Journal of Korean Academy of Fundamentals of Nursing (기본간호학회지)

Korean Academy of Fundamentals of Nursing (기본간호학회)
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Effects of Tai Chi Exercise on Physical Fitness, Bone Mineral Density, and Fracture Risk in Institutionalized Elderly

저강도 타이치 운동이 시설거주노인의 체력, 골밀도 및 골절위험도에 미치는 효과

  • Kim, Hyun-Li (College of Nursing, Chungnam National University) ;
  • So, Hee-Young (College of Nursing, Chungnam National University) ;
  • Song, Rha-Yun (College of Nursing, Chungnam National University)
  • Received : 2010.07.26
  • Accepted : 2010.08.13
  • Published : 2010.08.31
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Abstract

Purpose: The purpose of this study was to examine the effects of Tai Chi exercise on flexibility, balance, walking ability, muscle strength, bone mineral density, and fracture risk in institutionalized elders. Method: A quasi-experimental pretest-posttest design with a nonequivalent comparison group was utilized, and 53 older adults living in one institution were recruited and assigned to one of two groups, experimental group (18) or comparison (20). Both groups completed posttest measures at 6 months. There was a 31% rate of dropouts. Tai Chi exercise was provided twice a week for 24 weeks. Outcome measurements were conducted by a physiotherapist at a university hospital health promotion center who did not know the group assignment. Results: At 6 months, the experimental group had significantly greater grip strength(t=2.12, p=.04), back muscle strength (t=2.42, p=.02), balance (t=5.31, p<001), and flexibility (t=3.57, p<.001). They also showed significantly greater bone mineral density of lumbar spine and femur, and reduced fracture risk. Conclusion: Tai Chi exercise was safely and effectively used with institutionalized elders for 6 months and significantly improved physical fitness, bone mineral density along with a reduction in fracture risk. Whether Tai Chi exercise would lead to prevention of fall episodes and fall related fractures in this population will require further study.

