Physical Activity and the Multidisciplinary Team

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Multidisciplinary Team

Patients’ care yield better outcome when comprehensive approach, encompassing all healthcare professionals that has set role to play in alleviating patients ill health are used[1]. This is because the best and most cost-effective outcomes for patient/clients are achieved by professionals collaborating in work, learning, mapping out prognosis and creation of new ideas. This concept is termed Multidisciplinary team (MDT) approach to patient care.

Any word with a prefix “multi’ attached to it connotes “many”. The word disciplinary suggests “a concern with the knowledge and skills underlying particular roles”[2]. To better understand the concept of MDT, the termed 'team' needs to be explained.

What is a Team?

Cohen and Mohrman define a team as”a group of individuals who work together to produce products or deliver services for which they are mutually accountable”[3]. The shared goals of the team are made manifest by mutual and cordial interaction by team members, and the roles of each professional in the team are mutually interdependent and accountable to enable achievement of set goals.

In a Multidisciplinary team, each team member implements a specialized part of a care plan and the main aim of multidisciplinary teams is to collate a range of views on people’s care and to use optimally the knowledge and capabilities from many professionals and sectors.

Multidisciplinary Team versus Interdisciplinary team

Multidisciplinary team approaches make use knowledge and expertise of professionals from different disciplines, with each discipline approaching the patient from their own perspective. This approach often involves separate individual consultations. It is common for multidisciplinary teams to meet regularly, in the absence of the client to discuss about shared goals, findings and discuss future directions for attainment of set goals. Multidisciplinary teams provide more knowledge and experience than disciplines operating in isolation.

Interdisciplinary team approaches, on the other hand, integrate separate discipline approaches into a single consultation. That is, assessment, intervention and short- and long-term management goals are conducted by the team, together with the client, at the one time. The client is intimately involved in any discussions.

Physical Activity and its Benefits

Being active and keeping active are important whether one is young or old, able bodied or not able bodied, and male or female[4][5]. The term “physical activity” describes many forms of movement, including activities that involve the large skeletal muscles[6][4]. Physical activity is body movement produced by skeletal muscle contraction that results in energy expenditure[7].

PA Benefits includes but not limited to a reduced risk of premature mortality, non-communicable disease (NCDs) (such as coronary heart disease, hypertension, cancer, and diabetes mellitus), obesity, emotional stress and musculoskeletal disorders[8], better cardiovascular fitness and good health related quality of life. Research has demonstrated that virtually all individuals can benefit from regular physical activity, whether they participate in vigorous exercise or some type of moderate health-enhancing physical activity[9]. Even among frail and very old adults, mobility and functioning can be improved through physical activity[10]. see also...

Routine physical activity has been shown to lowers blood pressure[11][12], improve body composition (e.g., via a decrease in abdominal adiposity and normal body weight maintenance)[13], enhance lipoprotein profiles (e.g., through reduced triglyceride levels and low-density lipoprotein [LDL]-to-HDL with increased high-density lipoprotein [HDL] cholesterol levels)[9], enhanced glucose uptake[14], improve autonomic tone[15]  and reduce systemic inflammation[16].

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Multidisciplinary team for promotion PA Participation

It is widely accepted that no single medical discipline can provide complete care for people’s health and almost all health professionals has a stake in physical activity as the benefits are numerous. The importance of the role of Physical activity (PA) in disease prevention and health promotion is well documented in literatures[17][18][7][8]. There are also strong recommendations for the intensity and frequency of physical activity that everyone should aim to achieve throughout life to maintain good health. Despite these recommendations, there are evidences that PA rates decline consistently among adults[19][18]. So the need for PA promotion cuts across all health professional as it benefits all spheres of healthcare.

Working as a MD team for promotion of PA will include wide range of professionals such as Physiotherapists, doctors, nurses, midwives, health visitors, teachers, dieticians, psychologists/psychotherapists, health and fitness workers, community workers, health policy makers and many other relative to propagating enhanced PA Level among the masses.

Benefits of Multidisciplinary Team for promotion PA Participation

An MDT for PA promotion will be:

  • Working for common goals,
  • Pooling of expertise,
  • A forum for solving problems hindering PA participation
  • Creating innovative ideas on how to improve PA in the populace,
  • An avenue to motivates one another to persevere in PA promotion.
  • Harmonizing public or private organizations and groups who would not normally see themselves as having a role in PA promoting  alone.

Collaborative teamwork maximizes team members’ knowledge and understanding of each other, thus aid in roles description and boundaries as well as mitigate against rivalry.

There will be marked significant achievements, as there will be an increased access to networks and well as coordination in planning resources; and delivery of resources for professionals to use for service users’ benefits[2].

