The Effect of Slef-ditected Elastic band Exercise on physical function of older Adults with Frailty

Abstract

본 연구의 목적은 18주간 탄력밴드를 이용한 자조운동 프로그램이 노쇠노인들의 신체기능에 미치는 효과에 대해서 알아보기 위한 것이다. 서울시 J구에 거주하는 65세 이상, Short physical Battery의 총점이 9점 이하인 노인 17명을 대상으로 운동군(n=8)과 비운동운(n=9)으로 구분하였다. 운동군은 총 18주, 주 2회, 1회 60분 동안 탄력밴드를 이용한 저항성 운동에 참여하였으며, 첫 8주는 전문가 지도하에 운동을 실시하였고, 후반 10주 동안에는 운동의 방법 등이 제시되어 있는 비디오와 책을 이용하여 운동을 자조적으로 할 수 있도록 하였다. 측정은 세 번으로 중재 전, 전문가 지도 운동 후 , 자조운동 후에 측정하였으며 신체 기능 측정을 위하여, Short physical Battery를 비롯한, 악력, 계단 오르기, 다리의 등속성 근력을 측정하였고, 신계 계측을 검사하기 위해 DXA (Dual Energy X-ray Absorptionmetry)를, 심리적 기능 검사로는 운동 자존감 (Exercise self-efficacy )사용하였다. 신체 기능 변인 중 Short physical Battery (p<.05), 각속도 60°에서 몸무게 비율에 대한 오른다리 굴근력 (p<.05), 왼다리 신근력, 각속도 120°에서 몸무게 비율에 대한 각 오른다리·왼다리 굴근력과 신근력에서 (p<.05) 상호작용 효과가 나타났으며, 각 변인에서 대비검정 결과 자조운동을 실시한 10주에서 유의한 차이가 있는 것으로 나타났다. 신체계측에서는 Arm lean mass에서 유의한 차이가 있었으며(p<.05), 심리적 기능에서는 유의한 차이가 없었다. 그리하여 본 연구에서는 18주간 탄력밴드를 이용한 자조운동 프로그램이 노쇠노인들의 신체기능 향상에 효과가 있다고 사료된다.

Frailty is a common syndrome in older adults. Frailty is associated with increase of morbidity and reduced functional ability. However, few studies have introduced an exercise intervention for frailty. The purpose of this study was i) to investigate the effect of elastic band training, and ii) to evaluate the efficacy of self-directed elastic band exercise as a follow-up after supervised exercise on physical function of frail older adults. A total of 41 subjects were initially recruited in this study and 17 of older adults with frailty (≥65 years old) whose SPPB (Short physical performance Battery) score is below 9 were randomized into two groups; elastic band exercise group (EX, n=8) and non-exercised control group (CON, n=9). Exercise training was performed 1 hour twice a week for 18 weeks. For the first 8 weeks, participants exercised under the supervision. During the remaining 10 weeks, as a self-directed elastic band exercise, participants trained themselves following the video which demonstrated examples of the same exercises instructed by the supervisor. Physical function including SPPB, grip strength, stair climbing, sit & reach, and leg isokinetic strength and physiological function including exercise self-efficacy scale ware measured at baseline, after the 8-week exercise program, and upon completion of the 18-week exercise program, respectively. DXA (Dual Energy X-ray Absorptionmetry) is also measured for physical instramentation in pre-term and post-term. Eighteen weeks of elastic band training significantly increased the most of factors of physical function as followings: SPPB (P=.022); right knee flexion at 60°/s (p=.022); left knee flexion at 60°/s (p=.034); right knee extension at 120°/s (P=.022); left knee extension at 120°/s (p=.003); right knee flexion at 120°/s (P=.039) and left knee flexion at 120°/s (p=0.11). In physical instament, arm lean mass was significantly increase. Despite physical function were not statistically different between EX and CON from the 8-week supervised exercise program, after the follow-up seself-directed elastic band exercise for the remaining 10 weeks, physical functions were significantly improved in EX compared to CON in which physical functions were substantially decreased. These results shows that 18 weeks of supervised elastic band training significantly improved physical function of older adults with frailty and also suggest that self-directed elastic band exercise was effective to increase physical function.