Keywords

References

  1. American Geriatrics Society. (2001). Guideline for the prevention of falls in older persons: American Geriatrics Society, British Geriatrics Society, and American Academy of Orthopaedic Surgeons panel on falls prevention. Journal of the American Geriatrics Society, 49, 664-672. https://doi.org/10.1046/j.1532-5415.2001.49115.x
  2. Chan, K., Qin, L., Lau, M., Woo, J., Au, S., Choy, W. et al. (2004). A randomized, prospective study of the effects of Tai Chi Chun exercise on bone mineral density in postmenopausal women. Archives of Physical Medicine and Rehabilitation, 85(5), 717-722. https://doi.org/10.1016/j.apmr.2003.08.091
  3. Choi, E. S., & Kim, K. T. (2004). Relationships between falls experience, and chronic disease prevalence and fitness levels in elderly women. The Korean Journal of Physical Education, 43, 341-348.
  4. Choi, J. H., Moon, J. S., & Song, R. (2005). Effects of Sun-style Tai Chi exercise on physical fitness and fall prevention in fall-prone older adults. Journal of Advanced Nursing, 51, 150-157. https://doi.org/10.1111/j.1365-2648.2005.03480.x
  5. Erdfelder, E., Faul, F., & Buchner, A. (1996). G POWER: a general power analysis program. Behavior Research Methods, Instruments & Computers, 28, 1-11. https://doi.org/10.3758/BF03203630
  6. Gatts, S. K., & Woollacott, M. H. (2007). How Tai Chi improves balance: Biomechanics of recovery to a walking slip in impaired seniors. Gait and Posture, 25, 205-214. https://doi.org/10.1016/j.gaitpost.2006.03.011
  7. Hur, N. W., Choi, C. B., Uhm, W. S., & Bae, S. C. (2008). The prevalence and trend of arthritis in Korea: Results from Korea National Health and Nutrition Examination Surveys. Journal of the Korean Rheumatism Association, 15(1), 11-26. https://doi.org/10.4078/jkra.2008.15.1.11
  8. Hwang, O. N. (1998). A survey study on the factors associated with falls among elderly. Journal of Korean Academy of Adult Nursing, 10, 337-352.
  9. Jeon, M. Y., Jeong, H. C., & Choe, M. A. (2001). A study on the elderly patients hospitalized by the fracture from the fall. Journal of Korean Academy of Nursing, 31, 443-453.
  10. Kim, H. S., Jung, Y. M., & Lee, H. S. (2009). Cognitive impairment, behavioral problems, and mental health in institutionalized Korean elders: An eligibility issue for care settings. Journal of Korean Academy of Nursing, 39, 741-750. https://doi.org/10.4040/jkan.2009.39.5.741
  11. Kim, M. S., & Lee, E. N. (2006). A literature review of exercise intervention for fall prevention in the elderly. Journal of Muscle and Joint Health, 13(1), 7-19.
  12. Kohrt, W. M., Bloomfield, S. A., Little, K. D., Nelson, M. E., & Yingling, V. R. (2004). American College of Sports Medicine Position Stand: Physical activity and bone health. Medicine and Science in Sports and Exercise, 36, 1985-1996. https://doi.org/10.1249/01.MSS.0000142662.21767.58
  13. Kron, M., Loy S., Sturm, E., Nikolaus, T., & Becker, C. (2003) Risk indicators for falls in institutionalized frail elderly. American Journal of Epidemiology, 158, 645-653. https://doi.org/10.1093/aje/kwg203
  14. Lam, P. (2000). Tai Chi for Arthritis Handbook. Narwee, AU:East Acton.
  15. Li, F., Harmer, P., Fisher, K. J., McAuley, E., Chaumeton, N., Eckstrom, E., et al. (2005). Tai Chi and fall reductions in older adults: a randomized controlled trial. Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 60, 187-194. https://doi.org/10.1093/gerona/60.2.187
  16. Li, F., Harmer, P., Glasgow, R., Mack, K. A., Steet, D., Fisher, K. J. et al. (2008). Translation of an Effective Tai Chi Intervention Into a Community-Based Falls-Prevention Program, American Journal of Public Health, 98, 1195-1198. https://doi.org/10.2105/AJPH.2007.120402
  17. Lui, P. P., Qin, L., & Chan, K. M. (2008). Tai Chi Chuan exercises in enhancing bone mineral density in active seniors. Clinics in Sports Medicine, 27(1), 75-86. https://doi.org/10.1016/j.csm.2007.09.002
  18. Menz, H. B., Morris, M. E., & Lord, S. R. (2006). Foot and ankle risk factors for falls in older people: a prospective study. Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 61, 866-870. https://doi.org/10.1093/gerona/61.8.866
  19. Morgan, R. O., Virnig, B. A., Duque, M., Abdel-Moty, E., & DeVito, C. A. (2004). Low-intensity exercise and reduction of the risk for falls among at risk elders. The Journals of Gerontology: Series A Biological Sciences and Medical Sciences, 59, 1062-1067. https://doi.org/10.1093/gerona/59.10.M1062
  20. Ryeom, T. H., Kim, S. Y., So, Y. K., Park, S. Y., Lee, J. H., Cho, H. S. et al. (2001). The risk factors of falls in the elderly. Journal of Korean Academy of Family Medicine, 22, 221-229.
  21. Song, R., Lee, E. O., Lam, P., & Bae, S. C. (2003). Effects of tai chi exercise on pain, balance, muscle strength, and perceived difficulties in physical functioning in older women with osteoarthritis: a randomized clinical trial. Journal of Rheumatology, 30, 2039-2044.
  22. Song, R., Roberts, B. L., Lee, E. O., Lam, P, & Bae, S. C. (2010). A randomized study of the effects of t'ai chi on muscle strength, bone mineral density, and fear of falling in women with osteoarthritis. Journal of Alternative and Complementary Medicine, 16, 227-233. https://doi.org/10.1089/acm.2009.0165
  23. Wang, C., Collet, J. P., & Lau, J. (2004). The effect of Tai Chi on health outcomes in patients with chronic conditions: A systematic review. Archives of Internal Medicine, 164, 493-501. https://doi.org/10.1001/archinte.164.5.493
  24. Wayne, P. M., Kiel, D. P., Krebs, D. E., Davis, R. B., Savetsky-German, J., Connelly, M., et al. (2007). The effects of Tai Chi on bone mineral density in postmenopausal women: a systematic review. Archives of Physical Medicine and Rehabilitation, 88, 673-680.
  25. Woo, J., Hong, A., Lau, E., & Lynn, H. (2007). A randomised controlled trial of Tai Chi and resistance exercise on bone health, muscle strength and balance in community-living elderly people. Age and Ageing, 36, 262-268. https://doi.org/10.1093/ageing/afm005