Barriers to Multidisciplinary team work in promotion PA Participation

Factors that will hinder the progress/efficiency of this MDT includes:

  • Lack of commitment especially among the professionals that the higher stake holders;
  • Conflicting perceptions; professional rivalry;
  • Inequity in the contributions to reassure alliance among team;
  • Exclusion of new added team members; lack of relevant skills;
  • Lack of common achievable goals[20].
  • The difficulty in data dissemination among participants in a multi-diverse coalition is also a significant hindrance the MDT for PA Promotion should strive to avoid.[21]
  • The different geographical boundaries between authorities, sectors or agencies can influence the success or the failure of a collaborative PA promotion project, for example between a local authority and a health authority because they are not co-terminus - do not cover the same populations[22].
  • Due to private companies being finance driving in marketing their shares in a competitive market and the public sector having scarce resources for health, the two are usually competing with each other. Thus, competition between large organizations of care and health promotion be it private or public can complicate the work of a collaboration whose partners are competing against each other[23] . In order to tackle issues such as competition in coalitions between the private and the public sector, health promoters need to foster creative linkages and re-assess traditional and old fashioned perceptions[21].

References

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  1. Mitchell GK, Tieman JJ, Shelby-James TM. Multidisciplinary care planning and teamwork in primary care. MJA 2008; 188(8), S61-S64.
  2. 2.0 2.1 Payne M. Teamwork in Multi-professional Care. Palgrave. 2000; Chapter 1, 1-24 and Chapter 8:157-180
  3. Mohman SA, Cohen SG, Mohrman AM. Sr. Designing Team-Based Organizations. San Francisco: Jossey-Bass.1995.
  4. 4.0 4.1 World Health Organisation (WHO). Global Recommendations on Physical Activity for Health. Geneva, Switzerland: World Health Organization. 2010 
  5. Physical Activity Guidelines for Americans, 2008. U.S. Department of Health and Human Services. http://health.gov/paguidelines/guideline/chapter 2. qspx. (accessed 22/4/2018)
  6. Caspersen CJ, Powell KE, Christenson GM. Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Reports 1985; 100(2):126–131.
  7. 7.0 7.1 World Health Organisation (WHO). Global NCD Infobase 2006. Geneva. 2014
  8. 8.0 8.1 Lee DC, Pate RR, Lavie CL, Sui X, Church TS, Blair SN. Leisure-Time Running Reduces All-Cause and Cardiovascular Mortality Risk. Journal of American College of Cardiology 2014; 64: 5
  9. 9.0 9.1 Warburton DE, Nicol CW, Bredin SS. Health benefits of physical activity: the evidence. Canadian Medical Association Journal 2006; 174:801–9.
  10. U.S. Department of Health and Human Services. Healthy people 2002: national health promotion and disease prevention objectives. In. Washington: US Department of Health and Human Services. 2002
  11. Dimeo F, Pagonas N, Seibert F, Arndt R, Zidek W, Westhoff TH. Aerobic exercise reduces blood pressure in resistant hypertension. Hypertension 2012; 60(3):653-8
  12. Juraschek SP, Blaha MJ, Whelton SP, Blumenthal R, Jones SR, Keteyian SJ, et al.  Physical fitness and hypertension in a population at risk for cardiovascular disease: the Henry Ford Exercise Testing (FIT) Project. Journal of American Heart Association 2014; 3(6):e001268. 
  13. Maiorana A, O'Driscoll G, Taylor R. Exercise and the nitric oxide vasodilator system. Sports Medicine 2003; 33:1013-35.
  14. Hill JO, Wyatt HR. Role of physical activity in preventing and treating obesity. Journal of Applied Physiology 2005; 99:765–70.
  15. Tiukinhoy S, Beohar N, Hsie M. Improvement in heart rate recovery after cardiac rehabilitation. Journal of Cardiopulmonary Rehabilitation 2003; 23:84-7
  16. Adamopoulos S, Parissis J, Kroupis C. Physical training reduces peripheral markers of inflammation in patients with chronic heart failure. European Heart Journal 2001; 22:791-7.
  17. Ayanniyi O, Fabunmi AA, Akinpelu OO. Effect of age on physical activity levels among teachers in selected secondary schools, Ibadan, Nigeria. Medicina Sportiva 2012; 8 (4): 1978-1982.
  18. 18.0 18.1 Oyeyemi AL, Oyeyemi AY, Jidda ZA, Babagana F. Prevalence of physical activity among adults in a metropolitan Nigerian city: A cross-sectional study. Journal of Epidemiology 2013; 23(3):169-177. 
  19. Agha SY, Al-Dabbagh SA. Level of physical activity among teaching and support staff in the education sector in Dohuk, Iraq. Eastern Mediterranean Health Journal 2010; 16 (12) 
  20. Naidoo J, Wills J. Health Promotion/ Foundations for Practice. Bailliere Tindall, Royal College of Nursing 2001; Pp:71-90.
  21. 21.0 21.1 Tzenalis A, Sotiriadou C. Health promotion as multi-professional and multi-disciplinary Work. International Journal of Caring Sciences 2010; 3(2):49-55.
  22. Heitkemper M, McGrath B, Killien M, Jarrett M, Landis C, Lentz M, Woods, N, Hayward, K. The role of centers in fostering interdisciplinary research. Nursing Outlook 2008; 56(3): 115-122
  23. Scriven A, Orme J. Health Promotion Processional Perspectives. The Open University, Macmillan 1996; Pp:22-32