE; text-decoration: none; text-underline: none;">http://www.who.int/ageing/publications/Falls_prevention7March.pdf</span></a><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">?<br />
ua=<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: Arial; mso-fareast-language: EN-IE;">2.<span style="font-family: "Times New Roman"; font-size: 7pt; font-stretch: normal; font-variant-numeric: normal; line-height: normal;"> </span></span><!--[endif]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Fried LP, Tangen
CM, Walston J, et al. Frailty in older adults: evidence for a phenotype. J
Gerontol A Biol Sci Med Sci. 2001;56(3):M146-56.<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 8.55pt; margin-left: 22.5pt; margin-right: 0cm; margin-top: 0cm; mso-list: l1 level1 lfo2; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: Arial; mso-fareast-language: EN-IE;">3.<span style="font-family: "Times New Roman"; font-size: 7pt; font-stretch: normal; font-variant-numeric: normal; line-height: normal;"> </span></span><!--[endif]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Gillespie Lesley D,
Robertson MC, Gillespie William J, et al. Interventions for preventing falls in
older people living in the community. Cochrane Database of Systematic Reviews.
2012(9) </span><a href="http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD007146.pub3/abstract" title="http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD007146.pub3/abstract"><span style="color: #3554ae; font-family: "Times New Roman","serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE; text-decoration: none; text-underline: none;">http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD007146.pub3/abstract</span></a><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;"><o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 8.55pt; margin-left: 22.5pt; margin-right: 0cm; margin-top: 0cm; mso-list: l1 level1 lfo2; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: Arial; mso-fareast-language: EN-IE;">4.<span style="font-family: "Times New Roman"; font-size: 7pt; font-stretch: normal; font-variant-numeric: normal; line-height: normal;"> </span></span><!--[endif]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Hektoen LF, Aas E,
Luras H. Cost-effectiveness in fall prevention for older women. Scand J Public
Health. 2009;37(6):584-9.<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 8.55pt; margin-left: 22.5pt; margin-right: 0cm; margin-top: 0cm; mso-list: l1 level1 lfo2; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: Arial; mso-fareast-language: EN-IE;">5.<span style="font-family: "Times New Roman"; font-size: 7pt; font-stretch: normal; font-variant-numeric: normal; line-height: normal;"> </span></span><!--[endif]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Cameron Ian D,
Gillespie Lesley D, Robertson MC, et al. Interventions for preventing falls in
older people in care facilities and hospitals. Cochrane Database of Systematic
Reviews. 2012(12) </span><a href="http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD005465.pub3/abstract" title="http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD005465.pub3/abstract"><span style="color: #3554ae; font-family: "Times New Roman","serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE; text-decoration: none; text-underline: none;">http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD005465.pub3/abstract</span></a><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;"><o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 8.55pt; margin-left: 22.5pt; margin-right: 0cm; margin-top: 0cm; mso-list: l1 level1 lfo2; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: Arial; mso-fareast-language: EN-IE;">6.<span style="font-family: "Times New Roman"; font-size: 7pt; font-stretch: normal; font-variant-numeric: normal; line-height: normal;"> </span></span><!--[endif]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Sherrington C,
Tiedemann A, Fairhall N, et al. Exercise to prevent falls in older adults: an
updated meta-analysis and best practice recommendations. NSW Public Health
Bull. 2011;22(3-4):78-83. </span><a href="http://www.publish.csiro.au/?paper=NB10056" title="http://www.publish.csiro.au/?paper=NB10056"><span style="color: #3554ae; font-family: "Times New Roman","serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE; text-decoration: none; text-underline: none;">http://www.publish.csiro.au/?paper=NB10056</span></a><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;"><o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 8.55pt; margin-left: 22.5pt; margin-right: 0cm; margin-top: 0cm; mso-list: l1 level1 lfo2; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: Arial; mso-fareast-language: EN-IE;">7.<span style="font-family: "Times New Roman"; font-size: 7pt; font-stretch: normal; font-variant-numeric: normal; line-height: normal;"> </span></span><!--[endif]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Goodwin V, Briggs
