The Efficacy of Community-Based Rehabilitation Exercise to Improve Physical Function in Old Women with Knee Arthritis

지역사회중심재활운동이 여성 슬관절염 환자의 신체기능에 미치는 효과

  • Kim, Su-Min (Department of Physical Therapy, Ulsan College) ;
  • Song, Ju-Min (Department of Physical Therapy, Sunlin College University)
  • Received : 2009.07.08
  • Accepted : 2009.12.17
  • Published : 2010.02.25

Abstract

Purpose: The purpose of this study was to compare the effects of Tai-Chi exercise (TCE) and resistance exercise (RE) when used as part of a community-based exercise program on improvement of physical function in elderly women with knee arthritis. Methods: Forty-seven women with knee arthritis participated in this study. They were assigned to one of two groups: the TCE group (n=22) or the RE group (n=25). Tai-Chi exercise and resistance exercise sessions were held for 1 hour per session, twice per week, for 8 consecutive weeks. At pre-treatment and post-treatment, subjects were tested using the following measurements: one-legged stand test (sec), a functional reach test (cm), a test of the strength of the knee extensor and flexor muscles, determination of the pathway of center of foot pressure and vertical ground reaction force for stance phase at pre and post treatment time points. An independent t-test and a ${\chi}^2$ were used to determine the significance of differences between group means using SPSS 12.0. Results: After 8 weeks of participation in the exercise programs, there were significant improvements for both groups in joint pain, difficulty of performing activity, muscle strength of knee extensor and flexor. Also, vertical ground reaction force increased at the loading response phase for both groups. The RE group was significantly different from TC group on the eyes-closed one-legged stand test (sec). Conclusion: Tai-Chi exercise and resistance exercise programs improve physical functioning and reduce pain and locomotion difficulties.

