Mobility Action Programme projects

TBI Health provides a range of health and rehabilitation services throughout the country for people who have a range of musculoskeletal health conditions. Their Mobility Action Programme (MAP) is focused on providing community based, multi-disciplinary care for individuals with hip or Knee Osteoarthritis and/or Low Back Pain with a focus on long term self-management of the condition. The service is available in the Hutt Valley (Hip and Knee Osteoarthritis only) and MidCentral regions (Hip, Knee and Lower Back Pain).

Active+ has delivered community based, multi-disciplinary care for people with musculoskeletal health conditions across the North Island for 25 years. Their Mobility Action Programme (MAP) is focused on people who have osteoarthritis in their hips and knees in the Counties Manukau. Their MAP is a community based, multi-disciplinary model that includes comprehensive assessment to help identify specific needs of individuals. Following assessment, a programme of care will be planned and delivered that will help improve people’s quality of life and ability to self manage their conditions.

Body in Motion is a multidisciplinary team based throughout the Tauranga region. A strong community focus underpins their MAP which aims to improve access for all community members. Their MAP will offer an extension of their established educational and physical rehabilitation programmes for those impacted by osteoarthritis, rheumatoid arthritis or lower back pain.

PPIG is a private-public collaboration with a successful individualised exercise and multi-disciplinary education, self-management programme for people with hip and knee osteoarthritis. They have provided this service for the South Canterbury. Their MAP will be focused on expanding their service to improve access for people with hip and knee osteoarthritis including those on low incomes, and in isolated rural areas.

The Canterbury Initiative involves collaborating with Motus Health Network, a network of physiotherapy clinics in the Canterbury and South Canterbury community (Timaru to Cheviot). Together they will provide a community based Mobility Action Programme for people with musculoskeletal health conditions that are at various stages of progression, affecting people’s health and well-being differently and consequently requiring different levels of care.

• The Canterbury Initiative will be organising programmes of care for those whose musculoskeletal health conditions are more complex and severe. It will include an initial multi-disciplinary engagement session to learn about the programme and how it can help patients improve their self management. Clients will then progress to supervised group education and exercise classes.
• The Motus Health Network will provide care for those whose musculoskeletal health conditions are less advanced/severe, and require less extensive interventions that will help improve people’s quality of life and ability to more effectively self manage their conditions. Their Mobility Action Programme will be provided in parts of Christchurch and North Canterbury including the Waimakariri and Hurunui districts.

K’aute Pasifika Trust is a Pacific Provider based in Hamilton which has provided health education and social services to their community for the past 18 years. The Mobility Action Programme (MAP) is focused on people who have osteoarthritis or gout of the knees in Hamilton and Tokoroa. The Multidisciplinary Team is led by a specialist nurse, with GP oversight, and includes a physiotherapist with expertise in musculoskeletal conditions and exercise rehabilitation, a health and wellbeing coach with expertise in exercise and nutrition, and a dietician to educate clients and families. The MAP is community based, inclusive of all nationalities with a strong focus on the Pacific peoples.

This MAP involves a comprehensive assessment to help identify the specific needs of clients and a further assessment for fitness and general wellbeing. Following the assessment each client will be placed on a programme of care that will help improve their quality of life and ability to self-manage their conditions in the future.

Hawke’s Bay DHB, Health Hawkes Bay PHO and Ironmāori have established a partnership to address health inequities and reduce pain and disability in people with a musculoskeletal condition. The aim is to build community capacity and capability to support people in Hawkes Bay to participate to the full extent in work, leisure and home life.

A strong partnership approach with the Ministry of Social Development will ensure that people are supported to remain in work or to return to work. The service will be delivered through a Whānau Ora model of care using the principles of Relationship Centred Practise. Barriers to access will be addressed specifically targeting Māori, Pacific and people in work/training/or carers who live in areas of high health need of Wairoa, Takapau, Flaxmere, and Maraenui. Self-referral and walk-in services will be provided at no cost with a range of individually tailored options including physiotherapy assessment and treatment, community wellness programmes, healthy lifestyle education, and self-management support training including Whāriki Long Term Condition programme (Stanford model).

