낙상예방 운동 프로그램이 치매 노인의 균형, 보행과 하지 근력, 심리사회적 특성에 미치는 영향 = Impact of a Fall-Prevention Exercise Program on Balance, Gait, Lower Limb Strength, and Psychosocial Characteristics in Older Adults with Dementia

다국어 초록 (Multilingual Abstract)

PURPOSE: This study measured the impact of a 12-week fall-prevention exercise program on balance, ambulatory ability, lower limb strength, and psychosocial characteristics in older adults diagnosed with dementia.
METHODS: The participants comprised 31 older adults (9 men, 22 women) diagnosed with Alzheimer’s or vascular dementia at a long-term care hospital located in Gunsan City. A fall-prevention exercise program was provided to the experimental group, while the control group was only provided with instruction and materials related to the fall-prevention exercise program. The participants were evaluated before the intervention, 6 weeks after the intervention, and 12 weeks after the intervention on static and dynamic balance abilities (using Timed Up and Go test: TUG, Tinetti-balance scale, one-leg standing test: OLS), gait (Tinetti-balance scale, 6-minute walk test: 6MWT), lower limb strength (sit to stand test; STS), and psychosocial characteristics (Short Form 36 Health Survey-Korean version, Korean Mini-Mental State Exam).
RESULTS: An independent samples t-test and repeated measures analysis of variance were used for the statistical analysis. There were statistically significant improvements after the intervention (p<.05) in dynamic balance abilities (TUG and OLS using the left foot), gait (6MWT), and lower limb strength (STS) for the experimental group, but not for the control group. No difference was seen in psychosocial characteristics.
CONCLUSION: Older adults with dementia who participated in the fall-prevention exercise program showed significant improvements in their static and dynamic balance abilities, lower limb strength, and ambulatory ability after the intervention.

참고문헌 (Reference)

1 최성혜, "한국판 Global Deterioration Scale의 타당도" 대한신경과학회 20 (20): 612-617, 2002

2 심선미, "편마비 환자의 보행치료로서 6분걷기검사의 사용: 결과지식 제공을 통한 연습효과의 가능성" 대한임상건강증진학회 11 (11): 42-47, 2011

3 이소은, "치매 및 경도인지장애 노인의 건강관련체력과 골밀도에 관한 연구" 한국체육과학회 20 (20): 789-798, 2011

4 정미숙, "지역 거주 노인의 균형 능력과 낙상 공포감의 관계" 대한물리치료학회 24 (24): 23-28, 2012

5 임연희, "종합병원 간호사들의 직무스트레스와 건강수준(SF-36)과의 관련성" 한국산학기술학회 16 (16): 4745-4757, 2015

6 김순경, "복합운동프로그램이 경증치매여성노인의 일상생활활동 및 기능적 체력에 미치는 영향" 한국사회체육학회 (38) : 821-830, 2009

7 조휘영, "만성 뇌졸중 환자들의 Sit to Stand Test의 신뢰도와 타당도" 특수교육재활과학연구소 52 (52): 361-379, 2013

8 김다연, "뇌졸중환자의 동적 균형 평가를 위한 sit-to-walk의 신뢰도연구" 대한물리치료학회 25 (25): 303-310, 2013

9 이창형, "뇌졸중 환자의 한국판 Tinetti-균형 척도의 신뢰도와 동시타당도" 특수교육재활과학연구소 52 (52): 435-452, 2013

10 안승헌, "뇌졸중 환자들의 한국판 Tinetti-보행 척도의 측정자간·절대적 신뢰도와 동시 타당도" 대한물리의학회 9 (9): 201-211, 2014

11 김설향, "노인을 위한 주 1회 낙상 예방 프로그램의 효과 검증" 한국사회체육학회 (46) : 913-920, 2011

12 조희은, "낙상예방 프로그램이 노인의 체력, 낙상효능감 및 낙상예방행위에 미치는 효과" 한국재활간호학회 20 (20): 22-32, 2017

13 정태경, "감각운동훈련이 노인의 균형 및 보행에 미치는 영향" 대한물리치료학회 23 (23): 29-36, 2011

14 Goshtigian GR, "Using the selective functional movement assessment and regional interdependence theory to guide treatment of an athlete with back pain : A case report" 11 (11): 575-595, 2016

15 Boulgarides LK, "Use of clinical and impairment based tests to predict falls by community-dwelling older adults" 83 (83): 328-339, 2003

16 Goldet G, "Understanding grade : An introduction" 6 (6): 50-54, 2013

17 Podsiadlo D, "The timed up & go : A test of basic functional mobility for frail elderly persons" 39 (39): 142-148, 1991

18 Heyn P, "The effects of exercise training on elderly persons with cognitive impairment and dementia : A meta-analysis" 85 (85): 1694-1704, 2004

19 Ware JE, "The MOS 36-item short-form health survey(SF-36) : I Conceptual framework and item selection" 30 (30): 473-483, 1992

20 Lord SR, "Sit-to-stand performance depends on sensation, speed, balance, and psychological status in addition to strength in older people" 57 (57): 539-543, 2002

21 Morris JC, "Senile dementia of the Alzheimer’s type : An important risk factor for serious falls" 42 (42): 412-417, 1987