L. Guidelines for the physiotherapy management of older people at risk of
falling. London: AGILE: Chartered Physiotherapists working with Older People;
2012. </span><a href="http://agile.csp.org.uk/documents/guidelines-physiotherapy-management-older-people-risk-falling?networkid=33843" title="http://agile.csp.org.uk/documents/guidelines-physiotherapy-management-older-people-risk-falling?networkid=33843"><span style="color: #3554ae; font-family: "Times New Roman","serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE; text-decoration: none; text-underline: none;">http://agile.csp.org.uk/documents/guidelines-physiotherapy-management-ol...</span></a><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;"><o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 8.55pt; margin-left: 22.5pt; margin-right: 0cm; margin-top: 0cm; mso-list: l1 level1 lfo2; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: Arial; mso-fareast-language: EN-IE;">8.<span style="font-family: "Times New Roman"; font-size: 7pt; font-stretch: normal; font-variant-numeric: normal; line-height: normal;"> </span></span><!--[endif]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Arantes PMM,
Alencar MA, Dias RC, et al. Physical therapy treatment on frailty syndrome:
systematic review. Brazilian Journal of Physical Therapy. 2009;13(5):365-75. </span><a href="http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-35552009000500002&lng=pt&nrm=iso&tlng=en" title="http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-35552009000500002&lng=pt&nrm=iso&tlng=en"><span style="color: #3554ae; font-family: "Times New Roman","serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE; text-decoration: none; text-underline: none;">http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-35552009000...</span></a><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;"><o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 8.55pt; margin-left: 22.5pt; margin-right: 0cm; margin-top: 0cm; mso-list: l1 level1 lfo2; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: Arial; mso-fareast-language: EN-IE;">9.<span style="font-family: "Times New Roman"; font-size: 7pt; font-stretch: normal; font-variant-numeric: normal; line-height: normal;"> </span></span><!--[endif]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Clegg AP, Barber
SE, Young JB, et al. Do home-based exercise interventions improve outcomes for
frail older people? Findings from a systematic review. Reviews in Clinical
Gerontology. 2012;22 (1):6878.<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 8.55pt; margin-left: 22.5pt; margin-right: 0cm; margin-top: 0cm; mso-list: l1 level1 lfo2; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: Arial; mso-fareast-language: EN-IE;">10.<span style="font-family: "Times New Roman"; font-size: 7pt; font-stretch: normal; font-variant-numeric: normal; line-height: normal;"> </span></span><!--[endif]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Tinetti ME,
Speechley M, Ginter SF. Risk factors for falls among elderly persons living in
the community. N Engl J Med. 1988;319(26):1701-7.<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 8.55pt; margin-left: 22.5pt; margin-right: 0cm; margin-top: 0cm; mso-list: l1 level1 lfo2; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: Arial; mso-fareast-language: EN-IE;">11.<span style="font-family: "Times New Roman"; font-size: 7pt; font-stretch: normal; font-variant-numeric: normal; line-height: normal;"> </span></span><!--[endif]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">American Geriatrics
Society British Geriatrics Society American Association of Orthopaedic Surgeons
Panel on Falls Prevention. Guideline for the prevention of falls in older
persons. J Am Geriatr Soc. 2001;49(5):664-72.<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 8.55pt; margin-left: 22.5pt; margin-right: 0cm; margin-top: 0cm; mso-list: l1 level1 lfo2; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: Arial; mso-fareast-language: EN-IE;">12.<span style="font-family: "Times New Roman"; font-size: 7pt; font-stretch: normal; font-variant-numeric: normal; line-height: normal;"> </span></span><!--[endif]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Tinetti ME,
Speechley M. Prevention of falls among the elderly. N Engl J Med.
