Best Practices
Evidence-based programs available in Marathon County
Stepping On: building confidence and reducing falls – a program that empowers older adults to carry out health behaviors that reduce the risk of falls, improve self management, and increase quality of life. It has been shown to reduce falls by 31%. It is a community-based workshop offered once a week for seven weeks using adult education and self efficacy principles. Older adults develop specific knowledge and skills to prevent falls in community settings. Participants include those who are at risk of falling, have a fear of falling, or have fallen one or more times. Workshops are facilitated by two trained leaders, one health professional and one peer leader. The program is the work of D. Lindy Clemson, an occupational therapist from Australia, and has been adapted in Wisconsin for use in the United States.
For more information: http://www.dhs.wisconsin.gov/aging/CDSMP/SteppingOn/index.htm.
Living Well with Chronic Conditions (Wisconsin Name) – The Chronic Disease Self-Management Program (CDSMP), developed by Dr. Kate Lorig, out of Stanford University. Dr. Lorig, completed a five-year study in 1996 to develop the community-based self-management program that assists people with chronic illness. Over 1000 individuals with chronic disease were evaluated and numerous studies have been reviewed from that time. Decades of federal research shows that CDSMP results in significant, measurable improvements inpatient outcomes and quality of life. In Wisconsin, program participants who responded to a six-month follow-up survey reported a 27% decrease in emergency department visits and a 13% decrease in hospital stays after completing the program.
For more information: http://www.dhs.wisconsin.gov/aging/CDSMP/index.htm.
Arthritis Foundation Exercise Program–AFEP (formerly People with Arthritis Can exercise or PACE) is a community-based recreational exercise program developed by the Arthritis Foundation. Trained AFEP instructors cover a variety of range-of-motion and endurance-building activities, relaxation techniques, and health education topics. All of the exercises can be modified to meet participant needs. The program’s demonstrated benefits include improved functional ability, decreased depression, and increased confidence in one’s ability to exercise. Classes typically meet two times per week.
For more information: http://www.arthritis.org/programs.php.
StrongWomen Program (also called Strong Bones)–an evidence-based strength-training program developed by the staff of the John Hancock Center for Physical Activity and Nutrition, Friedman School of Nutrition Science and Policy, Tufts University. At the core of the model is the StrongWomen Toolkit, which comprises the primary functional materials to be used by community leaders to start programs within their town or county. The Toolkit works in a stepwise fashion covering topics ranging from, program promotion, when to gain medical clearance, to a comprehensive exercise prescription and easy-to-use nutrition information for older adults.
The benefits of strength training for older women have been studied extensively and include: increased muscle mass and strength; improved bone density and reduced risk for osteoporosis and related fractures; reduced risk for diabetes, heart disease, arthritis, depression, and obesity; improved self-confidence, sleep and vitality.
For information about instructor trainings contact: Angela Flickinger, angela.flickinger@ces.uwex.edu.
Tai Chi Fundamentals®–an exercise form that adapts the movements and principles of traditional Yang Style Tai Chi Ch’uan into a practice routine that is accessible to a wide range of abilities. In addition, it targets critical elements from the traditional form which enhance balance, coordination, strength and endurance. Each section can be practiced as a complete and challenging program depending on the abilities of the participant.
Tai Chi is a weight-bearing and moderate-intensity cardiovascular exercise. Current research suggests that practice of Tai Chi can improve balance, reduce falls and increase leg strength. It also lowers blood pressure, stress hormones, enhances respiratory and immune function, and promotes emotional well-being. It also has been found to lower blood pressure and cortisol levels.
For information about Tai Chi Fundamentals®: http://www.taichihealth.com/healthpro.html.
Other Evidence-based programs in Wisconsin
Otago Exercise Program–an individually tailored exercise program that is delivered in the home by a trained nurse or physical therapist. It has been shown to reduce falls by 35%. The OEP was designed by the Falls Prevention Research Group at the University of Otago Medical School. It consists of a series of leg-strengthening and balance-retraining exercises that become progressively more difficult as the participant gets stronger. For more information please visit: www.acc.co.nz/preventing-injuries/at-home/older-people/information-for-older-people/otago-exercise-programme/index.htm.
Sure Step–a multi-factorial, one-on-one intervention conducted by Jane Mahoney, MD, and Terry Shea, PT, in a randomized trial in Kenosha County, and was found to be effective in reducing falls in a subset of high risk older adults. Results to date show a 68% reduction in falls in the six months after the start of the intervention compared to the six months prior.
For more information: http://www.dhs.wisconsin.gov/health/InjuryPrevention/FallPrevention/.
Matter of Balance–emphasizes practical strategies to reduce fear of falling and increase activity levels. Participants learn to view falls and fear of falling as controllable, set realistic goals to increase activity, change their environment to reduce fall risk factors, and exercise to increase strength and balance. This program has been adapted from the original intervention to be more suitable for community-dwelling older adults by allowing small group sessions to be led by a trained facilitator.
For more information, visit http://www.mmc.org/mh_body.cfm?id=432.
