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An Effect of Muscle Strength Training Program on Muscle Strength, Muscle Endurance, Instrumental Activities of Daily Living and Quality of Life in the Institutionalized Elderly
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Hee Ja Kim, Yeo Shin Hong
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J Korean Acad Community Health Nurs. 1995;6(1):55-73. Published online June 30, 1995
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 Abstract
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- An Effect of Muscle Strength Training Program on Muscle Strength, Muscle Endurance, Instrumental Activities of Daily Living and Quality of Life in the Institutionalized Elderly Recent statistics shows that the aged are the fastest growing segment of our population by increasing life span. The age group of over 60 shows multiple health problems and the most serious handicapping problem of these. are related to the changes in muscular skeletal system. With aging, people lose. their muscle mass and muscle strength resulting from biological changes and physical inactivity. Studies documented a 30-50% loss of muscle mass in an advanced age and thus, ordinary life activities can be seriously affected due to weakened muscle strength. Preservation of muscle strength of lower limb is especially important in the aged. Since it is readily affected from reduced physical activity in old age, sometimes to the detriment of moving or walking. So muscle strength exercise program designed for the elderly to improve leg muscle strength and leg muscle endurance.
The research design used was nonequivalent control group pretest - protest design.
The purposes of this study were to test the effect of muscle strength exercise program utilizing Leg Press on muscle strength, muscle endurance, instrumental activities of daily living(IADL), cognitive perceptual variables and quality of life.
Forty nine subjects participating in this study consisted of twenty four male and twenty five female. Twenty four experimental group subjects were selected from C-institution in Chung Buk province, and twenty five control group subjects were selected from O-institution in Chung Nam province. The mean age of subjects was 72.8 years.
Muscle strength training program utilizing Leg Press for the experimental group was carried out three times a week for 9 weeks.
The data was collected from August, 1993 to October, 1993. Data were analyzed with chi2-test, t-test, ANCOVA test, Kruskal Wallis 1-Way ANOVA test using SPSS PC program.
Results
were obtained as follows : 1) The experimental group showed significantly higher scores on muscle strength (leg lift strength, back lift strength and grip strength) and muscle endurance than control group after the experiment lower right quadrantF=52.35(p=.001), F=54.07(p=.001), F=6.97(p=.011), F=18.17(p=.001)upper left quadrant 2) Experimental group were significantly higher scores on IADL than control group(F=7.51, p=.009).
3) Experimental group showed significantly higher scores on economical state and self esteem aspects of the quality of life scale than control group lower right quadrantF=10.59(p=.002), F=6.97(p=.011)upper left quadrant. But there were no differences in emotional state, physical and functional state and relationship with reatives in the quality of life between groups.
4) Scores on IADL showed a significant difference with the level of muscle strength and muscle endurance lower right quadrantchi2=7.73(p=.025),;chi2=8.86;(p=.011)upper left quadrant 5) Scores on self esteem and physical and functional state aspects of the quality of life scale showed a significant difference with the level of IADL lower right quadrantchi2=11.39(p=.003),;chi2=9.02(p=.011)upper left quadrant.
6) Scores of experimental group after the experiment in cognitive perceptual variables (perceived benefit on exercise, perceived health status, self efficacy, emotion on exercise) were significantly higher than those of control group lower right quadrantF=32.09(p=.001), F=5.07(p=.029), F=20.63 (p=.001), F=30.38(p=.001)upper left quadrant.
As a result of this study, the effect of strength training exercise program with Leg. Press had improved muscle strength, muscle endurance, IADL, and the perception of self esteem, physical and funtional state, and economical state.
Thus strength training program could be beneficially applied for the prevention of disablity and promotion of health and wellbeing in the aged easily and safely.
The subjects in the experimental group have maintained their exercises till six months after the cessation of the experiment.
This seem to illustrate that changes in cognitive perceptual variables and the improvement in health status have reinforced motivation for the continuation of voluntary exercises.
A further study is necessary to determine the factors affecting maintainance of muscle strength exercise and to assess the effect of weight training program on bone density.
