Self-management of Function in Older Adults: The Contribution of Physical Therapy

The increase in chronic disease and associated musculoskeletal impairment experienced by a rising number of older persons will contribute to a surge in the prevalence of disability globally. The prevention of functional decline and the challenge of maintaining optimal functioning is complex and understudied. This review explores how physical therapy principles are applied within self-management (SM) programs for older adults with chronic illnesses. A search was conducted for papers that evaluated a chronic disease SM intervention involving a physical therapist (PT) delivered to older adults. In the papers reviewed, physical activity was the predominant focus of the SM interventions. Nine studies measured mobility and five studies reported positive functional outcomes. When mapped to the ICF classification of functioning, there were more positive findings at the level of body functions and structure in the arthritis studies compared to the COPD studies, where there were more positive findings at the level of participation. Future research and development needs to focus on integrating theoretical frameworks and rehabilitation-derived SM into PT practice.