Journal of Korean Academy of Nursing

Research Paper

Comparison of the Effects of Education Only and Exercise Training Combined with Education on Fall Prevention in Adults Aged 70 Years or Older Residing in Elderly Residential Facilities: Hong, Chahwa , Lee, Haejung , Lee, Misoon; J Korean Acad Nurs 2021;51(2):173-187. Published online April 30, 2021; DOI: https://doi.org/10.4040/jkan.20203

Purpose
To compare the effects of education only and exercise training combined with education on fall knowledge, fall efficacy, physical activity, and physical function in adults aged 70 years or older residing in elderly residential facilities.
Method
A three-group pre- and posttest design was utilized: education only (EO; n = 23), education and TheraBand (ET; n = 22), and education and walking (EW; n = 22). Fall education was provided for all three groups. In addition, TheraBand exercise training was provided for the ET and a walking exercise for the EW. Data were collected from November 1st, 2017 to February 15th, 2019 and analyzed with χ² test, paired t-test, and one-way ANOVA using IBM SPSS/WIN ver. 22.0.
Results
Compared with the EO, the ET and the EW were more effective in terms of fall efficacy, physical activity, and lower extremity muscle strength. The EW showed higher improvement in walking abilities than the EO and the ET.
Conclusion
Exercise training combined with education is more effective in preventing falls among community-dwelling adults aged 70 years or older. When considering fall prevention programs for older adults, both TheraBand and walking exercise training combined with education can be chosen based on the participant’s physical status. Aggressive strategies to improve daily walking are required to maintain walking abilities among community-dwelling adults aged 70 years or older.

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Falls caused by balance disorders in the elderly with multiple systems involved: Pathogenic mechanisms and treatment strategies
Liwei Xing, Yi Bao, Binyang Wang, Mingqin Shi, Yuanyuan Wei, Xiaoyi Huang, Youwu Dai, Hongling Shi, Xuesong Gai, Qiu Luo, Yong Yin, Dongdong Qin
Frontiers in Neurology.2023;[Epub] CrossRef

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Original Articles

An Effect of Muscle Strengthening Exercise Program on Muscle Strength, Pain, Depression, Self-efficacy, and Quality of Life of Patients with Knee Osteoarthritis: Mi Ra Lee; Journal of Nurses Academic Society 1996;26(3):556-575. Published online March 30, 2017; DOI: https://doi.org/10.4040/jnas.1996.26.3.556

Abstract PDF

In an attempt to investigate the effect of a muscle strengthening exercise program on muscle strength, pain, depression, self-efficacy and quality of life of patients with knee osteoarthritis, a pre-experiment, one group pre-test and post-test design, was planned. Muscle strengthening exercise was carried out from May 22 through August 14, 1995 at isokinetic exercise room in rehabilitation department of University Hospital in Taejon. The subjects were seven female clients conveniently sampled from University Hospital located in Taejon, between 39 and 61 years of age, who had a osteoarthritis in knee. Muscle strengthening exercise program was composed of three sessions per week, one isokinetic exercise at angular velocity of 60degrees and 180degrees with Cybex isokinetic dynamometer and two resistance home exercise sessions with elastic band. Data were analyzed with frequency, percentage of change, Friedman test, Duncan test using SAS program. Results were obtained as follows: 1) Flexion and extension muscle strength at angular velocity of 60degrees and 180degrees were increased after 12weeks' exercise than those of before experiment. But exept flexion muscle strength at angular velocity of 180degrees (F=3.34, P=0.0261), there was no statistically significant difference among muscle strengths, which is measured every 3 weeks. 2) Pain was decreased after 6weeks' exercise than that of before experiment, and after 12weeks' exercise than that of 6weeks' exercise. There was statistically significant difference(F=4.28, P= 0.0396). 3) Depression was increased after 6weeks' exercise than that of before experiment, and after 12weeks' execise than that of 6weeks' exercise. There was no statistically significant difference between before experiment and after 6weeks' exercise. But, there was statistically significant difference between after 6weeks' exercise and 12weeks' exercise (F=9.38, P=0.0035). 4) Self-efficacy was decreased after 6weeks' exercise than that of before exercise. But, it was increased after 12weeks' exercise than that of before exercise and after 6weeks' exercise. But there was no statistically significant difference (F=1.46, P=0.2706). 5) Quality of life was increased after Gweeks' exercise than that of before exercise, and after 6weeks' exercise than that of 12weeks' exercise. But there was no statistically significant differ-ence(F=1.06, P=0.3816). Thus, the significant of muscle strengthening exercise for the improvement of muscle strength, pain, depression, is verified. But, this study was a preexperiment with small size subjects. So, controlled experimental study is necessary to determine the effect of this muscle strengthening exercise program on muscle strength, pain, depression, self-efficacy, and quality of life of patients with knee osteoarthritis.