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An Effect of the Self-Regulation Program for Hypertensives: Synthesis & testing of Orem and Bandura's theory
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Young Im Park, Yeo Shin Hong
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J Korean Acad Community Health Nurs. 1994;5(2):109-129. Published online December 31, 1994
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Abstract
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- Chronic health problems has become a major concern and challenge to the health care professionals today.
Especially hypertension, one of the leading primary cause of death in Korea, is a typical chronic disease requiring adequate and continuous management.
Though these hypertensives need to maintain desirable health practice by themselves for their life time, many previous studies indicated that most of the essential hypertensives have no specific symptoms and thus, reluctant to follow appropriate medical regimens causing the condition further aggravated and complicated.
Self-care is an essential factor that keeps chronic patients in control of their health and wellness.
Thus this study was conducted to identify the effect of the comprehensive self-regulation program as a nursing intervention on the promotion self-care performance and improvement in physical parameters of hypertensives.
For this purpose, a one group quasi-experimental research with pre and post test design was used. The subjects of the study was consisted of thirty persons with mild or moderate essential hypertension from two companies in Cheong-ju city. The whole program was carried out from October, 1993 to February, 1994.
The self-regulation program was consisted with group education on hypertension and self-care, self-regulation including the blood pressure self-monitoring and recording, recording of daily self-care activities, and encouraging and reinforcing self-efficacy through verbal persuation and enactive attainment.
The subjects were asked to measure their own blood pressure by themselves twice per day and to record blood pressure and the daily self-care performance according to the instructions provided during the whole period of 9 weeks.
The instruments used for data collection in this study were as follows : 1) Instruments used for measuring the knowledge about hypertension, multiple health locus of control, and perceived benifits and barriers were adapted from previous studies and modified by author to be fit for the subjects.
2) Self-efficacy scale and self-care performance record were developed by the author.
3) Physiological parameters included systolic / diastolic blood pressure, body weight, level of blood cholesterol, and 24hour ambulatory blood pressure.
The post-experimental Cronbach's Alpha as the reliability test of scales were 0.703-0.897, an appropriate level of confidence.
The effect of the program was analyzed by experimental stages ; the first week, the fifth week, and the ninth week since the experimental imput began. Data were analyzed by the SPSS PC+ program with paired t-test and t-test, repeated measure ANOVA, and pearson's correlation to de termine the effect of program.
The results were as follows : 1) After the self-regulation program, scores on knowledge(t=-2.41, p=.011), perceived self-efficacy (F=5.60, p=.001), self-care performance(F=22.31, p=.0001) were significantly higher than those before the program. 2) After the program, both systolic and diastolic blood pressure were significantly lower than those before the program(F=10.89 -13.11, p=.0001). However in 24hour ambulatory blood pressure, systolic mean pressure was nearly significantly lower, but not in diastolic mean pressure. 3) After the program, the body weight was significant decresed(t=5.53, p=.0001), but the blood cholesterol level was not decreased significantly except in those cases with higher cholesterol level. 4) There were significant relationships between changes in self-care performance and diastolic pressure at 1st week (r=.3389, p=.033) and changes in self-care performance and systolic pressure at 9th week(r=.3651, p=.024). 5) There were significant relationship between perceived self-efficacy and self-care performance at 5th week(r=.5313, p=.001) and 9th week (r=.3026, p=.052). 6) After the program, internal health locus of control and perceived benefits did not show significant change, but perceived barriers was significantly lower than those before the program (t=3.57, p=.0001). From the above results, it can be concluded that 1) The self-regulation program is an effective nursing strategy to promote self-care performance of hypertensives and to lower the blood pressure. Thus this program can be recommended in the management of the hypertensives in workplaces and community settings. 2) The synthesis of Orem's self-care theory and Bandura's self-regulation & self-efficacy theory in this study was proved to enhance explanation and prediction of the change of self-care behavior. Thus the result of the study would contribute in development of the self-care theory and an expansion of practice-theory.
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