Keywords

References

  1. Topp R, Woolley S, Hornyak J 3rd et al. The effect of dynamic versus isometric resistance training on pain and functioning among adults with osteoarthritis of the knee. Arch Phys Med Rehabil. 2002;83(9):1187-95. https://doi.org/10.1053/apmr.2002.33988
  2. Pang MY, Harris JE, Eng JJ. A Community-based upper-extremity group exercise program improves motor function and performance of functional activities in chronic stroke: a randomized controlled trial. Arch Phys Med Rehabil. 2006;87(1):1-9. https://doi.org/10.1016/j.apmr.2005.08.113
  3. Bae SS, Kim HB, Lee SY et al. A review of patellofemoral angle. J Kor Soc Phys Ther. 2001;13(1):197-204.
  4. Jin HM, Kim JE. The study of anthropometric variables and blood profiles by body mass index (BMI) in elderly people with chronic disease. Journal of Korean Physical education Association for Girls and Women. 2008;22(3):141-53.
  5. Jung KA, Lee WH. The influence of clinical symptoms and self-efficacy on function in women with osteoarthritis. Journal of the Korean Academy of University Trained Physical Therapists. 2007;14(1):55-63.
  6. Fransen M, Crosbie J, Edmonds J. Reliability of gait measurements in people with osteoarthritis of the knee. Phys Ther. 1997;77(9):944-53.
  7. Minor MA, Hewett JE, Webel RR et al. Efficacy of physical conditioning exercise in patients with rheumatoid arthritis and osteoarthritis. Arthritis Rheum. 1989;32(11):1396-405 https://doi.org/10.1002/anr.1780321108
  8. Jones AY, Dean E, Scudds RJ. Effectiveness of a community-based Tai Chi program and implications for public health initiatives. Arch Phys Medi Rehabil. 2005;86(4):619-25. https://doi.org/10.1016/j.apmr.2004.10.020
  9. Han TR, Bang MS. Rehabilitation Medicine. 3rd ed. Seoul, Kunja Co, 2008:919.
  10. Chua SD, Messier SP, Legault C et al. Effect of an exercise and dietary intervention on serum iomarkers in overweight and obese adults with osteoarthritis of the knee. Osteoarthritis Cartilage. 2008;16(9):1047-53. https://doi.org/10.1016/j.joca.2008.02.002
  11. Fisher NM, Pendergast DR. Reduced muscle function in patients with osteoarthritis. Scand J Rehabil Med. 1997;29(4):213-21.
  12. Yi seung, Lee HJ, Woo YK. Validity and reliability of the Western Ontario and McMaster universities osteoarthritis index (WOMAC)-VA3.0 in hip and knee osteoarthritis patients. Journal of the Korean Academy of University Trained Physical Therapists. 2008;15(2):20-9.
  13. Jun MK, Lim JG. The effects of exercise program on physical fitness in elderly with the knee osteoarthritis. J Kor Soc Phys Ther. 2006;18(5):35-41.
  14. Kisner C, Colby LA. Therapeutic Exercise: Foundations and techniques. 4th ed. Philadelphia, FA Davis Co, 2002:4-5.
  15. Kaplan RJ, Vo AN, Stitik TP et al. Rehabilitation of orthopedic and rheumatologic disorders. 1. Osteoporosis assessment, treatment, and rehabilitation. Arch Phys Med Rehabil. 2005;86(3 Suppl 1):S40-7.
  16. Li F, Fisher KJ, Harmer P et al. Delineating the impact of Tai Chi training on physical function among the elderly. Am J Prev Med. 2002;23(2 Suppl):92-7.
  17. Lee HY. Original articles: comparison of effects among Tai-Chi exercise, aquatic exercise, and a self-help program for patients with knee osteoarthritis. J Korean Acad Nurs. 2006;36(3):571-80.
  18. Wu G, Zhao F, Zhou Xet al. Improvement of isokinetic knee extensor strength and reduction of postural sway in the elderly from long-term Tai-Chi exercise. Arch Phys Med Rehabil. 2002;83(10):1364-9. https://doi.org/10.1053/apmr.2002.34596
  19. Choi JH, Yoo IY. Effects of Tai Chi self-help program on functional status of knee joint, fatigue, fear of falling for elderly woman patients with knee osteoarthritis. Journal of the Korean Gerontological Society. 2007;27(4):913-27.
  20. Choi KS. Physical science: Effects of Tai Chi program on muscle strength in women osteoarthritis patients. Journal of Korea Sport Reaserch. 2007;8(6):819-28.
  21. Jee YS, Choi PB, Kim CJ et al. Clinical article: influence of each other rehabilitative exercise therapies' modes on body composition and isokinetic functional levels in patients with osteoarthritis. J Kor Sports Med. 2006;24(1):55-63.
  22. Choi PB, Lee DT, Jin JK. Effects of aqua-exercises and knee joint-exercises on body composition and bone mineral density Levels in elderly with osteoarthritis. The Korean Journal of Physical Education. 2007;46(2s):379-87.
  23. Tsang WW, Hui-Chan CW. Effects of exercise on joint sense and balance in elderly men: Tai Chi versus golf. Med Sci Sports Exerc. 2004;36(4):658-67. https://doi.org/10.1249/01.MSS.0000122077.87090.2E
  24. Lam P. Teaching Tai Chi effectively. Sydney, Tai Chi Productions, 2006:35-72.
  25. Song JM, Park RJ, Kim JS. The effect of vision and audition on balance performance according to age. J Kor Soc Phys Ther. 1994;6(1):75-84.
  26. Yoo KT, Lee MG, Sung SC. Effects of combined and aerobic exercise training on functional fitness, gait, and stability in hemiplegic stroke patients. Korean journal of Sport Science. 2008;19(2):37-50.
  27. Putti AB, Arnold GP, Cochrane LA et al. Normal pressure values and repeatability of the Emed ST4 system. Gait Posture. 2008;27(3):501-5. https://doi.org/10.1016/j.gaitpost.2007.06.009
  28. Lee GO, Kim MY. Ground reaction force of walking for elderly women with degenerative osteoarthritis. Journal of Adapted Physical Activity & Exercise. 2003;11(3):183-94.
  29. Eng JJ, Kelly SC, Kim CM et al. A community-based group exercise program for persons with chronic stroke. Med Sci Sports Exerc. 2003;35(8):1271-8. https://doi.org/10.1249/01.MSS.0000079079.58477.0B
  30. Neumann DA. Kinesiology of the musculoskeletal system: Foundation for physical rehabilitation. St Luis Missori, Mosby, 2002:551-4.
  31. Yip YB, Sit JW, Fung KK et al. Impact of an arthritis self-management programme with an added exercise component for osteoarthritic knee sufferers on improving pain, functional outcomes, and use of health care services: An experimental study. Patient Educ Couns. 2007;65(1):113-21. https://doi.org/10.1016/j.pec.2006.06.019
  32. Lee HY, Lee KJ. Effects of Tai Chi exercise in elderly with knee osteoarthritis. J Korean Acad Nurs. 2008;38(1):11-8. https://doi.org/10.4040/jkan.2008.38.1.11
  33. Hulme J, Robinson V, DeBie R et al. Electromagnetic fields for the treatment of osteoarthritis. Cochrane Database Syst Rev. 2002;(1):CD003523.
  34. Iwamoto J, Takeda T, Sato Y. Effect of muscle strengthening exercises on the muscle strength in patients with osteoarthritis of the knee. Knee. 2007;14(3):224-30. https://doi.org/10.1016/j.knee.2007.03.002
  35. Wolfson L, Whipple R, Derby C et al. Balance and strength training in older adults: intervention gains and Tai Chi maintenance. J Am Geriatr Soc. 1996;44(5):498-506.