1989;320(16):1055-9.<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 8.55pt; margin-left: 22.5pt; margin-right: 0cm; margin-top: 0cm; mso-list: l1 level1 lfo2; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: Arial; mso-fareast-language: EN-IE;">13.<span style="font-family: "Times New Roman"; font-size: 7pt; font-stretch: normal; font-variant-numeric: normal; line-height: normal;"> </span></span><!--[endif]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">Nevitt MC, Cummings
SR, Kidd S, et al. Risk factors for recurrent nonsyncopal falls. A prospective
study. JAMA. 1989;261(18):2663-8.<o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="background: white; line-height: 16.3pt; margin-bottom: 8.55pt; margin-left: 22.5pt; margin-right: 0cm; margin-top: 0cm; mso-list: l1 level1 lfo2; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: Arial; mso-fareast-language: EN-IE;">14.<span style="font-family: "Times New Roman"; font-size: 7pt; font-stretch: normal; font-variant-numeric: normal; line-height: normal;"> </span></span><!--[endif]--><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;">National Institute
for Health and Care Excellence. Falls the assessment and revention of fall in
older people (CG 161). London: National Institute for Health and Care
Excellence; 2013. </span><a href="http://guidance.nice.org.uk/CG161" title="http://guidance.nice.org.uk/CG161"><span style="color: #3554ae; font-family: "Times New Roman","serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE; text-decoration: none; text-underline: none;">http://guidance.nice.org.uk/CG161</span></a><span style="color: #555555; font-family: "Arial","sans-serif"; font-size: 10.5pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-IE;"><o:p></o:p></span></div>
Abbey Physio Limerickhttp://www.blogger.com/profile/04355351899636585517noreply@blogger.com0tag:blogger.com,1999:blog-5313494908996277901.post-64070686693660088692016-11-08T09:06:00.000-08:002016-11-08T09:28:53.482-08:00How to Grow old Gracefully<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
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<!--[if !supportLists]--><b><span lang="EN-GB" style="font-size: 14.0pt; mso-ansi-language: EN-GB; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">1.<span style="font-size: 7pt; font-stretch: normal; font-variant-numeric: normal; font-weight: normal; line-height: normal;">
</span></span></b><!--[endif]--><b><span lang="EN-GB" style="font-size: 14.0pt; mso-ansi-language: EN-GB;">Immediately – Start
Now<o:p></o:p></span></b></div>
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<br /></div>
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<span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">1.1 <b>SKIN CARE<o:p></o:p></b></span></div>
<div class="MsoListParagraphCxSpFirst" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l4 level1 lfo1; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-GB" style="font-family: "wingdings"; font-size: 12.0pt;">§<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">Wear sunscreen <b>all </b>the time. 90% of skin damage is as
a result of sun exposure.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l4 level1 lfo1; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-GB" style="font-family: "wingdings"; font-size: 12.0pt;">§<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">Use SPF 30<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l4 level1 lfo1; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-GB" style="font-family: "wingdings"; font-size: 12.0pt;">§<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">Moisturise daily,
wash your face twice a day in warm water and use a mild cleanser.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l4 level1 lfo1; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-GB" style="font-family: "wingdings"; font-size: 12.0pt;">§<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">Exfoliate dead skin
cells gently but often, twice a week is recommended.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpLast" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l4 level1 lfo1; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-GB" style="font-family: "wingdings"; font-size: 12.0pt;">§<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">Moisture lips with
lip balm with SPF. <o:p></o:p></span></div>
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<span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">1.2</span><span lang="EN-GB" style="font-size: 14.0pt; mso-ansi-language: EN-GB;"> </span><b><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">STOP SMOKING <o:p></o:p></span></b></div>
<div class="MsoListParagraph" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l3 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-GB" style="font-family: "wingdings"; font-size: 12.0pt;">§<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">Smoking shortens
your lifespan, causes heart disease, lung disease and cancer.<o:p></o:p></span></div>
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<br /></div>
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<span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">1.3 <b>PLAN FOR RETIREMENT<o:p></o:p></b></span></div>
<div class="MsoListParagraphCxSpFirst" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l0 level1 lfo3; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-GB" style="font-family: "wingdings"; font-size: 12.0pt;">§<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">You are not your
job. You are not defined by your career.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpLast" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l0 level1 lfo3; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-GB" style="font-family: "wingdings"; font-size: 12.0pt;">§<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">What interests you?
