Kyla Alsbury-Nealy is connecting more clients with community-based exercise programs

Kyla Alsbury-Nealy had been working as a physical therapist for four years when she realized she wanted to make a bigger impact on the physical therapy profession. “That’s when I started thinking about going back to school to do my PhD – I thought I could contribute to the body of evidence that informs our practice and make a broader impact that way,” she says. 

Alsbury-Nealy connected with Nancy Salbach, a Professor in the Department of Physical Therapy, and learned about her research on the Together in Movement and Exercise (TIME^TM) program. TIME^TM is a group exercise program developed by physical therapists at the Toronto Rehabilitation Institute for people with mobility challenges and is licensed by the University Health Network. TIME^TM is an example of a community-based exercise program with a health care-community partnership (CBEP-HCP). In the CBEP-HCP model, trained fitness instructors deliver the exercise program with the support of a health care partner, often a physical therapist. Alsbury-Nealy realized some of her clients would have been perfect candidates for the TIME^TM program, but she didn’t know the program existed and so she wasn’t able to refer any clients. 

"These exercise programs fill a gap in our health care system. A lot of the participants are people who have had a stroke or have Parkinson's disease or another chronic condition that impacts their balance and mobility. If they can exercise regularly and safely at a local community centre, this can help to maintain health and reduce secondary complications of these conditions,” says Alsbury-Nealy. 

The realization that qualified participants were missing out on the benefits of the TIME^TM program laid the foundation for her first scoping review. Alsbury-Nealy found that one of the factors in developing health care-community relationships was having a boundary-spanner; a person who can go between different organizations to connect potential participants with the programs. Boundary spanners, like health care partners, can be a key factor in facilitating program participant referrals. 

In her recently published study, Exploring the role of healthcare partners in referrals to a community-based exercise program with a healthcare-community partnership designed for people with balance and mobility limitations, Alsbury-Nealy found that health care partners, like physical therapists, view their role in referrals as secondary to their role as educators and trainers. Despite the importance of the boundary spanning role of health care partners, another study found that only 42 per cent of community-based programs included in the study received referrals from health care partners.

These findings highlight an opportunity for enhanced support, training and resource allocation for health care and community partners, alongside educational initiatives for professionals to strengthen referral processes and optimize collaboration in community-based exercise programs. Alsbury-Nealy notes, “Our roles as physical therapists are changing. Our work isn’t always face-to-face. We are starting to take on more knowledge broker roles and are starting to span these boundaries to connect our clients with opportunities to exercise regularly.” 

Since completing her PhD post-graduate studies in the Rehabilitation Sciences Institute earlier this year, Alsbury-Nealy is looking to expand on the impact of her work in the rehabilitation sector. She co-founded SilicoLabs, where they have developed a no-code platform that allows anyone to easily create interactive experiences that simulate the real world using extended reality technology. This can help researchers to more easily collect data on human behaviour—bringing the real world back into clinical practice and research. For example, where traditional studies might ask participants to estimate how confident they are crossing a busy street, researchers using SilicoLabs’ software can create an extended reality experience to more accurately measure participants’ confidence. 

“For me, it's really exciting because I still get to make that wider impact because I'm providing software that helps all these researchers to do this cutting-edge work,” she says.