Developing Health Professional Capacity Through Community Partnership: Evaluation of an Inclusive Exercise Program for Adults with Physical Disability in Longford, Ireland

Abstract

Background: Adults with physical disability experience reduced access to structured physical activity and prolonged waiting times for rehabilitation services. Traditional one-to-one therapy models may not adequately address sustained physical activity needs while maintaining service quality and capacity. Community-integrated exercise pathways may offer a strategy to improve functional outcomes and alleviate system-level pressures.

Aim: To evaluate the functional and service-level impact of a community-based group exercise program implemented within an adult disability service.

Methods: A service evaluation was conducted of a community-based, group exercise program for adults with physical disability delivered in partnership between HSE adult disability services and community physical activity providers. Participants were referred through routine clinical pathways and screened for medical stability and suitability for group exercise. The intervention consisted of supervised exercise sessions delivered over an 8-week period. Outcome measures included the Five Times Sit-to-Stand Test (5TSTS), Berg balance scale, gait speed (10-metre walk test), 6-Minute Walk Test (6MWT) and self-reported health (VAS). Pre- and post-program assessments were completed by trained staff. Descriptive statistics were used to summarize outcomes, with paired analyses conducted using t-tests and Wilcoxon signed-rank tests as appropriate. Effect sizes (Cohen’s d) and percentage change were calculated. Clinical significance was interpreted using established Minimal Clinically Important Difference (MCID) thresholds.

Results: The sample included 23 participants (14 female (60%), 9 male (40%) with a mean age of 51.3 years (SD=12.3), a median age of 55 years and an age range of 21-65 years. Participants demonstrated improvements in mobility, lower limb strength, balance and health-related quality of life, with a majority achieving clinically meaningful gains in gait speed and functional strength. At a service level, physiotherapy waiting list volume reduced by 93.9% (66-4 clients) and maximum waiting time decreased by 86.7% (30-4 weeks), indicating substantial improvement in service flow.

Conclusion: A community-based group exercise pathway embedded within an adult disability service achieved meaningful functional improvements while significantly reducing waiting list pressures. These findings suggest that redistributing appropriate signposting into structured community programs can enhance equity of access, preserve clinical capacity for complex cases and support sustainable service redesign.