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Flashcards in Self Management Deck (16):
1

Define 'self management'

- the way a person PROACTIVELY plans + manages their life for their HEALTH, WELL BEING, and QoL when living with 1+ chronic conditions

2

Whats the recommended amount of physical activity (18-64 yrs) for gen pop?

150-300 mins of moderate intensity OR 75-150 of high intensity
- mm strengthening exercises on at least 2 days/week

(these guidelines are for gen pop and few people get this; even lower for people with neuro conditioning)

3

Describe the physical activity behaviours of people with:
MS
PD
Stroke
Brain injury

PD = 33% less active than older adults
MS = moderately less active than gen pop
Stroke = 50% of steps/day of gen pop
TBI = only 8% get the recommended amount of PA (compared to 50% of gen pop)

4

Winward et al (2011) ran a study that provided PD pt's all the resources (staff, money etc) to pursue an exercise program without supervision. What were their findings?

- out of the 60 sessions they were meant to do, subjects on average did only 15!
- not surprisingly, didn't get any of the benefits of exercise d/t low compliance

TAKE HOME POINT: not enough to give people exercise - they need more support

5

List some challenges to self management in people with neuro conditions

Cognitive
Decline
Disappointment *in not being able to do what they should be able to
Difficulty *in asking for help when they need it
Fatigue
Mental health (apathy/anxiety/depression) *both as a reaction to and as a result of the disease
Set backs

6

List barriers to exercise in neuro subjects

F.F.I.L.L.D
F - fatigue/apathy/depression
F - fear of falling
I - impairments
L - lack of time
L - low outcome expectation (they don't think exercise will do anything)
D - disappointment with performance

7

List facilitators to exercise in neuro subjects

E.S.C.A.A

E - easy access to venue
S - self efficacy*
C - college education
A - age
A - accountable

*more of a factor than disability in determining adherence to exercise

8

Define self efficacy
What increases it?

The belief in your capabilities to overcome personal, social, and environmental barriers

What increases it? M.E.S.S
M - modelling (seeing someone else do what you want to do)
E - education
S - social persuasion (eg. group activity)
S - success (if you've had success in the past more likely to think you can do it again)

9

What decreases SE?

Failure
Disappointment

10

List some behaviour change techniques to increase PA

G.R.I.P 'E.M

G = goal setting
R = review (skype/phone calls etc)
I = individualised exercises (something they're interested in)
P = PA status baseline
E = education
M = self monitoring (log books, pedometers etc)
B = barries/facilitators to PA

11

van der Ploeg et al (2006) incorporated counselling/behavior change techniques into physical activity compared to usual care for stroke, TBI, chronic LBP pts. What did they find?

Counselling group:
2x likely to participate in sport
1.5x likely to meet PA guidelines 9 weeks post discharge
Also more likely to meet guidelines 1 yr post follow up

12

What was the ParkFIT trial and what'd they find?

- conducted in Netherlands
- subjects were PD pts
- compared ParkFit program (usual physio + counselling + activity monitoring with fitbit) to ParkSafe program which was usual physio (and this was pretty good too!)
- ParkFit group saw 9% INCREASE in activity over 2 yrs vs usual care saw 3% DECREASE

13

Turner et al (2016) looked at motivational interviewing and telehealth coaching in MS pt's vs home based exercise alone. What did they find?

- in the coaching group - they saw an increase in fitness, reduction in depression, and reduction in fatigue

14

What is the evidence for dance?

- improves balance, endurance, motor impairment, and reduces falls
- but studies did show varied attrition rate 14% - 50% - mostly due to developing co-morbidities

15

Technology - pros

- provides feedback/motivation
- informs therapist of pt's activity level
- facilitate goal setting
- be part of the exercise (Wii, Xbox etc)

16

Technology - cons

- problematic to put on for people with coordination issues
- hard if not tech savvy?
- disappointing for people to see their inadequacies?