Outcomes of Alternative Exercise for Older Women Helen M. Taggart, DSN, RN, CS

Acknowledgements

Significance Rapidly increasing numbers of elderly Consequences of falls among elderly Healthy People 2000/2010 Interventions to reduce falls

Risk for Falling Predictors Impaired Balance Functional Mobility Fear of Falling

T’ai Chi Exercise Ancient Chinese exercise Integration of mind and body Reptetitive, slow, gentle circular movements Changes in center of gravity

Conceptual Framework Orem’s Self Care Theory Motor learning theory (Schmidt & Lee, 1999)

Purpose 1 Ascertain if there were improvements in pre- to postexercise scores for balance, functional mobility, fear of falling among, and self-assessed health among older women who participated in structured T’ai Chi classes for 3 months

Purpose 2Ascertain what other benefits were identified by the participants

Design Single-factor within subjects O1, baseline –Control period, 3 months O2, preintervention –Intervention, 3 months, twice weekly, 30 minute Tai Chi classes O3, postintervention

Instrumentation Basic Conditioning Factor Survey Berg Balance Scale (Berg, Wood-Dauphinee, et al. 1992) Timed Up and Go (Posiadlo & Richardson, 1991) Falls Efficacy Scale (Tinetti et al., 1992) Self-assessed Health (Strawbridge & Idler, 1999) T’ai Chi Form (Xu, 1996)

Data Analysis Descriptive statistics Hypotheses testing

Sample BCF (n = 45) Women, years old Family system –Marital status, widow, n = 31 (69%) –Living arrangements, alone, n = 39 (87%) –Time at retirement community, 2 weeks - 14 years

BCF Health State (n = 45) Body Mass Index, Chronic health problems, Daily medications, 0 – 6

BCF Patterns of Living (n = 45) Exercise, frequency = 0 - 7, types = Balance problems, n = 20 (44%) Use walking cane, n = 9 (20%) Falls in past year, n = 35 (78%) Change activities, n = 35 (78%)

Regression Model Balance Score Change

Regression Model Functional Mobility Score Change

Regression Model Fear of Falling Score Change

Discussion Balance Functional Mobility Fear of Falling Self-assessed health

Self-Reported Benefits Less pain with fibromyalgia Better blood pressure control Reduced insomnia Decreased urinary incontinence More energy

Recommendations Longitudinal study Replicate with diverse subjects Include variables related to social support Investigate the use of other balance tests Controlled studies