What are you passionate about? Consider
travelling, developing a spiritual life, meditation, yoga, mindfulness, explore
new interests, develop hobbies which challenge you and keep you interested,
such as art, dancing, music, choir, book clubs, walking groups, golf, bridge,
joining groups in your interest area, setting time aside to visit the theatre,
cinema or festivals. The opportunities are endless for new enthusiasm and new
friendships. <o:p></o:p></span></div>
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<span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;"> </span><span lang="EN-GB" style="font-size: 12pt;"> </span></div>
<div class="MsoListParagraph" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; mso-list: l9 level1 lfo4; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><b><span lang="EN-GB" style="font-size: 14.0pt; mso-ansi-language: EN-GB; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">2.<span style="font-size: 7pt; font-stretch: normal; font-variant-numeric: normal; font-weight: normal; line-height: normal;">
</span></span></b><!--[endif]--><b><span lang="EN-GB" style="font-size: 14.0pt; mso-ansi-language: EN-GB;">Cultivate the
attitude <o:p></o:p></span></b></div>
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<br /></div>
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<span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">2.1 <b>EMBRACE
YOUR AGE <o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span lang="EN-GB" style="font-family: "wingdings"; font-size: 12.0pt;">§<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">You are the age you
are now – OWN IT. Be happy that you have survived to this point, embrace where
you are and aim to maintain your current functional capacity. Or, improve what
you have!<b><o:p></o:p></b></span></div>
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<br /></div>
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<span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">2.2 <b>DITCH
STRESS</b> <o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="EN-GB" style="font-family: "wingdings"; font-size: 12.0pt;">§<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">Stress ages you,
can make you look 10 years older than you are. It will impair your immune
system.<b><o:p></o:p></b></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l6 level1 lfo5; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-GB" style="font-family: "wingdings"; font-size: 12.0pt;">§<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">It can lead to
weight gain, anxiety, depression, digestive problems, heart disease. <b><o:p></o:p></b></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l6 level1 lfo5; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-GB" style="font-family: "wingdings"; font-size: 12.0pt;">§<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">Stress is
unavoidable but how we <b>manage </b>stress
is something we can change.<b><o:p></o:p></b></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l6 level1 lfo5; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-GB" style="font-family: "wingdings"; font-size: 12.0pt;">§<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">Meditation can
reduce stress and anxiety significantly. Breathing exercises are beneficial and
can be learned.<b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span lang="EN-GB" style="font-family: "wingdings"; font-size: 12.0pt;">§<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">Try not to hold on
to old hurts or harbour grudges as these cause stress and can lead to
significant emotional and physical problems. Try to approach others positively
and not focus on negative comments or slights, that is their problem they are
expressing, it does not have to become yours. <b><o:p></o:p></b></span></div>
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<br /></div>
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<span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">2.3 <b>MAINTAIN
A POSSITIVE ATTITUDE <o:p></o:p></b></span></div>
<div class="MsoListParagraphCxSpFirst" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 108.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l8 level1 lfo6; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-GB" style="font-family: "wingdings"; font-size: 12.0pt;">§<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">Be optimistic, it
is linked to longevity and better physical and mental health.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpLast" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 108.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l8 level1 lfo6; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-GB" style="font-family: "wingdings"; font-size: 12.0pt;">§<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">Being positive
about ageing, accepting the inevitable changes, is linked to <b><o:p></o:p></b></span></div>
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<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<b><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;"> </span></b><b><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;"> </span></b></div>
<div class="MsoListParagraph" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; mso-list: l9 level1 lfo4; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><b><span lang="EN-GB" style="font-size: 14.0pt; mso-ansi-language: EN-GB; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">3.<span style="font-size: 7pt; font-stretch: normal; font-variant-numeric: normal; font-weight: normal; line-height: normal;">
</span></span></b><!--[endif]--><b><span lang="EN-GB" style="font-size: 14.0pt; mso-ansi-language: EN-GB;">MAINTAINING A
HEALTHY BODY <o:p></o:p></span></b></div>
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<br /></div>
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<span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">3.1 <b>MAINTAINING
A HEALTHY BODY</b> </span><b><span lang="EN-GB" style="font-size: 18.0pt; mso-ansi-language: EN-GB;"> <o:p></o:p></span></b></div>
<div class="MsoListParagraphCxSpFirst" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l5 level1 lfo7; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-GB" style="font-family: "wingdings"; font-size: 12.0pt;">§<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">Staying healthy as