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The effects of elastic band exercises and nutritional education on frailty, strength, and nutritional intake in elderly women
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Physical Activity and Nutrition.2020; 24(1): 37. CrossRef
The Relationship between Job Stress and Depression in Opticians in Seoul, Korea
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Retracted:Effects of Exercise Program on Physical Fitness, Depression, and Self‐Efficacy of Low‐Income Elderly Women in South Korea
Kyung Rim Shin, Younhee Kang, Hyo Jung Park, Margaret Heitkemper
Public Health Nursing.2009; 26(6): 523. CrossRef

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Effects of Biofeedback Exercise Training in Hemiplegic Patients after Stroke: Keum Soon Kim, So Woo Lee, Myung Ae Choe, Myung Sun Yi, Eun Jung Kim; Journal of Korean Academy of Nursing 2001;31(3):432-442. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.2001.31.3.432

Abstract PDF

PURPOSE: The purpose of this study was to investigate the effects of biofeedback exercise training on muscle activity and activities of daily livings (ADL) in hemiplegic patients. An experimental group consisting of 17 people, was given biofeedback exercise training for 30- 60 minutes per week for 5 weeks, while a control group consisting of 18 people, was given normal exercise with quasi-experimental design. RESULT: The results of the study show that biofeedback exercise is effective for improving muscle activity in hemiplegic patients, especially in the hemiplegic limbs. However, this study found no significant differences in ADL and IADL between the experimental and the control groups. It implies that ADL and IADL may not be improved for a short period of time, such as 5 weeks, for people with more than five years of hemiplegia. The study suggests that the effect of biofeedback exercise on ADL and IADL should be determined in hemiplegic patients in acute stage.

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The effects of training using EMG biofeedback on stroke patients upper extremity functions
Ju-Hong Kim
Journal of Physical Therapy Science.2017; 29(6): 1085. CrossRef
IT based EMG biofeedback training on the effects of upper extremity function in chronic stroke patients
Ju-Hong Kim, Myung-Hwa Oh
The Journal of the Korea institute of electronic communication sciences.2014; 9(1): 41. CrossRef
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E.‐Y. Kim, E. Cho, N.‐J. Lee
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The Effect of Dance Therapy on Physical and Psychological Characteristics in The Elderly: Young Ran Lee; Journal of Korean Academy of Nursing 1999;29(2):429-444. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.1999.29.2.429

