Original Article

The Benchmarking Exercise Programme for Older People (BEPOP): Design, Results and Recommendations from The First Wave of Data Collection

Lorna Caulfield¹, Susanne Arnold², Sarah De Biase³, Charlotte Buckland⁴, Philip Heslop⁵, Christopher Hurst^6,7, Avan A. Sayer^6,7, Dawn A. Skelton⁸, Miles D. Witham^6,7

1. South Tyneside and Sunderland NHS Foundation Trust, Sunderland, UK
2. Warwick Clinical Trials Unit, University of Warwick, Coventry, UK & AGILE, Chartered Society of Physiotherapy, London, UK
3. West Yorkshire Integrated Care Board Long-term Conditions and Personalisation Function, Wakefield, UK & AGILE, Chartered Society of Physiotherapy, London, UK
4. Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
5. CoCreate, School of Design, Northumbria University, Newcastle Upon Tyne, UK
6. AGE Research Group, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, UK
7. NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Foundation Trust, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust and Newcastle University
8. Research Centre for Health (ReaCH), School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK

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Keywords: Benchmarking, Older people, Quality improvement, Resistance exercise, Sarcopenia

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Abstract

Objectives: The Benchmarking Exercise Programme for Older People (BEPOP) service improvement project seeks to determine and promote the exercise training characteristics associated with positive outcomes for resistance exercise for older people living with, or at risk of, sarcopenia or physical frailty. Methods: Mixed-methods service improvement project. Ten UK National Health Service physiotherapist-led therapy services delivering exercise interventions for older people submitted anonymized data for up to 20 consecutive patients. A multidisciplinary expert panel generated a report and recommendations with site-specific benchmarking data and feedback. In parallel, participating physiotherapy team members were interviewed to elicit feedback on BEPOP rationale, processes and perceived value. Results: Data from 188 patients were included, mean age 80 years (range 60-101). 115 (61%) received objective assessment of strength-based physical performance. Bodyweight exercises (173 [92%]) and resistance bands (49 [26%]) were the commonest exercise modalities. Exercises progressed predominantly through increased repetitions (163 [87%]) rather than increased load. 50 (30%) had no reassessment of outcomes; only 68 (41%) were signposted to follow-on exercise services. Staff interviews identified themes around knowledge, diagnosis, data collection and practice reflection. Conclusion: BEPOP was feasible to deliver and generated actionable insights for service improvement via improved diagnosis, measurement and progression of resistance exercise.

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