you age is easier if you exercise moderately and consistently, every day. <b><o:p></o:p></b></span></div>
<div class="MsoListParagraphCxSpLast" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l5 level1 lfo7; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-GB" style="font-family: "wingdings"; font-size: 12.0pt;">§<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">A minimum of a
daily brisk walk for 30 minutes is sufficient to keep heart health, help in
weight loss, maintain bone health, muscle strength, mind sharp, increase circulation, prevent
constipation and much more. <b><o:p></o:p></b></span></div>
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<br /></div>
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<span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">3.2 <b>EAT
A HEALTHY DIET <o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span lang="EN-GB" style="font-family: "wingdings"; font-size: 12.0pt;">§<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">Eat to meet the demands
of your lifestyle.<b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span lang="EN-GB" style="font-family: "wingdings"; font-size: 12.0pt;">§<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">Ensure diet is low
in sugar and rich in vitamins<b><o:p></o:p></b></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l5 level1 lfo7; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-GB" style="font-family: "wingdings"; font-size: 12.0pt;">§<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><b><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">Vitamin E </span></b><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">– nuts, seeds, leafy greens,
vegetable oil, lowers the risk of stroke and heart attach.<b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span lang="EN-GB" style="font-family: "wingdings"; font-size: 12.0pt;">§<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><b><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">Vitamin C </span></b><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">– helps in production of
Vitamin E. Reduces cancer risk. Repairs Collagen. May reduce risk of cataracts
and cardiovascular disease. Available from citrus and potatoes. <b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span lang="EN-GB" style="font-family: "wingdings"; font-size: 12.0pt;">§<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><b><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">Vitamin D </span></b><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">– helps maintain healthy
bones, more essential, as we get older. Available from exposure to sunshine,
and from milk and yogurt. <b><o:p></o:p></b></span></div>
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<br /></div>
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<span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">3.3 <b>TURN
OFF T.V. <o:p></o:p></b></span></div>
<div class="MsoListParagraphCxSpFirst" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l5 level1 lfo7; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-GB" style="font-family: "wingdings"; font-size: 12.0pt;">§<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">Watching excessive
TV is as harmful as smoking to your health, or lack of exercise. <b><o:p></o:p></b></span></div>
<div class="MsoListParagraphCxSpLast" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l5 level1 lfo7; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-GB" style="font-family: "wingdings"; font-size: 12.0pt;">§<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">Look for activities
which are not sedentary to meet the 30 minutes minimum exercise level daily. <b><o:p></o:p></b></span></div>
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<br /></div>
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<span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">3.4 <b>DENTAL
HEALTH – Brush your teeth! <o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span lang="EN-GB" style="font-family: "wingdings"; font-size: 12.0pt;">§<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">Dental decay or
infection can increase risk of ill health.<b><o:p></o:p></b></span></div>
<div class="MsoListParagraphCxSpLast" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l5 level1 lfo7; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-GB" style="font-family: "wingdings"; font-size: 12.0pt;">§<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">Receding gums or
dry moth are early signs of risk of decay or infection. Keep up dental
appointments, floss daily, brush at least twice a day. <b><o:p></o:p></b></span></div>
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<br /></div>
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<b><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;"> </span></b><b><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;"> </span></b></div>
<div class="MsoListParagraph" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; mso-list: l9 level1 lfo4; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><b><span lang="EN-GB" style="font-size: 14.0pt; mso-ansi-language: EN-GB; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">4.<span style="font-size: 7pt; font-stretch: normal; font-variant-numeric: normal; font-weight: normal; line-height: normal;">
</span></span></b><!--[endif]--><b><span lang="EN-GB" style="font-size: 14.0pt; mso-ansi-language: EN-GB;">MAINTAINING A
HEALTHY MIND <o:p></o:p></span></b></div>
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<br /></div>
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<span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">4.1 <b>STAY
SOCIALLY CONNECTED <o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span lang="EN-GB" style="font-family: "wingdings"; font-size: 12.0pt;">§<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">Helps prevent depression and isolation.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="EN-GB" style="font-family: "wingdings"; font-size: 12.0pt;">§<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">Interacting with
others maintains neural connections, exposes you to humour, which brings