Abstract PDF

This study was performed to explore the effects of a dance therapy on physical and psychological characteristics in the elderly. The design of this study was a non-equivalent pre-post test experiment. The subjects consisted of elderly persons living in a facility located in Suweon and Bucheon. Fifty eight subjects, aged between 65 and 93 years who had normal cognition, sensory function, balance, and resting blood pressure. They underwent tests of balance, flexibility, muscle strength, depression, and anxiety as baseline data before dance therapy, and at 6 th week and at the end of the 12nd week after following dance therapy. Twenty seven elderly persons were assigned to the experimental group and participated with the dance therapy between April and July, 1998. The dance therapy was developed by the author with the help of a dance therapist and a physiatrist. This therapy was based on the Marian Chace's dance therapy and Korean traditional dance with music. The dance therapy was developed by the author with the help of a dance therapist and a physiatrist. This therapy was based on the Marian Chace's dance therapy and Korean traditional dance with music. The dance therapy consists of 50 minutes session, 3 times a week for 12 weeks. One session was consisted of warming-up, expression, catharsis, sharing, and closing stage. The intensity of the dance therapy was at the 40% of age-adjusted maximum heart rates. Data were analyzed with mean, standard deviation, Chi-square test, unpaired t-test, repeated measures ANOVA, and Bonferroni multiple regression using SAS program. 1. The results related to the physical characteristics were as follows : 1) The balance (standing on one leg, walking on the balancing bar), flexibility and muscle strength (knee extensor, knee flexor, ankle plantarflexor and dorsiflexor) of the experimental subjects significantly increased over time more than that of the control subjects. 2) The experimental group had significantly higher score for balance, flexibility, muscle strength of knee extensor, and knee flexor than the control group at the 12nd week after dance therapy. 3) The experimental group had significantly higher score for muscle strength of ankle dorsiflexor and plantarflexor than the control group at the 6th week and the 12nd week after dance therapy. 2. The results related to psychological characteristics were as follows : 1) Scores of Geriatric Depression Scale, Hamilton Depression Rating Scale, and Zung's Self-rating Anxiety Scale of the experimental group were significantly decreased over time more than that of the control group. 2) The experimental group had significantly lower score for depression than the control group at the 12nd week after dance therapy. 3) The experimental group had significantly lower score for anxiety than the control group at eh 6th week and the 12nd week after dance therapy. The findings showed that the dance therapy could be effective in improving the balances, flexibility, and muscle strength of lower limb, and effective in decreasing the depression and anxiety of the elderly. Additional merits of the dance therapy would be inexpensiveness, easy accessibility, and increasing interpersonal relationship. It can be suggested that the dance therapy is effective in the health promotion of the elderly.

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The Effects of a Health Management Program on Health-promoting Lifestyle and Depression in Older Adults Living at Home
Young Rye Park, Yang Gyeong Yoo
The Korean Journal of Rehabilitation Nursing.2013; 16(1): 71. CrossRef

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Effects of Muscle Strengthening Exercises Using a Thera Band on Lower Limb Function of Hemiplegic Stroke Patients: Sang Sook Han, Jeong Ja Her, Youn Jung Kim; Journal of Korean Academy of Nursing 2007;37(6):844-854. Published online March 28, 2017; DOI: https://doi.org/10.4040/jkan.2007.37.6.844

Abstract PDF

PURPOSE: This study was to verify the effect of muscle strengthening exercises using a Thera-Band on the lower limbs. METHODS: The design utilized for this study was a nonequivalent control group pretest-posttest design. A control group (16) and experimental group (16) were selected from stroke patients of K Oriental Medicine Hospital who were hospitalized for 5 months from December 2005 through April 2006. While only acupuncture therapy and physical therapy were used on the control group, acupuncture, physical therapy and additional muscle strengthening exercises using a red thera band were used on the experimental group. Muscle strengthening was performed 20 minutes per session, more than one session a day for 4 weeks. Hypotheses for this study were verified using Two-way repeated ANOVA and ANCOVA using a pre test score as a covariate. RESULTS: The experimental group with thera band muscle strengthening exercises showed a decrease in asymmetry weight loading percentage(F=14.704, P= .010), range of knee (Z=-3.15, P= .001) & deep tendon reflex score(Z=-2.52, P= .012) and moving performance(F=12.328, P= .001)compared to the control group. CONCLUSION: It is confirmed that muscle strengthening exercises using a Thera-Band can be used as an effective nursing intervention to improve the function of the lower limb of hemiplegic stroke patients.

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Effects of Resistance Exercise using Elastic Band on Range of Motion, Function and Shoulder Pain among Patients with Rotator Cuff Repair
Jae Ok Sim
Korean Journal of Adult Nursing.2016; 28(5): 491. CrossRef
Effects of a Thera-Band Exercise Program on Pain, Knee Flexion ROM, and Psychological Parameters Following Total Knee Arthroplasty
Ji Yeong Yun, Jong Kyung Lee
Journal of Korean Academy of Nursing.2015; 45(6): 823. CrossRef
Effects of a Muscle Strengthening Exercise Program on Muscle Strength, Activities of Daily Living, Health Perception, and Depression in Post-stroke Elders
Gi-Yon Kim, Bo-Eun Kwon, Hea-Kung Hur, Young-Sook Roh, Myoung-Jin Shin
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The Effect of a Health Maintenance Program on Physical Function and Mental Health of the Elderly in Nursing Homes: Ki Wol Sung; Journal of Korean Academy of Nursing 2007;37(4):478-489. Published online March 28, 2017; DOI: https://doi.org/10.4040/jkan.2007.37.4.478

Abstract PDF

Purpose

The purpose of this study was to determine the effects of a Health Maintenance Program on physical functions and mental health of the elderly in nursing homes.

