Earticle

본 연구는 농촌과 도시에 거주하는 노인 여성들의 체력과 낙상효능감에 대해 분 석하여 지역에 따른 노인들 의 건강요인들을 분석하기 위함이다. 본 연구 대상자는 주 2회 이상 지역 마을회 관에서 건강체조와 치어리딩를 하는 농촌 및 도시에 거주하는 노인 여성 98명(REG; n=46, 77.53±6.37 yrs, 151.81±5.26 cm, 60.00±9.42 kg, UEG; n=53, 73.57±2.70 yrs, 154.07±3.52 cm, 57.37±2.06 kg)으로 진행되었 다. 체력은 근지구력, 심폐 지구력, 유연성을 측정하였으며, 낙상효능감은 Tinetti 등이 개발한 10개 항목의 Fall Efficacy Scale을 사용하였 다. 도시 노인들이 유연성과 낙상효능감에서 유의한 차이가 나타났다(p<.01, p<. 05). 근지구력과 심페지구력에서는 유의한 차이가 나타나지 않았다(p>.05). 추후 지역의 노인들의 건강요인의 불균 형을 개선하기 위한 연구가 지속적 으로 이루어져야 할 것이다.

The purpose of this study is to analyze the health factors of the elderly according to the region by analyzing the physical fitness and fall efficacy of the female elderly living in rural and urban areas. The subjects of this study consisted of 98 female elderly people living in rural and urban areas who exercise health and cheerleading at least twice a week at the regional center(REG; n=46, 77.53±6.37 yrs, 151.81±5.26 cm, 60.00±9.42 kg, UEG; n=53, 73.57±2.70 yrs, 154.07±3.52 cm, 57.37±2.06 kg). Physical strength was measured for muscular endurance, cardiopulmonary endurance, and flexibility. Falling efficacy was measured using 10 items of Fall Efficacy Scale developed by Tinetti et al. Significant differences in flexibility and fall efficacy were found in urban older adults (p<.01, p<.05). There was no significant difference in muscular endurance and cardiac endurance (p>.05). In the future, studies to improve the imbalance of health factors of the elderly in the region should be continuously conducted.

This study aimed to examine the effects of exercise interventions devel-oped over the past 10 years to prevent falls among older adults. Co-chrane, PubMed, and Embase databases were systematically searched on November 3, 2022, using the following keywords: “elderly” or “aged” and “fall prevention exercise” and “randomized controlled trial.” A total of 918 articles were retrieved, and finally, 18 studies were included in the meta-analysis. main conclusions were as follows: fall prevention exercises showed moderately positive effects on balance, gait, mobility, physical function, lower limb power, and strength, but low effects on proprioception, vision, and reaction speed. The effect sizes were high-est when the intervention period was 1–24 weeks, time was 31–60 min, and frequency was thrice per week. Place of intervention (home, com-munity, laboratory) and age (>75 years, <75 years) showed similarly moderate effect sizes. A combined program that includes balance, co-ordination, and resistance exercises is appropriate to improve fall-relat-ed fitness and fall efficacy in community-dwelling older individuals.

Objective: The purpose of this study was to investigate the effects of anon-contact complex exercise program on muscle strength, fall efficacy, quality of life, and balance ability in older over 65 years of age. Design: A randomized controlled trial Methods: A total of 37 people in older over 65 years of age participated in the study. Random program was conducted and assigned to the experimental group (n=19) and the control group (n=18). Both groups performed the older people welfare center program. In addition, in the experimental group, a non-contact complex exercise program for muscle and balance exercise was performed. All interventions were performed 2 times a week, for a total of 6 weeks. chair stand test (CST), fall efficacy scale (FES), Euro quality of life 5 dimension (EQ-5D), Berg balance scale (BBS), timed up and go test (TUG), Fullerton advanced balance scale (FAB) were measured before and after the intervention to compare their effectiveness. Results: Both groups showed significant differences in CST, FES, EQ-5D, BBS, and TUG before and after intervention (p<0.05). FAB showed significant differences before and after intervention in all items except for FAB 8 and 9 items in the experimental group. In addition, the experimental group showed significant differences in CST, FES, BBS, TUG, FAB (except 1, 7, 8, 9) compared to the control group (p<0.05). Conclusions: The non-contact complex exercise program is an effective intervention method that has clinical significance in improving muscle strength, fall efficacy and static and dynamic balance abilities for the older over 65 years of age.

