• 근관절건강학회지
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• 제16권1호
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• pp.46-54
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• 2009

Purpose: The purpose of the study was to compare the effects of the Tai Chi self-help program with a self-help program on pain, stiffness, physical functioning, and fear of falling in women with osteoarthritis. Method: Total of 82 women with Osteoarthritis recruited from outpatient clinics or community health centers were randomly assigned either to a Tai Chi self-help group or a self-help group. Thirty subjects in the Tai Chi self-help group and 39 in the self-help group completed posttest measures(pain, stiffness, physical functioning, and fear of falling) at 6 months. Results: After the 6 month study period, the subjects in the Tai Chi self-help group reported significantly less difficulties in performing daily activities(mean difference=-0.16 vs. 6.19 for the self-help), and less fear of falling(mean difference=-3.20 vs. 0.27 for the self-help) than those in the self-help group. There were no significantly differences in pain and stiffness between the groups. Conclusion: The Tai Chi combined with self-help program was more effective than the self-help only program in reducing difficulties in performing daily activities and fear of falling in women with Osteoarthritis. Whether these changes prevent fall episodes requires further study.

• 한국노년학
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• 제29권1호
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• pp.243-258
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• 2009

배경: 낙상은 노인의 가장 일반적이고 심각한 건강문제로 대두되고 있다. 낙상은 중요한 신체적 심리적 영향을 주며 결과적으로 신체적 행동약화나 기능의 위축, 사회적 기능 약화 등을 야기시킨다. 하지만, 상대적으로 낙상 후의 심리적, 정신적 부분은 간과되어져왔다. 낙상 후 노인들이 심리적 또는 정신적으로 보고하는 대표적인 증상으로는 다시 낙상을 할 것이라는 두려움으로 나타났다. 목표: 이 논문은 노인의 낙상에 대한 두려움에 영향을 주는 요인에 대한 모델을 테스트하는데 있다. 또한, 낙상에 대한 두려움에 영향을 주는 중요한 요인 중 하나인 노인의 운동과 운동에 대한 신념, 운동에 대한 기대감의 관계를 연구함에 있다. 방법: 미국 메릴랜드주 볼티모어시 지역에 거주하는 노인149명을 대상으로 2004 11월부터 2005년 3월까지 수집된 2차 자료를 이용해서 결과가 분석되었다. 참가 가능 노인으로는 본 연구에 참여하기로 동의한 노인을 대상으로, 노인요양시설에 거주하며, 인지적으로 이상이 없고 (MMSE>20), 65세 이상의 나이를 가진 노인을 대상으로 한다. 자료 수집은 구조화된 설문지를 통해서 이루어졌다. 자료 분석을 위해, SPSS 12.0을 통해 빈도분석과 상관분석 등이 사용되었고, 모델 평가를 하기 위해서 AMOS프로그램을 통해 path analysis를 시행하였다. 결과: 모델 내 49개의 path중에 13개의 path가 유의하게 나타났고 모델의 22%가 설명되어졌다. 모델의 확실성은 chi-square를 통해서 조사되었고 결과 모델의 확실성이 입증되었다. 또한, CFI 는 0.99 RMSEA는 0.00으로 모델을 지지하는 결과가 나타났다. 특히, 성별, 과거 낙상경험, 운동은 노인의 낙상에 대한 두려움을 설명하는 중요한 변수로 나타났다. 논의: 본 연구는 노인의 낙상에 대한 두려움을 총체적으로 설명하기 위한 모델을 제시한다. 또한, 운동에 대한 신념과 결과에 대한 기대치가 노인의 운동을 설명하는 직접적 변수로, 낙상에 대한 두려움을 설명하는 간접적인 변수로 나타났다. 이 연구는 노인들이 낙상의 두려움을 줄이기 위해 적극적으로 운동에 참여하도록 하는데 중요한 이론적 근거를 제공한다.

• 한국산학기술학회논문지
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• 제18권7호
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• pp.193-199
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• 2017

