Effects of Tai Chi Exercise in Elderly with Knee Osteoarthritis

슬골관절염 노인환자의 타이치운동 효과

  • Published : 2008.02.29

Abstract

Purpose: This study was to determine whether the Sun-style 24 forms of Tai Chi exercise improve pain, stiffness, disability, knee joint motion, mobility, balance or falling. Method: Forty-six community-dwelling elderly subjects (mean age, $75.46{\pm}6.28$) voluntarily participated in an intervention group of either 24 forms of Sun-style T ai Chi for 60 min, 2 times per week for 12 weeks or a control group. A non-equivalent pretest-posttest design was used. Independent t-test and ANCOVA were used to examine group differences by using SPSS12.0. Result: The experimental group had significantly less pain (F=7.60, p=.008) and stiffness (t=-3.19, p=.003) than the control group. Also there were significant improvements in knee joint motion on the right knee (t=2.44, p=.019), left knee (t=2.30, p=.026), rising time (F=8.03, p=.07), balance on the left single leg test (t=2.20, p=.033), and fear of falling (t=-2.33, p=.024) in the Tai Chi exercise group. No significant group differences were found in disability and falls efficacy. Conclusion: The Sun-style 24 forms Tai Chi exercise is effective in decreasing pain, stiffness, fear of falling and it improves balance, rising time, and knee joint motion. We suggest a continuing long term intervention to decrease disability and increase efficacy concerning falls.

