REP 26: THINKING OF STARTING A COMMUNITY EXERCISE PROGRAM?
They say that local issues are best solved through local solutions. As physiotherapists, we have both the expertise and the opportunity to lead our communities toward healthy, active lifestyles. But, getting our program idea off the ground seems to be the biggest hurdle for many of us.
Is developing a community program really as complicated as we tell ourselves?
The Big Idea
For today’s Rep we decided to head to the front-lines and talk to a physiotherapist clinician who bit the bullet and launched a novel exercise program for children and youth in her community.
While working in Australia, Ottawa-based physiotherapist Michelle Bergeron developed a program for getting children active and building their body awareness through Pilates. Below is a transcript of our conversation.
Michelle’s take on things…
I’m glad we have this opportunity to talk. You’ve had an interesting career – what took you to Australia?
Australia was a place I had always wanted to go so when my husband decided to go to school there it was an opportunity for me to have a bit of an adventure. I got my license and worked there as a physiotherapist for four years while he was studying.
While you were there, I understand you launched a Pilates for Kids program. What was your inspiration?
Pilates and physiotherapy are really intertwined in Australia. It’s not quite like that here yet, but it seems to be getting there. Most Australian clinics have Pilates equipment and most physios get Pilates certification. People there use it as a way to do really specific rehab, because you can ‘unload’ people’s weight with the springs or add resistance with the equipment and get some good feedback.
I had been working at a Pilates physio clinic for about 2.5 years when I started the Pilates for Kids program. I’d had a lot of parents I was treating tell me they wished they could get their children to do that type of thing as well. They felt it was important for their kids to understand things like balance, control, and movement patterns. All the things that I was teaching them.
A few parents had athletic kids and they wanted to get them in to see me in the clinic, but I couldn’t really offer what I needed to offer them in that space. But I thought “Why not? Let’s just see if I can make this work.” So, I started talking to one of my colleagues and my husband, and ‘workshopped’ the idea around, found a space, and it took off from there.
So did you develop the program on your own or did you work with someone?
No, I did it myself. I had taken a Pilates for Kids one-day seminar while I was in Australia and it piqued my interest. So I used that, combined with my own exercise background and interest in kids, and blended it all together to make my sessions work for a younger population.
What would you say is the major difference between Pilates as an intervention for young athletes as opposed to the general population?
We typically provide a lot of feedback to adults, asking them to move and fix their posture and feel for different patterns, and that’s just not something that kids can grasp. With kids, we have to focus more on teaching them to use different cues, getting them to stand tall, helping them understand that balance can translate to moving better in their sport, or relating their movements to different things.
Did you find that they were more intuitive about their bodies then, if you weren’t giving them as much direct feedback?
Some were, some definitely weren’t. Unfortunately, I think a lot of kids don’t have the intuition that they should because they’re not doing the stuff that allows them to develop it. They’re sitting all day, and they’re only in really structured activities. It’s hard to find kids that are doing unsupervised and unstructured play, so it’s hard for them to gain that body awareness. So, part of what I wanted to do with the class was get the kids to understand and feel those things for themselves. And I think they did by the end.
Was the program completely self-selected?
It was open to anyone who was interested. I had some kids who were already athletic and some whose parents were hoping that this might spur an interest in becoming active. I really had the whole gamut in the group. There were a few kids who were shy and didn’t really like playing sports, whose parents thought this might be a good way for them to build their confidence – and body confidence, as well.
Was the Pilates for Kids program exclusively used as an interest program, or did you use it as a rehabilitation intervention as well?
For the most part it was an interest program, but a few of the older participants did have injuries that they were dealing with. For some of them there was a bit of rehab involved, and if it was necessary I just tweaked what exercise they would do or how they were doing what the rest of us were doing. But for the most part they were able to move through it. The young ones didn’t have any issues and were just using it as an opportunity for supervised play.
How did you find community response to the program?
It was surprisingly good, actually. The first session I ran was small. I started with two six-week classes. I think if I had had more opportunity to promote it, it could have been even better but at that point I really just wanted to get it off the ground. By the time I ran the second and third sessions, our neighbourhood paper had written a piece on us, and my clinic had been promoting it for me as well, so interest picked up pretty quickly. People started seeking out the program, and the classes sold out.
Have you ever considered implementing something similar in Canada?
I have, very much. It’s just a matter of finding time in my schedule to do so. It’s tricky, because you need to work out which days would work best for the kids in your area and that tends to change. But I have contemplated it and hopefully I will run another program in the future.
I currently train at a cross-fit gym, and there’s some interest in having a movement class for kids run in one of the back rooms while parents are working out in the gym. So, similar principles really, teaching kids to move and do things with their bodies that they don’t get to do on their own all that often.
What lessons did you learn having developed a program like that from scratch?
It was nice to learn that starting a program doesn’t necessarily require hundreds of hours of planning or thousands of dollars of equipment. I just had to find a hall and put some signs up. For equipment, I think I spent a total of $150 in yoga mats and balls. That’s it.
At the same time, it was challenging because I hadn’t considered how to design a program that would be interesting and could keep kids’ attention for the full duration of the session. I also had to learn how to design a website – it was basic, but it worked!
Really, I learned that it’s rewarding to do programs with kids. To have an 8 or 9 year old walk up and tell you at the end of a session how happy they are to be there and that they feel like they’re standing taller and doing things better now – that was nice to hear. Kids don’t often tell you those things.
If you could give one piece of advice to a fellow physiotherapist considering developing a novel exercise program in their local community, what would it be?
Just do it. It won’t be as much effort to get it off the ground as you think. A lot of people are out there looking for these types of programs and until we begin offering them they’re just going to continue looking. So, find a community centre and a few mats, and get it started.
As physios, we have a lot to offer people.
If you’re interested in learning more about Pilates, or how to incorporate it into your patient programs, both Stott Pilates and Polestar Pilates offer education programs for rehabilitation professionals.
Thinking of starting up a community-based program yourself? The CDC offers guidance on developing programs for increasing physical activity in the community.
Want even more inspiration? Here’s a short article describing a novel community-based exercise program developed by Toronto physiotherapist Jo-Anne Howe, for patients with neurological conditions.
If you’re still trying to work out your great community program idea, the Community Health Worker Evaluation Toolkit walks you through the steps of designing a program that will offer measurable outputs.
Have you noticed a need or developed a community-based exercise program in your area? We’d love to hear about your experiences.
About Michelle Bergeron
After graduating with an MSc Physiotherapy degree from McMaster University in 2006, Michelle moved to Perth, Western Australia, and quickly built up a thriving private practice clientele, predominantly filled with young athletes involved in a variety of state and national sport programs. In January of 2011, Michelle moved back to Canada to work for Cirque Du Soleil at their International Headquarters where she treated the highest-calibre international athletes and performing artists. Now settled in Ottawa with her family, Michelle works in a private clinical practice.