endorphins and maintains brain function.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="EN-GB" style="font-family: "wingdings"; font-size: 12.0pt;">§<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">Reap rewards from
maintaining old relationships and actively cultivating new relationships for
emotional and mental wellbeing. <o:p></o:p></span></div>
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<br /></div>
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<span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">4.2 <b>TRY
NEW EXPERIENCES <o:p></o:p></b></span></div>
<div class="MsoListParagraphCxSpFirst" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l2 level1 lfo9; tab-stops: 36.0pt 72.0pt 108.0pt 144.0pt 180.0pt 216.0pt 252.0pt 281.25pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-GB" style="font-family: "wingdings"; font-size: 12.0pt;">§<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">New challenges test
and push your brain’s limits and enable it to perform better.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l2 level1 lfo9; tab-stops: 36.0pt 72.0pt 108.0pt 144.0pt 180.0pt 216.0pt 252.0pt 281.25pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-GB" style="font-family: "wingdings"; font-size: 12.0pt;">§<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">New neural pathways
are created, existing ones are strengthened.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpLast" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l2 level1 lfo9; tab-stops: 36.0pt 72.0pt 108.0pt 144.0pt 180.0pt 216.0pt 252.0pt 281.25pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-GB" style="font-family: "wingdings"; font-size: 12.0pt;">§<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">Take a different
route when driving, try to use your left or non-dominant hand in daily
activities, try new activities to have a positive effect on brain function and
deter degeneration. <o:p></o:p></span></div>
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<br /></div>
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<span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">4.3 <b>SLEEP
WELL <o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span lang="EN-GB" style="font-family: "wingdings"; font-size: 12.0pt;">§<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">Sleep disturbance,
with lack of sleep or poor sleep pattern can lead to depression, memory loss,
impairment of judgment.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpLast" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l2 level1 lfo9; tab-stops: 36.0pt 72.0pt 108.0pt 144.0pt 180.0pt 216.0pt 252.0pt 281.25pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-GB" style="font-family: "wingdings"; font-size: 12.0pt;">§<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">A minimum of 7
hours sleep is needed, every night. <o:p></o:p></span></div>
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<br /></div>
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<span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;"> </span><span style="font-size: 12pt;"> </span></div>
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<!--[if !supportLists]--><b><span lang="EN-GB" style="font-size: 14.0pt; mso-ansi-language: EN-GB; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">5.<span style="font-size: 7pt; font-stretch: normal; font-variant-numeric: normal; font-weight: normal; line-height: normal;">
</span></span></b><!--[endif]--><b><span lang="EN-GB" style="font-size: 14.0pt; mso-ansi-language: EN-GB;">LOOK YOUR BEST –
WOMEN <o:p></o:p></span></b></div>
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<br /></div>
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<span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">5.1 <b>WEAR
LESS MAKE-UP <o:p></o:p></b></span></div>
<div class="MsoListParagraphCxSpFirst" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l1 level1 lfo10; tab-stops: 36.0pt 72.0pt 108.0pt 144.0pt 180.0pt 216.0pt 252.0pt 281.25pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-GB" style="font-family: "wingdings"; font-size: 12.0pt;">§<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">Makeup - foundation
and power can accentuate wrinkles and make lines more obvious. Wear less
blusher, apply to the highest point of your cheekbones, sweeping upwards.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l1 level1 lfo10; tab-stops: 36.0pt 72.0pt 108.0pt 144.0pt 180.0pt 216.0pt 252.0pt 281.25pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-GB" style="font-family: "wingdings"; font-size: 12.0pt;">§<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">Avoid eyeliner or
mascara on lower lids but apply to upper eyelids and lashes to open up the
eyes.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpLast" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l1 level1 lfo10; tab-stops: 36.0pt 72.0pt 108.0pt 144.0pt 180.0pt 216.0pt 252.0pt 281.25pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-GB" style="font-family: "wingdings"; font-size: 12.0pt;">§<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">Wear a lip liner to
avoid “bleeding” of lipstick into lines around the mouth. <o:p></o:p></span></div>
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<br /></div>
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<span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">5.2 <b>STAY
FABULOUS <o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span lang="EN-GB" style="font-family: "wingdings"; font-size: 12.0pt;">§<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">Stay true to
yourself, if you love long hair, keep it, if you love your hair grey, keep it.
Dye it if you prefer blond or brunette.<o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpLast" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l1 level1 lfo10; tab-stops: 36.0pt 72.0pt 108.0pt 144.0pt 180.0pt 216.0pt 252.0pt 281.25pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-GB" style="font-family: "wingdings"; font-size: 12.0pt;">§<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span lang="EN-GB" style="font-size: 12.0pt; mso-ansi-language: EN-GB;">Getting older, stay
fashionable, stay interested and interesting! Be Sexual, experience new
adventures, maintain a love of life. <o:p></o:p></span></div>
Abbey Physio Limerickhttp://www.blogger.com/profile/04355351899636585517noreply@blogger.com0