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

2. Acknowledgements

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

4. Risk for Falling Predictors Impaired Balance Functional Mobility Fear of Falling

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

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

7. 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

8. Purpose 2Ascertain what other benefits were identified by the participants

9. 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

10. 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)

11. Data Analysis Descriptive statistics Hypotheses testing

12. Sample BCF (n = 45) Women, 72 - 96 years old Family system –Marital status, widow, n = 31 (69%) –Living arrangements, alone, n = 39 (87%) –Time at retirement community, 2 weeks - 14 years

13. BCF Health State (n = 45) Body Mass Index, 18 - 38 Chronic health problems, 0 - 6 Daily medications, 0 – 6

14. BCF Patterns of Living (n = 45) Exercise, frequency = 0 - 7, types = 0 - 4 Balance problems, n = 20 (44%) Use walking cane, n = 9 (20%) Falls in past year, n = 35 (78%) Change activities, n = 35 (78%)

15. Regression Model Balance Score Change

16. Regression Model Functional Mobility Score Change

17. Regression Model Fear of Falling Score Change

18. Discussion Balance Functional Mobility Fear of Falling Self-assessed health

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

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