09:30:52 From hayley wellerd To Everyone: what type of pulse oximeter is the best to use? 09:31:13 From Julie Tollit To Everyone: we use nonin 09:31:59 From PRITCHARD Annie To Everyone: we use nonin 09:32:01 From Catriona Boyd To Everyone: we also use nonin. 09:32:09 From Catriona Boyd To Everyone: they have 09:32:29 From Catriona Boyd To Everyone: a wrist monitor is useful for when doing exercise testing 09:32:38 From Julie Pentony To Everyone: does anyone use an ear probe? 09:33:16 From Kelly Younger To Everyone: We have started using ear probes recently for patients that have poor circulation. 09:33:36 From Julie Tollit To Everyone: we have just tested a blue tooth monitor which has both a wrist and an ear monitor, we use the ear lobe one for those who have poor peripheral pick up 09:33:37 From Catriona Boyd To Everyone: if i have patients with raynauds poor peripheral circulation/ nail polish i would use an ear sensor 09:34:45 From Oliver Kennefick To Everyone: is the ESWT test more relevant and appropaite for patient on Amb O2 post PR? as the ISWT may show that the patient has increased their anaerobic capacity? 09:35:29 From PRITCHARD Annie To Everyone: we've seen approx. 5% higher sats readings via ears compared to fingers on same patient 09:36:01 From Julie Tollit To Everyone: we have found that an ear lobe monitor always shows a slightly higher SpO2 then a finger probe on the same individual 09:36:41 From Helen Jefford To Everyone: should a take home message be- safety use suppl oxygen for desaturators in case of undiagnosed PHT? 09:39:20 From Bev Quarton To Everyone: I worry about the potential instigation of O2 in PR rather than referral to a HOSAR service for full assessment 09:42:41 From Julie Tollit To Everyone: the ISWT/ESWT have good guideines on how to test for AOT, it is time consuming. minimum of 2 x ISWT both on room air and 2 x ESWT, one on room air, one in O2, if the O2 level is incorrect you have to test again. 09:53:48 From andrew holt To Everyone: When doing interval exercise do you rest during the intervals or active recovery between each exercise bout 09:55:40 From Helen van Uem To Everyone: I was wondering what the "rest" looks like too- moving between exercise stations adequate? 10:06:22 From PRITCHARD Annie To Everyone: we've tended to do 2 min stations and then rotate between stations - would this count as intermittent? 10:07:07 From PRITCHARD Annie To Everyone: in our venues we don't have access to treadmills/exercise bikes so rely on sit to stand/step up style aerobic exercises - is this adequate? 10:07:10 From Julie Tollit To Everyone: could you use the resistence exercises as your active rest? 10:12:40 From British Thoracic Society To Everyone: Please don't forget if you are interested in acting as a facilitator in the BTS Fundamentals of PR course, please email BTS@brit-thoracic.org.uk 10:13:43 From British Thoracic Society To Everyone: A note from Claire Nolan: - If you are interested in sharing a case study with the National Respiratory PR programme on how your service addressed a health inequality please email Claire.nolan@brunel.ac.uk 10:41:39 From Helen van Uem To Everyone: anecdotally we see improved balance just from the class we run 11:24:24 From Emma Chaplin To Everyone: Thanks Rachel 11:37:09 From Bev Quarton To Everyone: We do try to encourage this with music - which influences exercise rate (bmp) - also asking patients to elect or choose a genre - this makes the exercise more fun and they work harder 11:38:03 From Rachel Williams To Everyone: there are walking netball groups as well 11:38:57 From Theresa Hamer To Everyone: Walking football and walking cricket run by our local third party organisers - The Saints Foundation 🙂 11:39:58 From Julie Pentony To Everyone: we have circuit with arm curls heel digs, step ups, front raises and marching at the same time to music to increase intensity 11:40:13 From Bev Quarton To Everyone: I think there are some guidelines regarding staffing ratio and O2 patients in class 11:40:17 From Bev Quarton To Everyone: just trying to find it 11:41:56 From Bev Quarton To Everyone: The Provider shall adhere to minimum staffing ratios recommended in the UK for pulmonary rehabilitation supervision of exercise classes (1:8) and (1:16) for education sessions, with a minimum of two supervisors in attendance, one of whom must be a qualified respiratory specialist health care professional to supervise the exercise component (NB: greater staff: patient ratio is required if oxygen users/complex patients are included)27 11:42:20 From Bev Quarton To Everyone: https://www.england.nhs.uk/wp-content/uploads/2020/03/pulmonary-rehabilitation-service-guidance.pdf 11:44:30 From Kirsti Loughran To Everyone: Falls info for patients https://www.csp.org.uk/publications/get-go-guide-staying-steady-english-version COPD in a local falls prevention service https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-022-13832-3 Balance training with PR for just 5 minutes https://pubmed.ncbi.nlm.nih.gov/25517104/ 11:47:41 From Bev Quarton To Everyone: Kirsti - Which exercises were incorporated within the 5 mins please? 