Week 9 - Self Management, Overwork weakness, fatigue

Question 1

Define Self-management

Answer 1

Term given to the way a person proactively plans and manages their life and lifestyle for their health, well-being and QOL when living with one or more chronic conditions.

Question 2

What is the recommended amour of physical activity based on the Australian physical Activity sedentary behaviour guidelines for adults 18-64?

Answer 2

150-300 min of moderate intensity physical activity or 75-150 min of vigorous physical activity each week. Muscle strengthening at least 2 days/week.

Question 3

What is a secondary prevention approach?

Answer 3

Early intervention to establish self-management program with regular monitor prior to acute problems or right from diagnosis

Question 4

How active are people with PD compared to older adults without PD?

Answer 4

1/3rd less active

Question 5

what percentage of the people with TBI perform the recommended amour of physical activity

Answer 5

8% (compared to 50% general population)

Question 6

What are the barriers to physical activity in people with neurological conditions? (7)

Answer 6

ICE D FFT

1. Impairment
2. co-morbidities
3. expectations
4. Disappointment
5. Fear
6. fatigue
7. time

Question 7

What are the Facilitators to physical activity in people with neurological conditions? (5)

Answer 7

AS ICE

1. accountable for another person
2. self-efficacy
3. Easy access
4. Increase age
5. college education

Question 8

Define Self-efficacy

Answer 8

A person’s belief in his or her capabilities to overcome personal, social and environmental barriers to exercise

Question 9

What factors increase self-efficacy? (4)

Answer 9

Mess

1. Modeling
2. education
3. social persuasion
4. success

Question 10

What factors decrease self-efficacy? (2)

Answer 10

1. Failure

2. Disappointment

Question 11

List the behaviour change techniques to increase physical activity (7)

Answer 11

(E)llen (G)ot (I)n (BF)’s (E)mbrace (F)or the (R)eunion

1. Est. current physical activity status
2. Goal setting
3. Interests and local possibilities?
4. Barriers and facilitators?
5. Educate
6. self monitoring and feedback
7. Review

Question 12

What is the North West Community rehab motto

Answer 12

have a goal, have plan, have a go

Question 13

What was the evidence from Van der Ploeg et al (2006) comparing counselling groups to usual care

Answer 13

Counselling groups were twice as likely to participate in sport and 1.5 times as likely to meet recommended physical activity guidelines 9 weeks post discharge.

Question 14

Was was the evidence from the ParkFit trial (van him Wegen et al, 2013) comparing the addition of coaching to therapy vs. usual physical therapy?

Answer 14

intervention group increased activity 9% vs. control group decreased by 3%

Question 15

What was the evidence from Turner et al (2016) comparing telephone-based vs home-based exercise alone?

Answer 15

Treatment group decreased fatigue over 6 months while control stayed about same. Exercise increased and continued to increase
- decreased depression

Question 16

List recommended consideration for designing a self management program (5)

Answer 16

HPTCC

1. Community
2. Classes
3. Home-based
4. phone calls
5. Technology

Question 17

Shanahan et al (2016) study on partnered dance for PD helped?

Answer 17

Improved endurance
motor impairment
balance

Question 18

Li et al (2012) study on Tai chi for PD found

Answer 18

improved balance and reduced falls

Question 19

List the advantages and disadvantages of using technology as part of a self-management program

Answer 19

Advantages:
feedback
motivation
be part of exercise 
goal setting
inform patient's activity levels 

Disadvantages:

• difficult to put on
• unfamiliar and intimidating
• disappointment

Question 20

What does Buchners curve illustrate?

Answer 20

• relationship between strength and function
• threshold for strength affecting walking speed which can impact function
• may need to warn patients doing high intensity training depending where they are on the curve and risk of fall below threshold

Question 21

Define overwork weakness

Answer 21

Prolonged reduction in absolute strength and endurance of muscles due to excessive activity, often thought to be due to excessive eccentric activity

Question 22

What are the symptoms of overwork weakness

Answer 22

• Delayed onset muscle soreness

- Decreased max force which usually gradual recovers but can be prolonged or not reversible

Question 23

What was the evidence found by Dal Bello-Hass (2013) strength training exercise vs. usual care in patients with MND

Answer 23

Significant improvement found in activity with exercise group
- approx 7% improved activity but no strength

Question 24

What are the clinical implications for strength exercise training and overwork weakness?

Answer 24

Strength exercise training improves activity and only produces overwork weakness if training performed 4 x week or more

Question 25

What are some strategies to ensure strengthening exercise effective and reduce risk of overwork weakness (4)

Answer 25

RMMP

1. begin mild-moderate intensity
2. monitor fatigue
3. restrict high intensity training for each muscle group to 3 x week
4. progress by changing one parameter at any one time