Fatigue and physical deconditioning are common, difficult to treat conditions among patients with systemic lupus erythematosus (SLE). The aim of this pilot study is to evaluate the effectiveness of a home-based exercise program using the Wii Fit system in patients with SLE. Fifteen sedentary African American women with SLE experiencing moderate to severe fatigue participated in a home exercise program using the Wii Fit 3 days a week for 30 minutes each for 10 weeks. A one-group pretest-posttest design was used to evaluate the effectiveness of this program. Primary outcome measure was severity of fatigue. Secondary outcome measures were body weight, waist circumference, fatigue-related symptoms of distress, activity level and physical fitness. At the completion of the 10-week Wii Fit exercise program, participants perceived fatigue severity as measured by the Fatigue Severity Scale to be significantly decreased (P=0.002), body weight and waist circumference were significantly reduced (Ps=0.01). In addition, anxiety level as measured by Hospital Anxiety and Depression Scale, and overall intensity of total pain experience as measured by Short-form of the McGill Pain Questionnaire were also significantly reduced (Ps<0.05). Findings provide preliminary support that the Wii Fit motivates this population to exercise which leads to alleviation of fatigue and reduced body weight, waist circumference, anxiety level, and overall intensity of total pain experience.

Educators must determine whether occupational therapy students are adequately prepared for Level II fieldwork once they have successfully completed the didactic portion of their coursework. Although studies have shown that students regard the use of video cameras and simulated patient encounters as useful tools for assessing professional and clinical behaviors, little has been published in the occupational therapy literature regarding the practical application of simulated patients or reflective video analysis. We describe a model for a final Comprehensive Practical Exam that uses both simulated patients and reflective video analysis to assess student preparedness for Level II fieldwork, and we report on student perceptions of these instructional modalities. We provide recommendations for designing, implementing, and evaluating simulated patient experiences in light of existing educational theory.

MeSH TERMSexercise therapy home care services lupus erythematosus, systemic patient compliance self report OBJECTIVE. We examined agreement of data between self-reported and objectively assessed exercise adherence among women with systemic lupus erythematosus.METHOD. Eleven participants completed weekly exercise logs on date and duration of exercise during a 10-wk Wii Fit™ home-based program. Afterward, exercise data from the log were compared with those recorded in the Wii console. RESULTS.Of the paired data, the mean duration of exercise recorded in the Wii was 29.5 min and that recorded in the log was 33.3 min. The composite intraclass correlation for exercise duration between exercise log and the Wii Fit was 0.4. The 95% limits of agreement indicated large between-subjects variability.CONCLUSION. Exercise logs exhibit a marginally acceptable agreement with Wii estimation of exercise duration at a group level. However, caution should be applied when using the exercise log as a measure of a person's exercise behavior because of the tendency to overreport.

Objective To explore the process associated with the motivation for playing Wii Fit among patients with systemic lupus erythematosus (SLE). Methods Individual in-depth semi-structured telephone interviews were conducted with 14 sedentary African American women with SLE to explore their experiences and reflect on their motivation for playing Wii Fit after completing a 10-week home-based Wii Fit exercise program. Interviews were audio-recorded, transcribed verbatim, and analyzed using the constant comparative method to identify categories related to participants’ motivation. Three authors independently sorted, organized and coded transcript text into categories, then combined the categories into themes and subthemes. Results In addition to the two themes (Ethical principal of keeping a commitment, and Don’t want to let anyone down) generic to home-based exercise trials, we identified five themes (Enjoyment, Health Benefits, Sense of Accomplishment, Convenience, and Personalized) that revealed why the participants were motivated to play the Wii Fit. Enjoyment had three subthemes: Interactive, Challenging, and Competitive with an embedded social element. However, several participants commented they were not able to do many activities, master certain games, or figure out how to play some; as a result, they were bored with the limited selection of activities that they could do. Conclusions The motivational elements of the Wii Fit may contribute to improved exercise motivation and adherence in select sedentary African American women with SLE. Results provide a better understanding on the important elements to incorporate in the development of sustainable home-based exercise programs with interactive health video games for this population.

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