Physical Therapy Program, Kinesiology Department, University of Connecticut, Storrs.
Starfarm Tai Chi Qigong Search Center, Chaplin, Connecticut.
J Geriatr Phys Ther. 2019 Oct/Dec;42(4):209-215. doi: 10.1519/JPT.0000000000000153.
A growing body of literature substantiates that Tai Chi is a form of exercise that may help older adults increase strength, improve balance, lower fall rates, and experience less fear of falling. Few studies, however, offer controlled experimental design and simultaneously investigate multiple factors known to contribute to fall risk. The purpose of this study was to compare performance on measures relating to fall risk (strength, balance, functional mobility, and fear of falling) in older community-dwelling adults who participated in a community-based Tai Chi program with a control group of their peers who had no Tai Chi training over the same time period.
A quasi-experimental comparative pre- and posttest design was used to compare an experimental group of 16 community-dwelling older adults, mean (SD) age = 80.4 (6.8) years, participating in a 16-week Tai Chi training program with a group of 13 adults, mean (SD) age = 71.2 (6.1) years, who had no Tai Chi experience in the areas of knee extension strength (measured by handheld dynamometry), functional strength (by five-time sit to stand), mobility (by Timed Up and Go [TUG] test and Fifty-Foot Walk Test), balance (by Functional Reach and Berg Balance Scale), and fear of falling (by Activity-specific Balance Confidence scale). Within-group and between-groups comparisons were made using 2×2 mixed analysis of variance.
Tai Chi participants improved in nearly all measures, whereas controls did not. Tai Chi participants experienced significant improvement in the TUG test during the training period (P = .003), with significant difference when compared with controls (P = .049) and moderate effect size and observed power (ηp = 0.165; observed power = 0.512). Significant knee extension strength improvement occurred (P = .042) with moderate effect size and observed power (ηp = 0.183; observed power = 0.543). While the total balance confidence scale score did not change significantly, responses on many individual items did reach a level of significant change for persons participating in the Tai Chi training.
Older adults' participation in a community-based Tai Chi program may lead to improvement in strength, mobility, and confidence in performing functional tasks. Incorporation of elements of Tai Chi into therapy programs for older adults at risk for fall and referral to community-based Tai Chi programs may be viable options in the continuum of health-related care for older adults.
越来越多的文献证实,太极拳是一种运动形式,可能有助于老年人增强力量、改善平衡、降低跌倒率并减少跌倒恐惧。然而,很少有研究采用对照实验设计同时研究已知会增加跌倒风险的多个因素。本研究的目的是比较参加社区太极拳项目的老年社区居民与同期无太极拳训练的同龄人在与跌倒风险相关的测量指标(力量、平衡、功能移动性和跌倒恐惧)上的表现。
采用准实验对照前后测试设计,比较了一组 16 名平均(标准差)年龄为 80.4(6.8)岁的社区居住老年人的实验组,他们参加了 16 周的太极拳训练计划,以及一组 13 名平均(标准差)年龄为 71.2(6.1)岁的成年人,他们在膝关节伸展力量(通过手持测力计测量)、功能性力量(通过五次坐立测试)、移动性(通过计时起立行走测试和五十英尺步行测试)、平衡(通过功能性伸展和伯格平衡量表)和跌倒恐惧(通过活动特异性平衡信心量表)方面没有太极拳经验。使用 2×2 混合方差分析对内组和外组进行了比较。
太极拳参与者在几乎所有测量指标上都有所改善,而对照组则没有。太极拳参与者在训练期间 TUG 测试中显著改善(P =.003),与对照组相比具有显著差异(P =.049),且具有中等效应大小和观察到的功率(ηp = 0.165;观察到的功率 = 0.512)。膝关节伸展力量显著改善(P =.042),具有中等效应大小和观察到的功率(ηp = 0.183;观察到的功率 = 0.543)。虽然总平衡信心量表评分没有显著变化,但参加太极拳训练的人的许多单项评分都达到了显著变化的水平。
老年人参加社区太极拳项目可能会导致力量、移动性和执行功能任务的信心提高。在为有跌倒风险的老年人提供治疗方案中纳入太极拳元素,并将其转介到社区太极拳项目中,可能是老年人健康相关护理连续体中的可行选择。