11:48:59 From Kirsti Loughran To Everyone: Hi Ben, This is the information from the paper - 4. Balance training for 5 minutes consisted of static and dynamic exercises using mainly upright positions. Balance exercises were organized in the following 4 levels 6 : (1) postures that gradually reduced the base of support; (2) dynamic movements that perturbed the center of gravity; (3) stressing postural muscle groups; and (4) dynamic movements while performing a secondary task individually or in groups, with a progressively narrowed base of support. In this component, patients were also trained on how to lie down and get up from the fl oor. 11:49:00 From hayley wellerd To Everyone: Kirsti, did you say you would provide a link in the chat for the self help falls information we can provide to patients? 11:49:46 From Kirsti Loughran To Everyone: Hi Hayley, This is what I have printed and given out in the past https://www.csp.org.uk/publications/get-go-guide-staying-steady-english-version 11:56:41 From Kirsti Loughran To Everyone: Information to help you assess risk and for signposting file:///U:/Literature/Falls/McDermott%20et%20al.,%202022%20risk%20factors%20for%20injurious%20falls%20COPD.htm 11:57:25 From Lina Andersson To Everyone: Tabatha is a sort of interval training 11:58:57 From Julie Pentony To Everyone: Kirsty Is that link correct I can't seem to access it. 12:00:21 From Kirsti Loughran To Everyone: Risk Factors for Injurious Falls in the Last Two Years of Life Among Adults with Chronic Obstructive Pulmonary Disease (GP748) Author links open overlay panelCaraMcDermottPharmD PhD MSCLauraFeemsterMD MSRuthEngelbergPhDLauraSpeceMD MSJ. RandallCurtisMD MPH 12:00:35 From Julie Pentony To Everyone: thankyou 12:03:31 From Kirsti Loughran To Everyone: https://www.sciencedirect.com/science/article/pii/S0885392422006248 I think this should work as a link 12:38:42 From British Thoracic Society To Enya Daynes(Privately): Hi Enya, not sure if you managed to listen to Laura's recorded presentation that I sent via WeTransfer yesterday? Fingers crossed it worked! Are you happy to come on screen and take questions along with Emma if there are any? 12:58:04 From British Thoracic Society To Everyone: Please remember the note posted earlier. A note from Claire Nolan: - If you are interested in sharing a case study with the National Respiratory PR programme on how your service addressed a health inequality please email Claire.nolan@brunel.ac.uk 12:58:31 From British Thoracic Society To Everyone: Please don't forget if you are interested in acting as a facilitator in the BTS Fundamentals of PR course, please email BTS@brit-thoracic.org.uk 13:25:27 From Berkant Mehmed To Everyone: What would you recommend for pt's suffering with fatigue and SOB with prevalent fatigue and post exertional malaise. 13:25:51 From British Thoracic Society To Berkant Mehmed(Privately): 13:28:40 From hayley wellerd To Everyone: is Long Covid classified as a chronic lung disease? do other PR teams take patients with long covid in isolation? 14:05:36 From Helen van Uem To Everyone: do you mix the groups or run the post covid group separately? 14:11:32 From Lee Jemma To Everyone: Would you encourage patients to be seen by local long-covid services before accessing PR? 15:10:48 From Louise Sewell To Everyone: Fab job Craig - thank you! 15:19:10 From Dermot Bellew To Everyone: I find the ear probes much better with patient with HF and reduced peripheral blood flow/cold hands. 