22 Kim JE, "Selective Functional Movement Assessment(SFMA)-based therapeutic corrective exercises reduces knee joint pain in a patient with patellofemoral pain syndrome after pregnancy(case study)" 8 (8): 83-92, 2016

23 Nevitt MC, "Risk factors for recurrent non-syncopal falls : A prospective study" 261 (261): 2663-2668, 1989

24 Eriksson S, "Risk factors for falls in people with and without a diagnose of dementia living in residential care facilities : A prospective study" 46 (46): 293-306, 2008

25 Tinetti ME, "Risk factors for falls among elderly persons living in the community" 319 (319): 1701-1707, 1988

26 Richman J, "Research methodology and applied statistics. Part 3: Measurement procedures in research" 32 (32): 253-257, 1980

27 Morris S, "Reliability of measurements obtained with the timed up & go test in people with Parkinson disease" 81 (81): 810-818, 2001

28 Koh SB, "Reliability and validity on measurement instrument for health status assessment in occupational workers" 30 (30): 251-265, 1997

29 Kegelmeyer DA, "Reliability and validity of the Tinetti mobility test for individuals with Parkinson disease" 87 (87): 1369-1378, 2007

30 Lam LC, "Prevalence of very mild and mild dementia in community-dwelling older Chinese people in Hong Kong" 20 (20): 135-148, 2008

31 Shumway-Cook A, "Predicting the probability for falls in community dwelling older adults using the timed up & go test" 80 (80): 896-903, 2000

32 Becker C, "Physical training improves motor performance in people with dementia : a randomized controlled trial" 60 (60): 8-15, 2012

33 Hauer K, "Physical training improves motor performance in people with dementia : A randomized controlled trial" 60 (60): 8-15, 2012

34 Tinetti ME, "Performance oriented assessment of mobility problems in elderly patients" 34 (34): 119-126, 1986

35 Springer BA, "Normative values for the unipedal stance test with eyes open and closed" 30 (30): 8-15, 2007

36 Reisberg B, "Mild cognitive impairment (MCI): A historical perspective" 20 (20): 18-31, 2008

37 Bergland A, "Long-term effects of a 12 weeks high-intensity functional exercise program on physical function and mental health in nursing home residents with dementia: A single blinded randomized controlled trial" 3 (3): 158-, 2015

38 Kwon YC, "Korean version of mini-mental state examination(MMSE-K)Part I : development of the test for the elderly" 28 (28): 125-135, 1989

39 Sterke CS, "Is the Tinetti performance oriented mobility assessment (POMA) a feasible and valid predictor of short-term fall risk in nursing home residents with dementia?" 22 (22): 254-263, 2010

40 Allan L, "Incidence and prediction of falls in dementia: A prospective study in older people" 4 (4): e5521-, 2009

41 Tinetti ME, "Identifying mobility dysfunction in elderly patients. Standard neuromuscular examination or direct assessment?" 259 (259): 1190-1193, 1988

42 Baker NL, "Hip fracture risk and subsequent mortality among Alzheimer's disease patients in the United Kingdom, 1988-2007" 40 (40): 49-54, 2011

43 Ferri CP, "Global prevalence of dementia : A Delphi consensus study" 366 (366): 2112-2117, 2005

44 Beauchet O, "Gait analysis in demented subjects : Interests and perspectives" 4 (4): 155-160, 2008

45 Lach HW, "Falls and fall prevention in older adults with early-stage dementia an integrative review" 10 (10): 139-148, 2017

46 Perry BC, "Falls among the elderly : A review of the methods and conclusions of epidemiologic studies" 30 (30): 367-371, 1982

47 Prudham D, "Factors associated with falls in the elderly : A community study" 10 (10): 141-146, 1981

48 Steinberg M, "Evaluation of a home-based exercise program in the treatment of Alzheimer's disease : The Maximizing Independence in Dementia(MIND)study" 24 (24): 680-685, 2009

49 Franssen EH, "Equilibrium and limb coordination in mild cognitive impairment and mild Alzheimer's disease" 47 (47): 463-469, 1999

50 Doi T, "Effects of multicomponent exercise on spatial–temporal gait parameters among the elderly with amnestic mild cognitive impairment(aMCI) : Preliminary results from a randomized controlled trial(RCT)" 56 (56): 104-108, 2013

51 Uemura K, "Effects of exercise intervention on vascular risk factors in older adults with mild cognitive impairment : A randomized controlled trial" 2 (2): 445-455, 2012

52 Daly JJ, "A randomized controlled trial of functional neuromuscular stimulation in chronic stroke subjects" 37 (37): 172-178, 2006

53 Chai KJ, "A literature review a program of intervention for prevention of falling in the patients with dementia" 4 (4): 27-34, 2010

54 Mong Y, "5-repetition sit-to-stand test in subjects with chronic stroke : Reliability and validity" 91 (91): 407-413, 2010

55 Ministry of Health and Welfare, "2014-2018 Mid-term health insurance plan"

56 조성현, "12주간 복합운동프로그램이 혈관성 치매노인의 일상생활 수행능력과 삶의 질 지수에 미치는 효과" 대한물리의학회 5 (5): 633-644, 2010