본 연구의 목적은 노인의 낙상두려움, 일상생활수행능력, 삶의 질 정도를 낙상경험유무, 만성질환유무, 거주지역별로 비교분석하여 결과를 지역노인의 삶의 질을 증진시키기 위한 낙상방지 프로그램의 개발에 기초자료를 제공하고자 함이다. 본 연구는 J시의 시내 경로당 4곳과 농촌지역 주민 센터 4곳에서 지역 노인 185명을 대상으로 2016년 8월 15일부터 2016년 9월 17일까지 시행 되었다. 본 연구의 결과를 보면 낙상경험유무별 낙상두려움, 일상생활수행능력, 삶의 질 비교분석 결과 모든 항목에서 통계적으로 유의한 차이가 없었고, 만성질환유무별 낙상두려움, 일상생활수행능력, 삶의 질 비교에서는 낙상 두려움과 삶의 질에서 통계적으로 유의한 차이를 보였다. 그리고 거주지역별 낙상두려움, 일상생활수행능력, 삶의 질 비교에서는 일상생활수행능력 및 삶의 질에서 통계적으로 유의한 차이를 보였다. 낙상두려움, 일상생활수행능력, 삶의 질 간의 상관관계를 보면 낙상두려움은 일상생활수행능력과 유의하게 음의 상관관계를 보이고 있고(r=-.386, p<.000), 일상생활수행능력과 삶의 질과의 관계는 유의하게 양의 상관관계가 있음을 확인하였다(r=.513, p<.000). 따라서 노인의 낙상두려움을 낮추기 위한 안전한 환경을 마련이 중요함을 인식하여 환경개선교육 프로그램의 개발이 필요하고 노인들의 일상생활에서 낙상관련 필수적인 정보들을 얻을 수 있는 시스템 개발이 되어야하며, 일상생활수행능력을 높일 수 있는 프로그램을 삶의 질이 증진될 수 있음을 알 수 있다.

• 임상간호연구
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• 제21권2호
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• pp.266-275
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• 2015

Purpose: The objective of this study was to verify the effects of elastic-band exercise on pain, range of motion, and fear of falling in patients with total knee replacement. Methods: The study design was a nonequivalent control group non-synchronized quasi-experimental design. Data were collected from December 10, 2014 to January 10, 2015 in an orthopedic specialty hospital located in the C city. Forty-eight patients participated in the study, and each twenty-four were assigned to the experimental group and the control group. The elastic-band exercise was used with the experimental group for 10 days. The numeric rating scale was used to measure pain, goniometer to measure range of motion, and a questionnaire to measure fear of falling. The data were analyzed using $x^2-test$, Fisher's exact, t-test and paired t-test. Results: Compared to the control group, pain in the experimental group decreased (t=-2.89, p=.006), range of motion increased (t=2.98, p=.005), and fear of falling decreased (t=-4.63 p<.001). Conclusion: The elastic-band exercise for total knee replacement patients is considered to be an effective nursing intervention to decrease pain and fear of falling, and to increase range of motion.

• 지역사회간호학회지
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• 제30권2호
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• pp.141-149
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• 2019

Purpose: The purpose of this study is to identify risk factors of accidental falls by age in the Korean elderly. Methods: The study subjects included 10,242 community-dwelling elders aged 65 or over. The data were analyzed by logistic regression analysis. Results: The risk factors of accidental falls in the younger old group (aged 65~74) include fear of falling (OR=16.28, 95% CI: 12.03~22.03), depression (OR=1.24, 95% CI: 1.06~1.44), and hearing impairment (OR=1.20, 95% CI: 1.01~1.43). The risk factors of accidental falls in the older old group (aged 75~84) include fear of falling (OR=11.54, 95% CI: 7.04~18.93), muscle strength (OR=1.36, 95% CI: 1.15~1.60), number of chronic disease (OR=1.65, 95% CI: 1.09~2.50), and presence of spouse (OR=1.27, 95% CI: 1.06~1.51). The risk factors of accidental falls in the oldest old group (aged 85 years old or older) include fear of falling (OR=8.05, 95% CI: 1.85~34.98) and exercise (OR=2.91, 95% CI: 1.36~6.24). Fear of falling is defined as a common factor in the all age groups. Conclusion: Different strategies should be developed for age groups to prevent elderly falls with understanding of contributing factors of falls in each group.

• PNF and Movement
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• 제12권4호
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• pp.259-266
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• 2014

Purpose: The purpose of this study is to describe the effects of proprioceptive neuromuscular facilitation (PNF) on gait speed and genu recurvatum episodes in stroke patients. Methods: The patient is a 58-year-old woman with left hemiplegia who presented with genu recurvatum while walking. Each week the patient received two sessions of PNF that each lasted 45 minutes. During a six-week interval the patient underwent therapeutic exercises and occupational therapy five times a week between the two PNF treatments. During each treatment a preand post-test (a 4 m walk test) was conducted, the patient described their fear of falling down (10-point visual analogue scale), and the number of genu recurvatum episodes was recorded. Results: After the first PNF treatment, the fear of falling down was decreased from 8 points to 7 points, and the number of genu recurvatum episodes decreased from 11 to 6. After the second PNF treatment, the fear of falling down decreased from 6 points to 5 points, and the number of genu recurvatum episodes decreased from 5 to 1. The 4 m walking test time also decreased from 30 seconds to 24 seconds. Conclusion: The PNF treatment is beneficial for reducing the fear of falling down, reducing the number of genu recurvatum episodes, and improving the gait speed of stroke patients.