15:20:51 From Julie Tollit To Everyone: we are purchasing a blue tooth probe which allows us to monitor when they desaturate, immediately, gradually or at the end of max exertion 15:21:28 From Julie Tollit To Everyone: 8 out of 12 is the guideline 15:21:44 From PRITCHARD Annie To Everyone: NACAP records a completer as someone who has had a pre and post assessment.. number of sessions attended make no difference 15:21:47 From Rachel Garrod To Everyone: that sounds very interesting , I will look into that. 15:22:12 From Kelly Younger To Everyone: The software as far as I am aware for the Bluetooth one needs to have a licence. We decided against the software as we would have had to pay a separate licence per laptop used. Plus get it through our IT dept!!! 15:24:00 From Julie Pentony To Everyone: We use blue tooth probes with apps on our phones, no licence needed. 15:24:09 From Julie Tollit To Everyone: you have to have a licence for downloads but a free app if you arent going to download 15:24:46 From Kelly Younger To Everyone: can you send me more details about that app. Kelly.younger@southernhealth.nhs.uk 15:25:51 From Julie Pentony To Everyone: HI Kelly, it depends on the device you buy, which will have it's own free app for connection. Masimo Health is one of the probes we use 15:27:06 From Julie Tollit To Everyone: Hi Kelly, depends on the device, we have nonin, but it only works on iphones 15:27:35 From Julie Tollit To Everyone: Nonin connect 15:29:33 From Julie Tollit To Everyone: the nonin also has an ear probe attachment and a finger attachment 15:30:09 From Julie Pentony To Everyone: That is good to know Julie Tollit thanks 15:30:30 From PRITCHARD Annie To Everyone: there is no set timescale in guidance on delay between pre-assessment and start of course. We utilise telephone review if longer than 3 months 15:31:23 From PRITCHARD Annie To Everyone: if there is a clinical change then we take it on individual basis as to whether a repeat pre-assessment is needed or complete a 6MWT on session 1 to reset measures 15:31:30 From Isobel Amey To Everyone: Our service aims to start patients on a PR programme within 1 month of completing their ISWT 15:32:35 From Julie Pentony To Everyone: We are lucky with a rolling programme, they can start straight away 15:32:41 From hayley wellerd To Everyone: Do people routinely request fitness to exercise from GP if there are no contraindications post assessment? 15:32:57 From PRITCHARD Annie To Everyone: no 15:33:18 From PRITCHARD Annie To Everyone: only if there are medical concerns - such as cardiac deceleration or low BP etc 15:33:25 From Bev Quarton To Everyone: Rolling gold standard 15:33:26 From Shabana Younis To Everyone: how is everyone carrying out practice walk tests? 15:33:40 From hayley wellerd To Everyone: thanks Annie 15:34:10 From Kelly Younger To Everyone: I have to leave unfortunately for a meeting. Thank you for 2 fabulous days. Thank you group F you were great 15:34:28 From Theresa Hamer To Everyone: Even with rolling programme, we often have a wait unfortunately 15:34:46 From Doreen Berry To Everyone: We are not allowed to do rolling programme due to infection control guidance. We have to do block classes to maintain covid bubble and size of classdepends on size of room. 15:35:01 From Kate Geofferson To Everyone: we can offer both so patients have a choice 15:35:59 From Bev Quarton To Everyone: That's interesting, as that is what we have found Rachel - there are considerably fewer drop outs in cohort 15:36:06 From Isobel Amey To Everyone: It was mentioned yesterday that there is a SOP for a 1 rep max test on either the PRSAS or respiratory futures website... I had a look but couldn't find the document. Is anyone able to direct me to where I would find this? 15:39:27 From Julie Tollit To Everyone: thank you Kelly for facilitation grp F, really good. 15:40:56 From Kate Pinckney To Everyone: Our paperwork is all sent out prior to AX 15:42:02 From Theresa Hamer To Everyone: Group assessment is not an approach I’ve encountered so will be interesting to see if this could work for our team 15:42:51 From Stuart Lightfoot To Everyone: Most patients improve walking distance on second attempt. Huge learning effect on walking field tests 15:44:01 From Stuart Lightfoot To Everyone: Many thanks to all the speakers and everyone from group B for their participation in discussions 15:44:03 From Julie Pentony To Everyone: group assessment is difficult with low staff numbers. 15:44:05 From Kate Plunkett To Everyone: Thanks so much for a great 2 days 15:44:06 From Kate Geofferson To Everyone: Thank you everyone for some good discussion and pragmatic advice 15:44:17 From Rachel Garrod To Everyone: great to hear all the enthusiasm around pulmonary rehab and the wonderful professionalism and care for our patients.