Method

Sixty elderly(over 65 years old) in a randomized control study participated in a 16-week group-based intervention including functional exercises and health education. The participants were divided into 3 groups(Health Maintenance Program Group, Supportive Music Exercise Group, and Control Group) of 20 elderly each. Data was collected from Dec. 1st, 2005 to Mar. 30th, 2006. Physical function of lower body strength was assessed using a 30-second chair test, flexibility was assessed using a sit-and-reach test, and static balance was assessed by the ability to balance on one leg with open and closed eyes. Depression was assessed using the Korean Form of the Geriatric Depression Scale and self esteem was assessed using Rosenberg's Self Esteem Questionnaire. Data was analyzed by Chi-square test, One-way ANOVA, and Repeated measure two factor analysis.

Results

A Health Maintenance Program significantly increased muscle strength, flexibility and static balance, but depression and self-esteem scores were not significantly changed.

Conclusion

Findings demonstrated that a Health Maintenance Program was more effective on physical function than mental health of the elderly in nursing homes.

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Journal of Nursing Research.2020; 28(5): e111. CrossRef
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Characteristics of nutrient intakes, basal physical fitness and serum markers in elderly women with osteopenia
Ji Yeon Kim, Hyo Jin Kim, Jee Young Hong, Dong Ho Park, Chang Sun Kim
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Korean Journal of Adult Nursing.2013; 25(1): 105. CrossRef
The Effects of Exercise in the Frail Elderly
Young-Im Park, Kang-Yi Lee, Tae-Im Kim, Moung-Hee Jeon, Dong-Oak Kim, Ji-Hyun Kim
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Young-Hee Kim, Jin-Sook Han
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The Effects of BeHaS Exercise Program on Muscle Strength and Flexibility in Institutionalized Elders
Sun-Ae Kim
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Eun Young Jeon, Sook Young Kim, Hyun Suk Yoo
Journal of Korean Academy of Nursing.2009; 39(6): 829. CrossRef

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The Development and Evaluation of an Incontinence Intervention Program for the Elderly Women at Elderly Welfare Center: Jeungim Kim; Journal of Korean Academy of Nursing 2004;34(8):1427-1433. Published online March 28, 2017; DOI: https://doi.org/10.4040/jkan.2004.34.8.1427

Abstract PDF

Purpose

The elderly with UI experienced urine leakage for a long time. The prevalence of UI has increased and it makes costly. Particularly, the elderly were reluctant to visit a hospital or a clinic for the reasons of modesty and poverty. To solve this problem, incontinence intervention programs should be provided at the elderly welfare center. The purpose of this research was to develop Incontinence Intervention Program for the Elderly Women (IIPE) and evaluate in its effect.

Methods

The study design was quasi-experimental with pre and post-test. The study was performed for ten weeks at one elderly welfare center, Seoul, Korea. The subjects were gathered through an official announcement and informed consent was obtained. IIPE, in this study, was consisted of diagnosis, education, exercise and evaluation. The study variables were PFM exercise adherence, pelvic muscle strength, Continence selfefficacy, geriatric depression and incontinence stress. The effects of the IIPE on PFM exercise adherence, pelvic muscle strength, Continence self-efficacy, geriatric depression and incontinence stress were also evaluated.

Results

The mean age of the subjects was 75.2 years. The average attendance was 6.2 times. The IIPE improved PFM exercise adherence, intra-vaginal contraction power and CSE significantly. But it was not significant in incontinence stress and geriatric depression. Other important results were that the two-finger test and urine stream interruption were more useful for elderly women with rigid vaginas in teaching and evaluating.

Conclusion

The Findings suggest that IIPE is effective to the community-residing elderly. Further investigation is needed on a long-term basis with control group.

