Group therapy

[Carole101]

I am starting some group therapies at work- UL, LL and general exercise. Does anyone have any experience running a group? Any ideas on what works and doesn't? ratios?
Any help is greatly appreciated.
Thanks

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• Group therapy

[neving]

are these groups with able, healthy people or patients? how many?
neving

[Carole101]

Generally neurologically impaired people (strokes, TBI, SCI, PD, MS etc) at the moment we have a fairly small group size of around 5 for the MDT group and 8 for the PTA led general exercise group. I am looking for any guidelines that you are aware of or and titbits of information, research etc.
Thanks

[neving]

groups can be great, very effective, stimulating to the patients and a lot of fun.
try to group people with similar skill levels together, eg. everybody able to ambulate independently, etc.
make sure there is enough room, and all the space is utilized.
make sure everybody can see you and you can see everybody as well.
tell the patients what to do rather than ask them, eg: "bend"' not "could you bend"...
whenever indicated and possible, move around amongst the patients.
position yourself in front of the patients whenever possible.
explain/show the exercise first, or have someone demonstrate,
carefully chose the starting position for every exercise and make sure everyone is in proper position befor you start.
give help, advice and encouragement while the exercise is being performed.
praise, praise, praise and then praise.
exercise groups should have a certain structure:
1. warm up exercises: running, jumping,.. at least large movements involving large joints.
2. the main part of the group should include stretching, strengthening, conditioning, coordination and balance exercises.
3. cool down exercises should end the class, eg.: posture exercises, etc.
for me the greatest benefit of groups is the ability to get patients involved with each other, eg. exercise in pairs, threes or teams. Patient respond usually well to each other and there is the additional benefit of getting them to realise they "are not alone".
a few more pointers:
get your patients to help you to set up and clear away equipment etc.,
make sure you know all your patients by name.
be prepared, be prepared, be prepared.
have the exercises progress in a logical manner,
avoid too many position changes ( eg. from prone to supine to kneeling to prone again, etc)
vary the exercises from session to session.
use music or rhythmic instruments (even just clapping your hands works.)
have fun!!!
neving