Arthritis New Zealand and Melon Health Ltd have collaborated to create the Managing Osteoarthritis (MOA) programme, an online 16 week self-management programme to support and educate people with mild to moderate osteoarthritis. The MOA includes a personal health coach from Arthritis New Zealand, 8 learning modules with tracking tools and a private online community. PHOs in five participating districts (Taranaki, Whanganui, West Coast, Lakes and Wairarapa) are supporting the project with identified primary care practices taking part.

TBI Health Group Ltd has consulted with Nelson Marlborough DHB, Nelson Bays and Marlborough PHOs and Te Piki Oranga Ltd (TPO) to enable, effective community-based management of musculoskeletal low back pain.

The programme will be delivered in localities with Very Low Cost Access (VLCA) practices and where people live who experience disparities in access and health outcomes. 

Individual programme components will depend on individual needs, but generally include community based education, physiotherapy-led rehabilitation, access to a specialist team, online resources and use of Telehealth. Participants will be supported to maintain progress and incorporate lifestyle changes.

The Southern Rehab MAP is a 12 week structured programme of self-management education, individualised rehabilitation and community support for people aged over 45 years with osteoarthritis of the hip or knee who live in Dunedin and Balclutha. An occupational therapist, physiotherapist, or nurse practitioner will work with the patient to design their programme based on their individual needs. The programme includes disease management education, weight loss, psychological management, exercise, and cultural/community support.

Tairawhiti region in collaboration with Turanga Health Maori Health Provider have developed a 6-week physiotherapy-led programme for people with mild to moderate osteoarthritis of the hip and knee who live in the Gisborne region. The target population includes those experiencing disparities in access to health services and clinical outcomes. Programmes incorporate cardiovascular, strength and stretching exercises, self-management education, dietary advice and structured group work.  

Providers include physiotherapists, dietitians, pharmacists and Māori health coaches. Programme components include cooking classes, cultural heritage walks and a 3-month refresher class. The programme plans to utilise connections to other community groups such as Turanga Health and Green Prescription to support participants to make long-term changes and to self-manage their condition.

The Coast to Coast Hauora Trust supports the MAP collaboration of Restart Rehab & Associates (physiotherapists and occupational therapists), Coast to Coast Health Care (PHO), Te Ha Oranga (Maori health provider), Coast to Coast Hauora Trust and Active Living Physio. The services target people living in the rural (and often high deprivation) areas around Paparoa, Wellsford, Maungaturoto, Kaiwaka and Mangawhai who have a broad range of musculoskeletal conditions.

The programme includes goal setting, a group MAP learning and exercise programme, whānau health literacy, occupational therapy, pain management and self-efficacy, physiotherapy and hydrotherapy sessions with holistic approaches to self-management. Participants who wish it will be supported throughout the programme by Kaimanaaki.

Active+ has collaborated with Auckland district and ProCare to deliver a two-stage programme for people with low back pain. The programme is located in areas where there are large numbers of people who are experiencing disparities in access to services and health outcomes. 

Stage 1 includes a 6-week physio led exercise and multi-disciplinary education programme. It includes input from psychologists, dietitians and pharmacists to support improved management of their condition once a week for 2 and a half hours.

Stage two is for those who require further support to build confidence in their ability to manage their health and keep up the changes they are making. This involves the 6 week Stanford Model of Self-Management of Pain programme and a 30 minute peer support walking group.

The REACH programme is a collaboration of Northland DHB, Active+, Hokianga Health Enterprise Trust (HHET), Te Tai Tokerau PHO and AWA Films Ltd. The programme is for people living in the Hokianga region with low back pain and osteoarthritis of the hip and knee.

This model includes AWA Films making a series of short films that tell individual stories showing the impact on people’s lives of living with painful musculoskeletal conditions and how their health and wellbeing can be improved by learning to manage their pain. 

The MAP Programmes for participants includes a 5-week structured group exercise and education programme supported by trained local allied health professionals such as the physio or community nurse. At the conclusion of the exercise session the participants will watch an episode of the film demonstrating the power of self-management and be lead in group discussion around applying the principles in their own lives.

The group will also be able to link to a multidisciplinary team that is based in Auckland for support. The film and use of videoconferencing with the outside team is an innovative approach that if successful may be adapted for use beyond Hokianga in other remote or rural communities.