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Do levels of self-efficacy affect urinary incontinence, falls, quality of life, sleep, and physical activity in elderly people with urinary incontinence?
Melda Başer Seçer, Özge Çeliker Tosun, Gökhan Tosun
Irish Journal of Medical Science (1971 -).2023; 192(2): 935. CrossRef

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Effect of Muscle Strength Training on Urinary Incontinence and Physical Function: A Randomized Controlled Trial in Long-term Care Facilities: Hyekyung Kang, Gwi-Ryung Son Hong; J Korean Acad Nurs 2015;45(1):35-45. Published online February 27, 2015; DOI: https://doi.org/10.4040/jkan.2015.45.1.35

Abstract PDF

Purpose

This study was done to determine whether muscle strength training programs have an impact on improving symptoms of urinary incontinence (UI) and physical function among elderly women with UI who reside in long-term care facilities.

Methods

A randomized controlled trial was conducted. Participants had to be over 65 years, score over 15 score on the mini-mental state examination, and be able to walk alone or with an assistant. Seventy residents were randomly allocated to either the training group (n=35) or control group (n=35). The program consisted of 50 minutes, twice a week for 8 weeks, and included Kegel's exercise, Thera-band training and indoor walking. Main outcomes were UI symptoms, peak vaginal pressure and physical functions measured with timed up and go test (TUG), one leg standing test (OLST), activities of daily living (ADL) and grip strength. Changes in outcome measurements were calculated from baseline to 4 weeks and to 8 weeks using repeated measures ANOVA.

Results

There were significant differences in peak vaginal pressure (p<.001), TUG (p<.001), OLST (p=.012) and grip strength (p<.001) in the interaction between groups and time.

Conclusion

Future studies are suggested to confirm the effect of muscle strength training in long-term care facilities where elderly women with UI reside.

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Effects of Community-based Comprehensive Fall Prevention Program on Muscle Strength, Postural Balance and Fall Efficacy in Elderly People: Jeongyee Bae, Seong-il Cho; J Korean Acad Nurs 2014;44(6):697-707. Published online December 31, 2014; DOI: https://doi.org/10.4040/jkan.2014.44.6.697

Abstract PDF

Purpose

The purposes of this study was to develop a comprehensive community-based fall prevention program and to test the effects of the program on the muscle strength, postural balance and fall efficacy for elderly people.

Methods

The design of this study was a nonequivalent control group pretest-posttest design. There were 28 participants in the experimental group and 29 in the control group. The program consisted of balance exercises, elastic resistance exercises and prevention education. The program was provided five times a week for 8 weeks and each session lasted 90 minutes. Data were analyzed using χ²-test, independent t-test and paired t-test using the SPSS program.

Results

Muscle strength of the lower extremities, postural balance and fall efficacy scores significantly improved in the experimental group compared to the control group.

Conclusion

These results suggest that this program can improve lower extremity muscle strength, postural balance and fall efficacy in elders. Therefore, this program is recommended for use in fall prevention programs for elders living in the community.

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Effectiveness of Home Health Care Service for Elders after Spinal Surgery: Myunghee Jun, Ji Young Jung; J Korean Acad Nurs 2012;42(7):1009-1018. Published online December 31, 2012; DOI: https://doi.org/10.4040/jkan.2012.42.7.1009

Abstract PDF

Purpose

This study was done to evaluate effectiveness of home healthcare services (HHCS) specialized for elders who received spinal surgeries.

Methods

A non-equivalent control group pre-post test quasi-experimental study was performed. HHCS was developed based on the Rice model of dynamic self-determination for self-care. For data collection, a control group (n=23) and an experimental group (n=23) were selected by matching age, BMI, pain, general characteristics and type of spine surgery. Measurement tools to evaluate uncertainty and knowledge were developed by the authors. The Numeric Rating Scale (NRS) and Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ) were used to evaluate pain levels. Muscular strength in the legs was measured using a digital muscle tester and tape ruler. Questionnaires were used to evaluate disability in performing ADL and psychological distress levels.

Results

The experimental group showed significant decrease in uncertainty (p=.028), increased knowledge (p=.038), and partially decreased pain (p=.003-.331). Partial muscle strength increased significantly (p=.021-.644). Disability in performing ADL and psychological distress in the experimental group decreased significantly compared to control group (p=.002, p=.004).

