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The NHS virtual gym boosting fitness and social connections for cystic fibrosis patients

BMJ 2020; 371 doi: (Published 23 October 2020) Cite this as: BMJ 2020;371:m4063

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  1. Emma Wilkinson, freelance journalist
  1. Sheffield
  1. emmalwilkinson{at}

Staff behind an online fitness project set up as a result of covid-19 are now making the case for a permanent change for cystic fibrosis care. Emma Wilkinson reports

The All Wales Adult Cystic Fibrosis Centre in Llandough, near Cardiff, has four purposebuilt gyms in its outpatient department where patients are offered one-to-one training sessions. When covid-19 hit and patients could no longer come in, the team rapidly developed another way to keep patients fit and stay in touch.

By the end of March a virtual leisure centre with daily classes covering aerobics, spin, strengthening, and body conditioning was up and running. Thought to be the first of its kind in the NHS, groups of eight to 10 patients could sign up to classes done over Zoom.

Almost overnight it became apparent that patients who had never exercised before, who had rejected all the attempts to get them to come into the bricks and mortar centre for sessions, were signing up and enjoying it. The virtual leisure centre is now here to stay, says lead consultant Jamie Duckers, and it should be something the NHS routinely offers for cystic fibrosis patients as they increasingly lead healthier and busier lives.

“With new life changing treatments coming in, exercise is going to be a massive part of care for these patients,” says Duckers, who explains that it helps patients to clear their chests —a part of physiotherapy treatment they generally hate. “The other thing is they want a bit of normality and they see their friends doing sport and exercise and they want to join in.”

Range of exercisers

The 300 patients across Wales served by the centre range from elite athletes to people who have never exercised before. For many, worries about exercising in front of others as well as infection risk in gyms even before covid-19 stopped them doing as much as they would like to, says specialist physiotherapist Aimee Johnson. Some patients would have had to travel from the other side of Wales for a session.

“When covid started we needed to think how we could adapt for those who would regularly attend the centre, but also we were aware that all of the patients needed to have something in place. We are on week 23 now, and even now that shielding has stopped we are still going and still well attended.”

Mat Cochrane, 33, a driving instructor, is one of those patients who had put off exercising—wanting to do more but struggling to find the time and not having the confidence to go to a regular gym. Cochrane, who lives in Barry, just outside Cardiff, says he has been doing three sessions a week since the start of the virtual centre and has continued now he is back at work. His favourite class is the high intensity interval training sessions.

“I like the challenge. At the start of lockdown I couldn’t do a press up and I couldn’t do a sit up—and I wouldn’t have attempted to do one on my own. I can now. It’s made a massive difference: I’m getting fitter and I feel more energised.”

Social support for shielding

But for Cochrane, who has spent the whole time since lockdown shielding on his own because his naval officer husband has been away on duty, it was the social side of the sessions that was most important “It made shielding a lot less lonely, and I liked seeing everyone, and I got to know some of them. Seeing other people with cystic fibrosis exercising has been really interesting. I know patients at other centres who have had nothing like this.”

Steve Howard, an exercise technician who runs the classes with a physiotherapist there to support anyone who may need advice or help, says there has been a real camaraderie. “We can create a very positive training atmosphere with people yelling encouragement. It’s been quite uplifting.”

Duckers says they had thought about doing some online sessions before the pandemic, but red tape meant it never got off the ground. It is now here to stay, and for the moment classes are timetabled three days a week with a later session for those who have returned to work.

“The concept of a virtual leisure centre is going to be important in cystic fibrosis,” he says. “We will be investing more in this and adapting it to what patients tell us they want.”


  • Competing interests: I have read and understood BMJ policy on declaration of interests and have no relevant interests to declare.

  • Provenance and peer review: Commissioned; not externally peer reviewed.

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