A review of the efficacy of the self-management model on health outcomes in community-residing older adults with arthritis.

BACKGROUND: Chronic disease and disability have a significant impact on individuals, families, and society, resulting in limitations in personal care, premature loss of wages, higher mortality rates, and overall poor quality of life. Arthritis is a painful disease that limits physical activity, social functioning, and mental health and is hallmarked by an increasing prevalence in community-dwelling older adults. Self-management strategies reduce pain and disability while improving self-efficacy and quality of life. AIMS: The purpose of this review is to evaluate the efficacy of the self-management program in adults with arthritis on the outcome of functional disability. METHODS: Literature review. Search strategy included MEDLINE, CINAHL, and the Cochrane Library from 1985 to 2008 for studies using self-management interventions. RESULTS: Across studies of chronic disease, effect sizes were moderate for most variables. Subgroup ana- lyses for arthritis only demonstrated a greater magnitude of effect in variables related to functional health. CONCLUSIONS: While this review suggests small efficacy in the self-management program, with improvement in certain cognitive-behavioral markers for self-management, the functional gains that can be achieved in a growing older adult population translate into a larger effect overall.

Feasibility of a Home-Based Balance Intervention in Middle-Aged Women Using Wii Fit Plus®.

BACKGROUND: This study evaluated the feasibility and effectiveness of a home-based exercise intervention using the Wii Fit Plus®. METHODS: A randomized, controlled trial of 24 women (age 53.6 [5.4] y) was used to assess compliance and changes in balance over 12 weeks. Balance was measured via the Berg Balance Scale and Frailty and Injuries: Cooperative Studies of Intervention Techniques-4 Scale at baseline and week 6 and week 12. Participant compliance to the intervention was captured via paper logs and the electronic record collected by the Wii Fit Plus®. RESULTS: Participants in the intervention group were 95% compliant based on electronic records. There were no significant differences between groups for total score on either balance scale. There was a significant group × time interaction in favor of the intervention for maximum velocity y (P < .05), average velocity (P < .05), and was trending for maximum velocity x (P = .05) in the tandem step, eyes closed position. CONCLUSIONS: The results suggest that the Wii Fit Plus® is appropriate for home-based interventions in middle-aged women. Modest improvements in balance indicate that this may be an effective means to improve or maintain balance in older women. More research is needed to determine compliance and benefits to reducing fall risk in durations exceeding 12 weeks.