Conclusion

Results indicate HHCS is an efficient home care nursing program for these elders. Further experimental studies with larger samples are required to confirm effects of HHCS.

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Richard Meyrat, Elaina Vivian, Archana Sridhar, R. Heath Gulden, Sue Bruce, Amber Martinez, Lisa Montgomery, Donald N. Reed, Peter J. Rappa, Hetendra Makanbhai, Kenneth Raney, Jennifer Belisle, Stacey Castellanos, Judy Cwikla, Kristin Elzey, Kristen Wilck
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Effects of Passive Upper Arm Exercise on Range of Motion, Muscle Strength, and Muscle Spasticity in Hemiplegic Patients with Cerebral Vascular Disease: Dong Soon Shin, Rhayun Song, Eun Kyung Shin, Sung Ju Seo, Jeong Eun Park, Seung Yeon Han, Hoi Yong Jung, Choon Ji Ryu; J Korean Acad Nurs 2012;42(6):783-790. Published online December 31, 2012; DOI: https://doi.org/10.4040/jkan.2012.42.6.783

Abstract PDF

Purpose

The purpose of this study was to investigate the effects of passive upper arm exercise on range of motion, muscle strength, and muscle spasticity in hemiplegic patients with cerebral vascular disease.

Methods

A quasi-experimental design with nonequivalent control group was utilized. According to inclusion criteria, 25 patients were assigned to the control group with routine care, followed by 25 to the intervention group with passive exercise for 30 minutes per session, twice a day for 2 weeks. Eighteen patients in the intervention group and 17 in the control group completed the posttest measurement, including range of motion for upper arm joints, manual muscle test, and Modified Ashworth Scale for muscle spasticity.

Results

The intervention group had a significantly improved range of motion in the shoulder and wrist joints. No interaction effect was found for the elbow joint. No significant differences were found in muscle strength or muscle spasticity between the groups.

Conclusion

Results of the study indicate that passive exercise safely applied for two weeks improves range of motion in joints of the upper arm in these patients. Further study with long-term follow-up is needed to verify the role of passive exercise in preventing muscle spasticity in this population.

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The Mediating Effect of Depression in the Relationship between Muscle Strength of Extremities and Falls among Community-Dwelling Elderly: Hyoung-Sook Park, Kyung-Yeon Park; J Korean Acad Nurs 2008;38(5):730-738. Published online October 12, 2008; DOI: https://doi.org/10.4040/jkan.2008.38.5.730

Abstract PDF

Abstract Purpose

The purpose of this study was to identify the mediating effect of depression in the relationship between muscle strength of extremities and falls among community-dwelling elderly.

Methods

Two hundred forty-seven participants were recruited from a public health center, a hall for the aged and a school for the aged in B city. Face-to-face interviews were conducted using questionnaires from May to September of 2007. Data was analyzed with descriptive statistics, Pearson correlation, and multiple regression using the SPSS WIN 14.0 program.

Results

There was a significantly negative relationship between muscle strength of lower extremities and falls, muscle strength of left upper extremity and falls, and muscle strength of right upper extremity and falls. Depression positively correlated with falls. Depression showed mediating effects between muscle strength of extremities and falls. Weakness of muscle strength of extremities increased depression and the increased depression increased the frequencies of falls.

Conclusion

For the effective management and prevention of community-dwelling older adults’ falls, exercise programs including depression-decreasing strategies should be established. These exercise programs can decrease depression which is the mediator role between the degrees of muscle strength of extremities and falls.

Citations

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Kyung Rim Shin, Younhee Kang, Mi Young Kim, Dukyoo Jung, Jeong Soo Kim, Chong Min Hong, Eun Suk Yun, Rye Won Ma
Nursing & Health Sciences.2010; 12(4): 493. CrossRef
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Jeung-Im Kim, Myoung-Ae Choe, Young Ran Chae
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Vanessa Helena Santana Dalla Déa, Edison Duarte, José Rubens Rebelatto, Alessandra Paiva de Castro
Acta Ortopédica Brasileira.2009; 17(6): 322. CrossRef

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