• PNF and Movement
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• 제15권1호
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• pp.105-113
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• 2017

Purpose: The purpose of this case study was to examine the effects of an intervention based on the concept of proprioceptive neuromuscular facilitation (PNF) on the weight-supporting ability, fear of falling, and stair-walking ability of stroke patients. Methods: One pretest, three intervention sessions, and one posttest were conducted. In the tests, weight-supporting ability, manual muscle strength, the fear of falling, and the time to go up and down a 'ㄱ'-shaped stair-walking machine were measured and compared. The intervention was implemented for 30 minutes per day for three days in combination with general rehabilitation. The intervention was planned and implemented based on the concept of PNF, and the goal was for the subjects, after their consent, to walk backward down the stairs. Results: After the intervention, functional improvement was seen in weight-supporting ability and the fear of falling felt when walking down the stairs. Whereas the subjects could not perform the task of walking down the stairs on the 'ㄱ'-shaped stair-walking machine in the pretest, they could perform the task in the posttest, and their stair-climbing speed was greater than before the intervention. Conclusion: This study verified that a PNF-based intervention can improve stroke patients' weight-supporting ability and stair-walking ability. Therefore, this intervention can be clinically applied to stroke patients.

• 근관절건강학회지
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• 제18권2호
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• pp.137-146
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• 2011

Purpose: The purpose of the study was to compare the effects of Tai Chi exercise program on arthritic pain, difficulties in performing activities of daily living, and fear of falling in women with osteoarthritis (OA) and rheumatoid arthritis (RA). Method: A quasi-experimental design with two intervention groups was used. According to the inclusion criteria, 35 women with OA and 22 with RA were recruited and participated in the Tai Chi for arthritis program for 12 weeks. In 12 weeks, 21 in the OA group and 15 in the RA group completed both pretest and posttest measures. Outcome variables consisted of pain, difficulties in performing activities of daily living, and fear of falling for both groups. Results: The women with OA (64 years) were significantly older and perceived better health than those with RA (49 years) with more than 6 years of diagnosis. The pain scores and the performance of activities of daily living were significantly improved in the OA group at the completion of 12 week Tai Chi exercise, but RA group decreased pain only. The improvements in pain and activities of daily living were significantly more in women with OA than those with RA. No significant changes were found in fear of falling for both groups. Conclusion: The 12 week Tai Chi exercise was more effective on pain and activities of daily living for women with OA than those with RA. Considering that the women with RA perceived more pain and had limited activities of daily living, Tai Chi exercise should be applied slowly and gradually for longer period of time than those with OA.

• 동서간호학연구지
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• 제27권1호
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• pp.61-69
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• 2021

Purpose: This study aims to determine the association between fear of falling, falls efficacy, and fall prevention behaviors in older adults in outpatient and identify the factors affecting fall prevention behaviors. Methods: This was a descriptive study. A total of 137 older adults aged 60 or older with more than one disease in an outpatients setting were recruited from a university hospital in Seoul. Data were collected from March 11 through April 8, 2016. Results: The experience of a fall was significantly associated with age (t=-2.71, p=.008), gender (𝛘²=14.32, p<.001), education (𝛘²=6.05, p=.049), income (𝛘²=9.93, p=.019), physical activity status (𝛘²=16.84, p<.001), and the number of diseases (t=-2.89, p=.004). Fall experience was not significantly associated with marital status (𝛘²=3.79, p=.285). Multiple regression analysis revealed that the most influential factor of fall prevention behaviors was the fear of falls (β=-.37, p<.001), followed by the number of diseases (β=-.20, p=.013). Conclusion: It is necessary to provide preventive fall education with older adults in outpatients settings considering the fear level of falling and the numbers of accompanying diseases.

• 지역사회간호학회지
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• 제18권1호
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• pp.14-22
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• 2007

Purpose: The purpose of this study was to investigate the experience of falls, the fear of falling and fall efficacy and identify the predictors of falls in the elderly at senior citizens' centers. Method: The subjects of this study were 106 elders who used senior citizens' centers in Chungcheongbuk-do, Korea. Data were collected from May to June, 2006 through a survey using a structured questionnaire. Result: Of the elderly sampled, 35.8% experienced falls during the last 1 year. Of falls experienced by the elderly, 53% occurred indoors, 47% outdoors, 15.8% in the bathroom or toilet. In addition, 57.8% of the elderly had injuries on the hip and waist related with falls. The fear of falling was higher in those with experience in falls than in those without. Factors affecting the elders' falls were age (OR=1.113, 95% CI=1.012-1.224), the number of chronic disease (OR=2.342, 95% CI=1.365-4.019) and the fear of falling (OR=4.279, 95% CI=1.901-9.634). The predictor of the frequency of falls was fall efficacy ($R^2=24.9$). Conclusion: As a result, it is essential to develop fall prevention programs based on the fear of falling, fall efficacy, chronic diseases and medication state. And in senior citizens' centers, fall prevention safety education should be activated as a health promotion program.