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Delivering a Healthy WA
Community Physiotherapy Services (CPS)  

Program Overviews

Please see below for a brief description of the different types of exercise classes offered by CPS:

Functional Rehabilitation

Slow stream rehabilitation program designed for adults with reduced functional ability due to chronic conditions, including neurological, musculoskeletal, cardiovascular, respiratory, falls and de-conditioning. The program delivers targeted exercises and education to assist clients to better manage their own health through physical activity.

The main objective of this program is to maximise functional ability, and facilitate clients remaining independent at home.

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Hydrotherapy

Water-based rehabilitation programs designed for adults with chronic conditions who are unable to exercise on land, or whose chronic conditions benefit from water based exercise. Such conditions include arthritis and chronic pain.

Clients must be able to access and manage in a pool independently, or must have a capable carer to assist with this.

The main objective of this program is to maximise functional ability, and minimise the impact of joint pain on physical activity.

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Orthopaedic Programs

CPS Orthopaedic programs are specifically designed for:

  • adults with chronic Orthopaedic conditions
  • adults with severe Osteoporosis who are at high risk of sustaining or who have already sustained osteoporotic fractures

In addition to the general CPS criteria, to be eligible for enrolment in a CPS Orthopaedic program a client must, with or without carer assistance:

  • have a diagnosed orthopaedic condition that will benefit from rehabilitation and/or physical activity

The main objective of these programs is to maximise functional ability and reduce the secondary impacts of pain.

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Falls Prevention Programs

Rehabilitation programs designed to minimise falls risk and optimise balance, physical ability and function. These programs are targeted at adults identified as at risk, or with a history of falls.

Classes are based on the “Otago” falls prevention program, incorporating both education and exercise components. Participants are able to use walking aids but must be able to stand independently for short periods.

The main objective of these programs is to maximise functional independence and reduce unplanned Health Care Utilization via reduction in the number and severity of falls.

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Stroke

Stroke classes are suitable for adults affected by a stroke who have been discharged from out-patient rehabilitation, and chronic stroke patients requiring further rehabilitation to maintain or improve functional independence. The program will also accept clients with other similar neurological presentation e.g. subdural haematoma, head injury, and some progressive neurological conditions.

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Young Neuro Gym (Pilot Program)

Young Neuro classes are a pilot program suitable for clients under the age of 65 who have had a neurological event or an exacerbation of an existing neurological condition. The group is appropriate for clients who have had a stroke but also for people diagnosed with Acquired Brain Injury, Spinal Cord Injury, Multiple Sclerosis, etc.

The class is based in a community gym with the aim of establishing an individualised exercise program incorporating cardiovascular and strengthening exercises. The aim of the group is to increase overall independence of the individual within the community.

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Parkinson’s Disease

The Parkinson’s disease (PD) classes are suitable for adults with a primary diagnosis of PD or Parkinsonism, living in the community, who have had individual therapy.

There are different levels of CPS PD programs based on client’s cognitive and functional status. Regardless of level, all programs within the CPS PD service aim to maximise the participants’ functional ability, quality of life and to prevent falls. The aim is to give the participants the best chance to adapt to living with PD within their community, and to maximise self efficacy through supporting the client to better manage their own health.

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Cardiac Rehabilitation Initial (Phase 2)* Pilot Program

Please contact CPS office for specific Phase 2 Cardiac Rehabilitation referral forms as this is a pilot program.

CPS is currently piloting a Phase 2 community-based cardiac rehabilitation program.  The program aims to provide the exercise training component of Phase 2 cardiac rehabilitation, for low risk cardiac clients post cardiac event or surgery. High risk clients should be referred to a hospital-based program. This program is also suitable for adults with known cardiac disease, or multiple cardiovascular risk factors.  The program is for 8 weeks with clients attending twice per week, and includes endurance walking and upper/lower limb resistance exercises. Clients are assessed pre and post program, and are also provided with a home exercise program to complete in conjunction with CPS classes. Clients will be referred to existing services for the education component of cardiac rehabilitation. Upon completion of the Phase 2 program, clients can be referred to a Phase 3 CPS class if appropriate.

Referral Process

Referrals accepted from Cardiologists, General Practitioners, Physiotherapists, or Cardiac Rehabilitation teams.

Eligibility criteria:

  • Resting ejection fraction >30%; or ejection fraction <30% with an automated implantable cardioverter defibrillator in situ
  • Uncomplicated Myocardial Infarction or angioplasty/stenting within the last 8 weeks if seen by and deemed safe to exercise in the community by the Cardiologist
  • Absence of complicated ventricular arrhythmias at rest or on exercise
  • Stable on medication, motivated and willing to participate in an 8-week program
  • Absence of a significant musculoskeletal or neurological condition that limits ability to exercise.

