简化太极拳运动对减轻社区老年人害怕跌倒的效果研究
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摘要
目的评价简化太极拳运动对社区老年人害怕跌倒心理和平衡能力的影响。方法根据纳入排除标准选取80名社区老年人作为研究对象,采用随机数字表法分为试验组和对照组各40名。试验组在对照组干预措施的基础上进行简化太极拳运动,对照组接受健康宣教和随访,干预时间均为6个月。干预前后分别评价两组害怕跌倒心理水平、平衡能力、是否跌倒等指标。结果两组共72名老年人完成研究。试验组简化太极拳运动干预集中练习和居家个人练习依从性较好,分别为75.68%和64.86%。干预后,试验组的害怕跌倒心理水平和平衡能力均优于干预前和对照组,差异有统计学意义(P<0.05)。但干预后,两组是否跌倒比较,差异无统计学意义(P>0.05),两组组内干预前后纵向比较,差异均有统计学意义(P=0.001)。结论简化太极拳运动适合害怕跌倒的老年人练习,能够显著减轻老年人害怕跌倒心理水平和提高老年人平衡能力。
Objective To evaluate the effects of simplified Tai Chi exercise for reducing fear of falling(FOF)and improving balance ability among the elderly living in communities. Methods Eighty eligible old persons(≥65)with FOF were randomly assigned to the intervention group and the control group by random number table method,with 40 in each group. Elderly in the control group received regular health education and follow-up for six months. Simplified Tai Chi exercise was implemented in the intervention group for six months in addition to regular care. Level of FOF,balance ability,and occurrence of falling were compared between two groups at baseline and after intervention. Results Totally 72 elderly completed the study. Adherence to group exercise and individual exercise for simplified Tai Chi exercise in the intervention group were relatively good,which were 75.68% and 64.86%. After intervention,level of FOF and balance ability in the intervention group were significantly better than those at baseline,and better than those in the control group(P<0.05). No significant difference was found in occurrence of falling between two groups after intervention(P>0.05),and there were significant differences before and after intervention in two groups(P=0.001). Conclusion Simplified Tai Chi exercise is suitable for elderly with FOF to practice,and can reduce FOF and improve balance ability.
Objective To evaluate the effects of simplified Tai Chi exercise for reducing fear of falling(FOF)and improving balance ability among the elderly living in communities. Methods Eighty eligible old persons(≥65)with FOF were randomly assigned to the intervention group and the control group by random number table method,with 40 in each group. Elderly in the control group received regular health education and follow-up for six months. Simplified Tai Chi exercise was implemented in the intervention group for six months in addition to regular care. Level of FOF,balance ability,and occurrence of falling were compared between two groups at baseline and after intervention. Results Totally 72 elderly completed the study. Adherence to group exercise and individual exercise for simplified Tai Chi exercise in the intervention group were relatively good,which were 75.68% and 64.86%. After intervention,level of FOF and balance ability in the intervention group were significantly better than those at baseline,and better than those in the control group(P<0.05). No significant difference was found in occurrence of falling between two groups after intervention(P>0.05),and there were significant differences before and after intervention in two groups(P=0.001). Conclusion Simplified Tai Chi exercise is suitable for elderly with FOF to practice,and can reduce FOF and improve balance ability.
引文
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[17]Tennstedt S,Howland J,Lachman M,et al.A randomized,controlled trial of a group intervention to reduce fear of falling and associated activity restriction in older adults[J].J Gerontol B-Psychol Sci,1998,53(6):384-392.
[18]Tousignant M,Corriveau H,Roy PM,et al.The effect of supervised Tai Chi intervention compared to a physiotherapy program on fall-related clinical outcomes:a randomized clinical trial[J].Disabi Rehabi,2012,34(3):196-201.
[19]管细红,吴红梅,刘桂连,等.太极拳训练对早期帕金森病患者平衡功能及害怕跌倒心理的影响[J].江西医药,2017,52(11):1124-1127.
[20]管细红,唐霞珠,刘建民.太极拳训练对帕金森病病人步行能力及害怕跌倒的影响[J].护理研究,2016,28(30):3514-3517.
[21]Zwick D,Rochelle A,Choksi A,et al.Evaluation and treatment of balance in the elderly:a review of the efficacy of the Berg Balance Test and Tai Chi Quan[J].Neurorehabilitation,2000,15(1):49-56.
