Training practitioners for the Ronnie Gardiner Method
The HOPE Foundation supports training of Ronnie Gardiner Method practitioners in 2023
The Ronnie Gardiner Method (RGM) is a cognitively challenging exercise programme designed to provide activation for those with Parkinson's disease, rehabilitation for those with stroke, possibly delay in cognitive decline and improvement in functional measures related to falls. (1-4) It is also very acceptable and fun for healthy older people. The RGM uses rhythm and movement in upright stance to challenge balance, memory and coordination. Of particular interest is an observed positive impact on late-stage stroke victims. (2) Important components are the music, the social interaction, the challenging exercises, and the skilled instructor. (3) There is also preliminary evidence that cognition and function are stimulated for those with mild cognitive impairment. (1)
Learning the method entails a two-day initial training, regular practice with groups of clients, and a two-day final training to reinforce development of exercise plans musical and rhythm, and progression of delivery skills. RGM is fun for participants and brings an extension to rehabilitation and may also be useful in traumatic brain injury.
Currently in New Zealand we have had visits from the training experts in RGM and four people are actively training practitioners at both the Introductory and Ground course (training as accredited practitioners) level. There are approximately 20 trained practitioners in New Zealand with an additional 15 being trained in 2022. The training is provided pro-bono by practitioners, some as part of their role (as Joyce Cook Chair, to promote healthy ageing, president of the Diversional Therapy association – to promote the methods to members) and some as part of the development of the method in preparation greater training numbers when there may be capacity to pay the trainers.
Most of those trained are using the method within their usual employment e.g. as diversional therapists in aged care settings, or as part of their Aged Concern employment. There are not sufficient practitioners offering private classes to meet public demand. Therefore, the HOPE Foundation supports training for more practitioners by funding for 2 separate practitioners to deliver two sequential courses of 12 weekly RGM sessions for four groups (two each practitioner) of healthy older people and administrative support for the scheduling of classes, upkeep of websites, coordination of practitioner support meetings and organising training events.
The RGM programme is delivered in small groups to a range of people. These classes will specifically be for healthy older people who want to improve their physical and cognitive performance and gain social connections. Group participants will be recruited through public notices and word of mouth and meet at a community location acceptable to the group on a weekly basis. The RGM practitioner will work with each group to develop their musical preferences, offer interesting choreoscores designed to gradually challenge and extend physical and cognitive capability. the programme will progress throughout the 12 weeks and then the participants with work with the practitioner on negotiating a sustainable way to continue the classes. The practitioner will start a second group with new people for the second 12 weeks, and if possible continue to work with the first group.
As part of the programme development evaluation is essential. The impact of the RGM on physical functioning and wellbeing will be assessed on individuals participating in the four groups of older people before and after their course (and also on other RGM groups funded separately, e.g. Oceania). Each participant will be invited to complete a short assessment before and after the course. The assessment will comprise the timed up and go physical function test, and the mini-ACE cognitive scale. They will also be screened with a physical safety questionnaire (e.g. recent heart attack, unstable angina) and asked to fill in an evaluation sheet at the conclusion of the programme.
The physical performance and cognition scores will be combined with all other RGM participants and compared before and after to investigate change over time. The evaluations will be used to improve the course delivery.
At present practitioners are accredited and accepted by the professional body – Exercise Practitioners Association – and they are working on the applied health professionals recognising this method as valuable in the allied health therapeutic space. More research is needed to prove the impact of the programme.
References
1. K Zawaly, et al. Efficacy of the Ronnie Gardner Method: Pilot randomized controlled trial in older adults with mild cognitive impairment. Alz Dem 2018;14(7)1331
2. Bunketorp-Käll L, Lundgren-Nilsson Å, Samuelsson H, et al. Long-term improvements after multimodal rehabilitation in late phase after stroke. A randomized controlled trial. Stroke 2017;48:1916–24. doi: 10.1161/strokeaha.116.016433
3.Pohl P, Carlsson G, Bunketorp Käll L, et al. Experiences from a multimodal rhythm and music-based rehabilitation program in late phase of stroke recovery – A qualitative study. PLoS ONE 2018;13(9):e0204215. doi: 10.1371/journal.pone.0204215
4. Pohl, P., et al. The Ronnie Gardiner Rhythm and Music Method - a feasibility study in Parkinson's disease. 2013. Disabil Rehab doi: 10.3109/09638288.2013.774060
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