Clients who demonstrate the following criteria should be referred to a hospital-based cardiac rehabilitation program for management:

  • Unstable angina or exercise-induced angina within the previous 8 weeks
  • Complicated myocardial infarction (MI) within the previous 8 weeks
  • Post –operative coronary artery bypass graft within the previous 8 weeks
  • Pulmonary embolus or pulmonary infarction within the previous 8 weeks
  • Complicated coronary angioplasty/stenting within the previous 8 weeks
  • Complex congenital heart disease
  • Severe impairment in left ventricular function (ejection fraction <30%)
  • At least one coronary vessel at least 70% occluded without surgical or percutaneous intervention
  • New York Heart Association (NYHA) Functional Class III-IV

For a more detailed list of inclusion and exclusion criteria for community and hospital-based cardiac rehabilitation, please contact CPS.

* Please note that within the area of Pulmonary/Cardiovascular Rehabilitation:

  • Phase 1 refers to inpatient rehabilitation
  • Phase 2 refers to sub acute/early outpatient rehabilitation
  • Phase 3 refers to maintenance rehabilitation.

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Pulmonary Rehabilitation Initial (Phase 2)* Program

Please contact CPS office for specific Phase 2 Pulmonary Rehabilitation referral forms as this is a pilot program.

Phase 2 Pulmonary Rehabilitation is currently being piloted in community (non-medical) settings by CPS. These programs are for people with chronic lung disease who are limited by breathlessness on physical activity and are at a low risk of an adverse event during exercise. Clients at a higher risk of an adverse event (eg profound oxygen desaturation, complex co-morbidities) should be referred to a hospital-based program. The program comprises assessment, exercise training and disease-specific self-management information sessions. Clients are required to attend classes for 8 weeks, two sessions per week, and are provided with a home exercise program to complete in conjunction with the classes. On completion of the Phase 2 program, clients can be referred to a Phase 3 CPS class if suitable.

Referrals are accepted from Respiratory Physicians, Physiotherapists and General Practitioners where a diagnosis of respiratory disease has been established (spirometry).

Eligibility criteria:

  • Breathless on activity, stable on medication, motivated and willing to participate in an 8-week program
  • Low cardiovascular risk i.e. no significant ischaemia, left ventricular dysfunction or complex arrhythmias
  • Absence of significant musculoskeletal or neuromuscular disease that limits ability to exercise
  • Resting SpO2 ≥ 92% and SpO2 ≥ 85% during 6MWT

Clients who demonstrate the following criteria should be referred to a hospital-based PR program for management:

  • SpO2 <85% during 6MWT (if available)
  • Oxygen dependent and requiring assistance to manage (community programs have no back-up oxygen)
  • Moderate/high cardiovascular risk i.e. recent significant cardiac event (<6months), severely impaired left ventricular function (ejection fraction < 30%), or symptomatic cardiac disease

* Please note that within the area of Pulmonary/Cardiovascular Rehabilitation:

  • Phase 1 refers to inpatient rehabilitation
  • Phase 2 refers to sub acute/early outpatient rehabilitation
  • Phase 3 refers to maintenance rehabilitation.

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Cardiopulmonary Maintenance (Phase 3)* Program

CPS Cardiopulmonary Maintenance Programs (Phase 3) are designed to maximise physical ability, function and endurance to minimise the impact of chronic heart and lung disease and related secondary complications. Programs follow best practice guidelines and incorporate education to empower clients to better manage their own health.

For clients with a primary respiratory diagnosis completion of a Phase 2 pulmonary rehabilitation program is a requirement (hospital or community based).

Inclusion/Exclusion Criteria

In addition to the general CPS criteria, to be eligible for enrolment in a CPS Cardiopulmonary Phase 3 Program a client must:

  • have demonstrated stability in cardiovascular and pulmonary status during Phase 2 pulmonary/cardiac rehabilitation program
  • have a resting SpO2 ≥92% at rest, and maintain a SpO2 ≥85% during 20MWD or endurance walking component of training program
  • be a minimum of 4 weeks post cardiac surgery or 8 weeks post Myocardial Infarction
  • if requiring supplemental oxygen during exercise, be independent and safe in the provision and care of their portable oxygen equipment (cylinder must be portable, utilising a suitable trolley, have an appropriate delivery device and an adequate supply of oxygen) and meet specified resting and exercise SpO2 parameters (as outlined above).

Exclusion Criteria

  • Severe pulmonary hypertension
  • Unstable cardiovascular disease (see Phase 2 criteria)
  • Uncontrolled diabetes
  • Severe musculoskeletal or neurological impairment affecting ability to perform endurance walking program

* Please note that within the area of Pulmonary/Cardiovascular Rehabilitation:

  • Phase 1 refers to inpatient rehabilitation
  • Phase 2 refers to sub acute/early outpatient rehabilitation
  • Phase 3 refers to maintenance rehabilitation.

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