[22]Yao L,Foley KT,Kolanowski AM,et al.Proto Tai Chi:in search of a promising group exercise for the frail elderly[J].Geriatric nursing(New York,NY),2014,35(2 Suppl):S21-S26.
[2]Aibar-Almazan A,Martinez-Amat A,Cruz-Diaz D,et al.Sarcopenia and sarcopenic obesity in Spanish community-dwelling middle-aged and older women:association with balance confidence,fear of falling and fall risk[J].Maturitas,2018,107:26-32.
[3]Carlsson G,Nilsson MH,Ekstam L,et al.Falls and fear of falling among persons who receive housing adaptations-results from a quasi-experimental study in Sweden[J].Healthcare(Basel,Switzerland),2017,5(4):66.
[4]Peeters G,Leahy S,Kennelly S,et al.Is fear of falling associated with decline in global cognitive functioning in older adults:findings from the Irish longitudinal study on ageing[J].JAm Med Dir Assoc,2018,19(3):248-254.e3.
[5]李莺,程云,赵丽蓉.老年人害怕跌倒的研究进展[J].中华护理杂志,2014,49(4):458-462.
[6]Kumar A,Delbaere K,Zijlstra GA,et al.Exercise for reducing fear of falling in older people living in the community:Cochrane systematic review and meta-analysis[J].Age Ageing,2016,45(3):345-352.
[7]Denkinger MD,Lukas A,Nikolaus T,et al.Factors associated with fear of falling and associated activity restriction in community-dwelling older adults:a systematic review[J].Am J Geriatr Psychiatry,2015,23(1):72-86.
[8]叶盛,陈利群,石丹,等.运动锻炼对社区老年人跌倒预防效果的证据总结[J].中华护理杂志,2017,52(9):1112-1118.
[9]李莺,程云,赵丽蓉,等.奥塔戈运动对老年脑卒中患者害怕跌倒的影响[J].中华护理杂志,2014,49(12):1442-1447.
[10]李博,钟清玲,余红,等.太极拳训练对帕金森患者平衡功能及害怕跌倒的影响[J].中国康复医学杂志,2017,32(3):309-312.
[11]杨雷,金文泉.轻松学太极(十三)24式简化太极拳(21~24式)[J].药物与人,2008,1:68-69.
[12]郝燕萍,刘雪琴.修订版跌倒效能量表在我国老年人群中的测试研究[J].中华护理杂志,2007,42(1):19-21.
[13]卫生部.老年人跌倒干预技术指南[J].中国实用乡村医生杂志,2012,19(8):1-13.
[14]Tinetti ME,Richman D,Powell L.Falls efficacy as a measure of fear of falling[J].J Gerontol,1990,45(6):239-243.
[15]Hill H,McMeekin P,Parry SW.Does the Falls Efficacy Scale international version measure fear of falling:a reassessment of internal validity using a factor analytic approach[J].Age Ageing,2014,43(4):559-562.
[16]刘娜,宋圆圆,谷岩梅,等.跌倒效能对社区老年人日常活动能力的影响[J].中华现代护理杂志,2017,23(19):2466-2468.
[17]Tennstedt S,Howland J,Lachman M,et al.A randomized,controlled trial of a group intervention to reduce fear of falling and associated activity restriction in older adults[J].J Gerontol B-Psychol Sci,1998,53(6):384-392.
[18]Tousignant M,Corriveau H,Roy PM,et al.The effect of supervised Tai Chi intervention compared to a physiotherapy program on fall-related clinical outcomes:a randomized clinical trial[J].Disabi Rehabi,2012,34(3):196-201.
[19]管细红,吴红梅,刘桂连,等.太极拳训练对早期帕金森病患者平衡功能及害怕跌倒心理的影响[J].江西医药,2017,52(11):1124-1127.
[20]管细红,唐霞珠,刘建民.太极拳训练对帕金森病病人步行能力及害怕跌倒的影响[J].护理研究,2016,28(30):3514-3517.
[21]Zwick D,Rochelle A,Choksi A,et al.Evaluation and treatment of balance in the elderly:a review of the efficacy of the Berg Balance Test and Tai Chi Quan[J].Neurorehabilitation,2000,15(1):49-56.
[22]Yao L,Foley KT,Kolanowski AM,et al.Proto Tai Chi:in search of a promising group exercise for the frail elderly[J].Geriatric nursing(New York,NY),2014,35(2 Suppl):S21-S26.
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