Vol.132 (Healthcare and Nursing 2016), pp.93-98 http://dx.doi.org/10.14257/astl.2016. Effect of Tai Chi Fall Prevention Program for Community-dwelling Older Adults on Physical and Psychological Fall Risk Factors Young-JuJee 1 1 College of Nursing Kyungnam University, Woryeongbuk 16-gil Masanhappo-gu, Changwon-si, Gyeongsangnam-do, Korea jeeyoungju@kyungnam.ac.kr Abstract. The purpose of this study was to evaluate the effect of Tai Chi fall prevention program for community-dwelling older adults on physical and psychological fall risk factors. This study was designed as non-equivalent control group pre and post-test research. The Tai Chi exercise program was provided two times a week over 6 months for the experimental group. There were statistically significant differences between the experimental group and the control group in Lt. muscle strength, Rt. muscle strength, balance, Fall efficacy and Fear of falling. The Tai-Chi exercise program was beneficial for older adults with arthritis in rural communities. Keywords: Fall, Adults, Rural, Fear, Balance 1 Introduction Falling means to fall or collapse to lower than standing position or to lie on the floor[1]. Thus, falls occur by the complex function of physical factors such as a sense of balance, muscle strength, and flexibility and psychological factors such as fear of falling[2]. Therefore, when confirming the reduction of the risk of falls through intervention to improve this and socially diffusing the results, it is considered that this will form a part of reducing access to health care environment for the elderly population. Tai Chi exercise is a traditional Chinese martial arts consisting of elegant and slow movements and has the advantages of being interesting because it aims for various movements with knees bent, of not requiring specific facilities or devices, and of being accessible at any time[3-5]. This study was conducted to measure the effect of the Tai Chi fall prevention program on physical and psychological fall risk factors after implementing it for community-dwelling older adults. ISSN: 2287-1233 ASTL Copyright 2016 SERSC
2 Method 2.1 Design This study was a non-equivalent quasi-experimental research. 2.2 Subjects and Data Collection The study subjects were people over the age of 65 belonging to two senior colleges located in Metropolitan City B. The intervention and control groups were allocated by tossing up. This study was conducted between August 1, 2015 to February 1, 2016, and the data of 47 subjects were used for analysis. 2.3 Instrument 1) Fall prevention program The fall prevention education was provided to the experimental and control groups a total of four sessions during four month excluding the first and last months for six months. With regard to the Tai Chi exercise program, an expert instructor provided the experimental group with the Sun-style tai chi 21 movements 50 times for each session twice a week. 2) Physical factors Muscle strength, flexibility, and a sense of balance were measured. 3) Psychological factors The falls efficacy using the Korean Falls Efficacy Scale and fear of falling using fear of falling questionnaire were measured. 4) General characteristics The questions were asked about their age, educational background, the number of diagnosed diseases, weight, height, marital status, family size, presence or absence of fall experience for the past year, and type of chronic diseases (multiple answers allowed). 2.4 Data Analysis The SPSS / Win 21.0 program was used to analyze the data in this study. 94 Copyright 2016 SERSC
3 Results 3.1 Homogeneity Test for Demographic Characteristics Table 1. Homogeneity Test for Demographic Characteristics (N=47) Characteristics Experimental(n=23) n(%), mean(sd) Control(n=24) n(%), mean(sd) χ 2 or t P Gender Male 7(30.0) 9(36.0) Female 16(70.0) 15(64.0) 0.22.591 Age 74.18(6.99) 75.20(6.22) -0.77.471 BMI 26.01(4.17) 25.55(3.14) 1.19.255 marriage 11(48.0) 13(54.17) Marital status Single (divorced, widowed, separ ated) 12(52.0) 11(45.83) 0.09.777 Family numbe r 1 5(21.7) 6(25.0) 2 12(52.2) 11(45.8) 0.81.491 more than 3 6(26.1) 7(29.2) Copyright 2016 SERSC 95
Falls experienc e Yes 8(34.8) 8(33.3) No 15(65.2) 16(66.7) 0.01.921 Osteoarthritis 13 15 Chronic diseas e Rheumatoid art hritis 2 4 (Multiple resp onses possible) Diabetes 4 7 Hypertension 16 18 Heart disease 5 5 3.2 Effect of Tai Chi Fall Prevention Program Table 2. Differences in physical fall risk factors between two groups Variables Experimental(n=23) Control(n=24) t or F P Pre. 2.24(0.31) 2.03(0.42) 1.65 0.108 Muscle st rength Anterior Rt. Pos. 2.71(0.55) 2.40(0.59) 1.61 0.116 Lt. Pre. 2.14(0.33) 1.090(0.56) 1.57 0.125 96 Copyright 2016 SERSC
Pos. 2.73(0.07) 2.24(0.58) 2.48 0.018 Posterior * Rt. * Lt. Pre. 2.43(0.39)_ 2.15(0.41) 2.08 0.045 Pos. 2.61(0.49) 2.24(0.39) 1.29 0.289 Pre. 2.18(0.36) 1.62(0.72) 2.98 0.005 Pos. 2.43(0.57) 2.06(0.57) 5.01 0.013 Flexibility Back Pre. 16.00(6.81) 12.89(4.58) 1.61 0.117 Pos. 16.33(6.75) 13.50(2.96) 1.63 0.112 Balance one leg sta nd Pre. 1.37(0.98) 2.50(3.23) 2.06 0.153 Pos. 3.02(2.47) 2.25(2.82) 2.09 0.001 * ANCOVA was done using pretest Rt & Lt posterior muscle strength as a covariate. Table 3. Differences in between two groups Variables Experimental(n=2 3) Control(n=24) t P Fall effica cy Pre. 42.76(14.60) 40.36(12.96) 1.52 0.76 Pos. 45.22(15.55) 40.19(11.26) 1.32 0.012 Copyright 2016 SERSC 97
Fear of fa lling Pre. 16.70(11.42) 17.58(10.85) 2.54 0.81 Pos. 10.57(9.70) 18.25(11.35) -3.5 2.001 4 Conclusion Based on the above results, the Tai Chi fall prevention program is regarded as an appropriate nursing intervention program capable of expecting the positive effects on their physical and psychological fall risk factors. Furthermore, the Tai Chi fall prevention program is easy for the elderly to learn and master. Thus, this study emphasizes that the program can be a sustainable exercise program for the elderly groups by finding instructors from themselves and then fostering them as an expert only if public health centers in their community provide early education and management investment. References 1. Tideiksaar, R.: Falls in older people-prevention and management(3rd ed.), Baltmore, Maryland: Health Professional Press, Inc.(2002) 2. Gagnon, N., Flint, A. J., Naglie, G., Devins, G. M.: Affective correlates of fear of falling in elderly persons, The American Journal of Geriatric Psychiatry, Vol.13, No.1, pp.7-14(2005). 3. Choi, K. W., Lee, I. S.: Fall risk in low-income elderly people in one urban area, Journal of Korean Academy of Nursing, Vol.40, No.4, pp.589-598(2010) 4. Gu, M. O., Jeon, M, Y., Kim, H. J., Eun, Y.: A review of exercise interventions for fall prevention in the elderly, Journal of Korean Academy of Nursing, Vol.35, No.6, pp.1101-1112(2005) 5. Kwon, M. S.: Effects of a fall prevention program on physical fitness and psychological functions in community dwelling elders, Journal of Korean Academy of Nursing, Vol.41, No.2, pp.165-174(2011) 98 Copyright 2016 SERSC