본 연구는 노인 뇌졸중 환자에게 오타고 운동프로그램을 제공하여 신체기능과 낙상 효능감 및 두려움 정도의 변화를 분석하고, 낙상예방 운동프로그램으로서의 신체적, 심리적 효과를 통해 자신감 회복 및 건강증진에 대한 기초자료를 제시하고자 하였다. 연구결과는 오타고 운동프로그램에 따른 신체기능의 변화에서 하지근력, 유연성, 정적균형, 동적균형의 증진이 있었고, 낙상 효능감은 증가하였으며, 낙상 두려움은 감소하였다. 따라서 지역사회에 기반을 둔 오타고 운동프로그램은 노인 뇌졸중 환자의 낙상 예방에 영향을 미칠 수 있는 신체적·심리적 기능을 증진시키는데 긍정적 인 변화를 이끌었다. 움직임과 관련된 신체기능의 향상은 낙상에 대한 자신감을 유도하여 기능적 활동 수준에 도움을 줄 수 있을 것으로 생각한다.

This study was planned for presenting basic data about confidence recovery and health improvement through physical and psychological effects of fall-prevention exercise program. plus, It analyzed a change of fear level, fall-efficiency and body function by providing otago exercise program to senior stroke patient. Result of the study could prove that lower extremity muscle strength, flexibility, static balance, and dynamic balance were promoted in a change of physical function by otago exercise program and The fall efficacy was elevated but the fall fear was declined. So, the otago exercise program based on local community brought positive changes for improving physical and psychological functions of senior stroke patient`s fall fear prevention. Physical function improvements related movement can induce a confidence for fall fear and lead a big help for functional activity level.

본 연구의 목적은 지역사회 재가노인을 대상으로 Home Support Exercise Program(HSEP)을 적용한 다면적 낙상예방프로그램 실시 후 노인의 신체균형과 보행정도, 하지근력, 낙상공포 및 낙상효능감에 미치는 영향을 파악하기 위한 것이다. 연구 설계는 비동등성 대조군 사전, 사후 유사 실험연구이다. 연구대상자는 충북 지역 내 일개 시의 2개 경로당을 이용하는 65세 이상 노인을 대상으로 하였다. 최종연구대상자는 실험군 20명, 대조군 21명으로 총 41명이었다. 자료수집은 일대일 면담 측정을 통하여 수집하였으며 사전조사, 실험처지, 사후조사 순으로 진행하였다. 낙상예방프로그램은 HSEP와 낙상예방 교육으로 구성되어 있으며, 경로당에서 8주간 주 1회 1시간씩 HSEP 운동과 함께 낙상예방 지식을 교육하였고, 가정에서 주 2회 자가 운동을 수행하도록 하여 총 3회/1주의 HSEP 운동을 하도록 하였다. 낙상예방프로그램 실시 후 실험군이 대조군보다 신체균형감과 보행정도, 하지근력(대퇴신전근과 굴곡근, 무릎 굴곡근, 발목관절 족저굴곡근과 족배굴곡근), 낙상효능감이 통계적으로 유의하게 증진되었다. 결론적으로 HSEP를 적용한 낙상예방프로그램은 재가노인의 낙상예방을 위해 효과적이었으므로 경로당, 노인복지관, 노인시설 등 다양한 낙상위험 환경에 처해있는 노인을 대상으로 낙상예방 프로그램을 적용하여 효과를 검증하는 연구가 확대되어야 할 것이다.