Keywords

References

  1. Allegrante, J. O., Kovar, P. A., Mackenzie, C. R, Peterson, M. G. E., & Gutin, B. (1993). A walking education program for patients with osteoarthritis of the knee: theory and intervention strategies. Health Educ Q, 20, 63-81 https://doi.org/10.1177/109019819302000107
  2. Arnold C. M., & Faulkner R A. (2007). The history of falls and the association of the timed up and go test to falls and near-falls in older adults widi hip osteoarthritis. BMC Geriatr, 7, 17 https://doi.org/10.1186/1471-2318-7-17
  3. Bae, S. C, Lee, H. S., Yun, H. R, Kim, T. H., Yoo, D. H., & Kim, S. Y. (2001). Cross-cultural adaptation and validation of Korean Western Ontario and McMaster Universities (WOMAC) and Lequesne osteoarthritis indices for clinical research. Osteoarthritis Cartilage, 9,746-750 https://doi.org/10.1053/joca.2001.0471
  4. Bellamy, N. (1993). Musculoskeletal clinical metrology. London: Kluwer Academic Publishers
  5. Bellamy, N., Buchanan, W. W., Goldsmith, C. H., Campbell, J., & Stitt, L. W. (1988). Validation study of WOMAC: a health status instrument for measure clinically important patient relevant outcomes to antirheumatic drug therapy in patient with osteoarthritis of the hip or knee. J Rheumatol, 15, 1833-1840
  6. Campbell, A. J., Robertson, M. C, Gardner, M. M., Norton, R N., & Buchner, D. M. (1999). Falls prevention over 2 years: A randomized controlled trial in women 80 years and older. Age Ageing, 28, 513-518 https://doi.org/10.1093/ageing/28.6.513
  7. Fuller, G.F. (2000). Falls in the elderly. Am Fam Physician, 67,2159-2168
  8. Hoffman, D. F. (1993). Arthritis and exercise. Prim Care, 20, 895-910
  9. Jordan, K M„ Arden, N. K, Doherty, M., Bannwarth, B., Bijlsma, J. W, & Dieppe, P., et al. (2003). EULAR recommendations 2003: an evidence based approach to the management of kneeosteoarthri-tis: Report of a task force of the standing committee for international clinical studies including therapeutic trials (ESCISIT). Ann Rheum Dis, 62,1145-1155 https://doi.org/10.1136/ard.2003.011742
  10. Korea Institute for Health and Social Affairs (2006). 2005 national health and nutrition survey
  11. Lam, P. (1998). New horizons. Developing tai chi for health care. Aust Fam Physician, 27,100-101
  12. Lam, P. (2000). How does Tai-Chi improve health and arthritis? form http://www. taichiproductions.com
  13. Lee, H. Y, & Kim, H. I. (2004). Effects of sun style tai chi program on muscle strength and physical function in osteoarthritis patients. J Korean Nurses Association for Complementary Alternative Therapy, 1,43-52
  14. Lee, H. Y., Suh, M. J., Lee, E. O., Eun, Y., & Choi, J. H. (2004). Analysis of die effectiveness of Tai Chi exercise for improving balance. J Korean Acad Adult Nurs, 16,409-420
  15. Li, F., Harmer, P., Fisher, K. J., McAuley, E., Chaumeton, N., Eck-strom, E., et al. (2005). Tai Chi and fall reductions in older adults: a randomized controlled trial. J Gerontol A Biol Sci Med Sci, 60, 187-194 https://doi.org/10.1093/gerona/60.2.187
  16. Mathias, S., Nayak, U. S. L., & Isaacs, B. (1986). Balance in the elderly patient: The "Get-up and Go" test. Physical Medicine Rehabilitation, 67, 587-591
  17. McAlindon, T. E., Wilson, P. W., Aliabadi, P., Weissman, B., & Felson, D. T. (1999). Level of physical activity and the risk of radiographic and symptomatic knee osteoarthritis in the elderly: the Framinghamstudy. Am J Med 106, 151-157 https://doi.org/10.1016/S0002-9343(98)00413-6
  18. McCarberg, B. H., & Herr, K A., American Academy of Pain Medicine (2001). Osteoarthritis. How to manage pain and improve patient function. Geriatri, 56, 14-24
  19. Pandya, N. K, Draganich, L. F., Mauer, A., Piotrowski, G. A., & Pottenger, L. (2005). Osteoarthritis of the knees increases the propensity to trip on an obstacle. Clin Orthop Relat Res, 431, 150-156
  20. Ross, M.C., Bohannon, A.S., Davis, D.C., & Gurchiek, L. (1999). The effects of a short-term exercise program on movement, pain, and mood in the elderly. Results of a pilot study. J Holist Nurs, 17,139-147 https://doi.org/10.1177/089801019901700203
  21. Schoenfelder, D. P. (2000). A fall prevention program for elderly individuals. Exercise in long-term care settings. J Gerontol Nurs, 26, 43-51 https://doi.org/10.3928/0098-9134-20000301-09
  22. Song, R Y., 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. J Rheumatol, 30, 2039-2044
  23. Taggart, H. M. (2002). Effects of Tai Chi exercise on balance, functional mobility, and fear of falling among older women. Appl Nun Res, 15,235-242 https://doi.org/10.1053/apnr.2002.35975
  24. Tideiksaar, R. (1997). Falling in old age. Prevention and management (2nd ed.). New York; Springer publishing Co
  25. Tinetti, M. E., Baker, D. I., McAvay, G., Claus, E. B., Garrett, P., Gottschalk, M., et al. (1994). A multifactorial intervention to reduce the risk of falling among elderly people living in the community. N Engl J Med 331, 821-827 https://doi.org/10.1056/NEJM199409293311301
  26. Tinetti, M. E., & Speechley, M. (1998). The effect of falls and fell injuries on functioning in community-dwelling older persons. J Gerontol, 53, 112-119
  27. Tinetti, M. E., Richman, D., & Powell, L. (1990). Falls efficacy as a measure of fear of falling. J Gerontol, 45, 239-243 https://doi.org/10.1093/geronj/45.6.P239
  28. van Baar, M. E., Dekker, J., Lemmens, J. A., Oostendorp, R. A, & Bijlsma, J. W. (1998). Pain and disability in patients with osteoarthritis of hip or knee: The relationship with articular, kinesi-ological, and psychological characteristics. J Rheumatol 25,125-133
  29. Wang, T. J., Belza, B., Thompson, F. E., Whitney, J. D., & Bennett, K. (2006). Effects of aquatic exercise on flexibility, strength and aerobic fitness in adults with osteoarthritis of the hip or knee. J Adv Nurs, 57,141-152
  30. Wolf, S. L., Barnhart, H. X., Kutner, N. G., McNeely, E., Coogler, G, Xu, T., et al. (1996). Reducing frailty and falls in older persons: an investigation of Tai Chi and computerized balance training. J Am Geriatr Soc, 44,489-497 https://doi.org/10.1111/j.1532-5415.1996.tb01432.x