Purpose: This research was conducted to determine the effects of a multifactorial fall prevention program applying HSEP(Home Support Exercise Program) on physical balance and gait, leg strength, fear of falling and falls efficacy of the community-dwelling elderly. Method: The design of this study was a nonequivalent control group pretest-posttest design. There were 20 subjects in the experimental group and 21 in the control group. The fall prevention program consists of HSEP and fall related education. The intervention was performed for once a week in the senior citizen center and twice a week at home for 8 weeks. Results: There were significant differences in physical balance and gait, leg strength(hip extensor, hip flexor, knee flexor, ankle plantarflexor, ankle dorsiflexor) and falls efficacy between the experimental group and control group. Conclusion : The fall prevention program applying HSEP used in this study was very effective in increasing physical balance and gait, leg strength and falls efficacy. Finally this study would recommended that a fall prevention program applying HSEP should be extended to community facilities such as elderly welfare center and nursing home.

본 연구의 목적은 넘어짐 예방 운동이 여성노인의 체력, 자세, 낙상효능감에 미치는 영향을 규명하는 것이다. 연구 대상은 65세 이상의 여성노인 30명을 대상으로 하였으며, 그 중 14명은 운동집단, 16명은 비교 집단으로 하였다. 넘어짐 예방운동 프로그램은 탄성밴드를 이용한 다방향 근력․근지구력, 파워 운동, 자세 정렬 운동과 한국무용 동작을 접목한 다방향 동적균형, 협응력 운동으로 구분하였고 총 12주간, 주 2회, 각 60분으로 진행하였다. 운동 프로그램 전후의 체력, 자세, 낙상 효능감을 측정하여 비교하였다. 연구 결과 운동 집단은 악력을 제외한 근지구력, 심폐지구력, 유연성, 평형성, 협응력에서 유의하게 증가하였고, 자세는 상체 기울기를 제외한 어깨 기울기, 견갑골 기울기, 골반 기울기, 종골각 기울기, 다리길이 차이가 유의하게 감소하였다. 낙상효능감 점수는 운동 집단에서는 증가하고 비교 집단에서 감소하였으나, 모두 통계적으로 유의하지는 않았다. 그러므로 넘어짐 예방운동은 체력 향상과 자세교정에 효과적이라는 결론을 내릴 수 있다. 그러나 악력(근력)을 증가하는 것과 상체기울기를 교정하는 운동프로그램의 보완이 필요하다.

The purpose of this study is to analyze the effects of exercise program for prevention of falling on physical fitness, posture and fall prevention self-efficacy for elderly women. 30 females above the age of 65 were subjects for this study. Over an twelve week period, 14women in the experimental group performed exercise 2 times a week for 60 minutes per session. 16women in the control group didn't participate in the exercise program. The independent variable was a exercise program for prevention of falling. Dependent variables were physical fitness, posture and fall prevention self-efficacy. Prevention of falling exercise program is consisted of an elastic band using exercise and Korean dance movement exercise. Physical fitness consisted of grip strength, upper and lower body endurance, cardiovascular endurance, flexibility, balance, coordination. The posture was measured the static posture when standing, using a high-resolution camera, body style to automatically measure the distance and angle(M-zen, Korea). Posture was measured in both the coronal and sagittal plane via reference board. Fall prevention self-efficacy was measured via questionnaire using the Korea Falls Self-Efficacy Scale (FES-K). The physical fitness, posture and fall prevention self-efficacy were measured twice with pre and post exercise, and the difference between groups with Wilcox signed rank test, and the group-specific post verification was carried out with U-validated methods (Mann Whitney U test). Statistical significance level was verified by setting the p <.05. Lower body endurance, cardiovascular endurance, flexibility, balance and coordination significantly increased in the experimental group. The control group was no significant increase in physical fitness variables. shoulder slope angle, pelvic slope angle(coronal/sagittal), leg length difference, scapular inferior angle and left/ right calcaneus angle significantly decreased in the experimental group. Both the experimental group and control group were no significant increase in fall prevention self efficacy. The prevention of falling exercise program for elderly women indicated the positive changes in physical fitness(except grip strength) and posture(except upper body slope). However, there are no significant differences of falling prevention self-efficacy between the both group. Thus, the prevention of falling exercise program for the elderly has been proved that it is highly efficient on improving physical fitness and posture proofreading. However, we still need to consider supplement exercise for grip strength and upper body slope.