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Effects of Tai Chi Exercise on Muscle Strength, Balance, Flexibility and Bone Mineral Density of Community Dwelling Elderly Women

Heeyoung So1, Kyungok Ju2, Insook Park1, Rhayun Song1, Hyunli Kim1, Sukhee Ahn1
Korean Journal of Adult Nursing 2013;25(1):105-112.
Published online: February 18, 2013

1College of Nursing, Chungnam National University, Daejeon

2Graduate School of Education, Chungnam National University, Daejeon, Korea

Corresponding author: Ju, Kyungok Graduate School of Education, Chungnam National University, 1-6 Munwha-dong, Jung-gu, Daejeon 301-747, Korea Tel: +82-42-580-8321, Fax: +82-42-580-8309, E-mail: jko2080@hanmail.net
• Received: February 15, 2012   • Accepted: February 21, 2013

© 2013 Korean Society of Adult Nursing

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Purpose
    The purpose of this study was to examine the effects of Tai Chi exercise on muscle strength, balance, flexibility and bone mineral density among community dwelling elderly women.
  • Methods
    A quasi-experimental pretest-posttest design with a nonequivalent comparison group was utilized, Elderly women were recruited from the community settings and assigned to either the treatment group (n=30) or the comparison group (n=34). Both groups completed the pretest and the posttest measures at six months with an 29.7% of dropouts. Tai Chi exercise was performed for 60 minutes, three times a week for 24 weeks. The study participants were referred to the sports clinic of the university hospital where an exercise therapist and a technician measured muscle strength, balance, flexibility, and bone mineral density without the knowledge of the group assignment. Data were collected from June 14, 2010 to May 27, 2011.
  • Results
    At the completion of 6 month Tai Chi exercise, the experimental group showed a significant difference in knee flexor strength (t=3.26, p =.002), flexibility (t=-2.93, p =.005), and bone mineral density in femur (t=2.20, p =.032), compared to the control group.
  • Conclusion
    Tai Chi exercise could be performed safely to community dwelling elderly women and effective for preventing declining in physical function in this population. Whether or not this health benefits would lead fall prevention will require further study.
  • Key Words: Tai Chi; Muscle strength; Balance; Flexibility; Bone mineral density
Table 1.
Homogeneity Test for General Characteristics of the Subjects by Group (N=64)
Characteristics Categories Total Exp. (n=30) Cont. (n=34) x2 or t p
n (%) or M±SD n (%) or M±SD n (%) or M±SD
Education(year)   4.85±3.34 4.30±3.81 5.35±2.83 -1.23 .221
Body mass index(kg/m2)   24.55±3.53 25.24±2.77 23.93±4.03 1.52 .133
Number of chronic disease   1.60±1.16 1.60±1.06 1.61±1.25 -0.06 .951
Age (year)   74.89±6.73 74.36±6.90 75.35±6.66 3.14 .208
＜70 17 (26.6) 11 (36.7) 6 (17.6) -0.58 .563
70~79 29 (45.3) 11 (36.7) 18 (52.9)    
≥80 18 (28.1) 8 (26.6) 10 (29.5)    
Marital status Married 28 (43.8) 12 (40.0) 16 (47.1) 0.32 .570
Others 36 (56.3) 18 (60.0) 18 (52.9)    
Type of family members Alone 17 (26.6) 13 (43.3) 4 (11.8) 8.14 .017
With spouse only 22 (34.4) 8 (26.7) 14 (41.2)    
With family 25 (39.0) 9 (30.0) 16 (47.1)    
Regular exercise Yes 39 (60.9) 14 (46.7) 25 (73.5) 4.83 .028
No 25 (39.1) 16 (53.3) 9 (26.5)    
Chronic disease† Osteoarthritis 22 (34.4) 14 (46.7) 8 (23.5)    
RA 5 (7.8) 1 (3.3) 4 (11.8)    
Diabetes 9 (14.1) 4 (13.3) 5 (14.7)    
Heart disease 12 (18.8) 5 (16.7) 7 (20.6)    

Exp.=experimental group; Cont.=control group; RA=rheumatoid arthritis.

†Multiple response.

Table 2.
Homogeneity Test for Muscle Strength, Balance, Flexibility, BMD between the Experimental and Control Groups at the Pretest (N=64)
Variable Categories Exp. (n=30) Cont. (n=34) t p
M±SD M±SD
Knee strength (Nm/kg) Flexor 59.41±26.73 75.90±29.99 -2.30 .024
Extensor 130.45±49.66 153.97±60.79 -1.68 .098
Knee endurance (W/kg) Flexor 58.97±22.21 67.46±24.65 -1.43 .155
Extensor 89.02±28.44 100.03±34.38 -1.38 .171
Balance (sec) 2.66±1.98 2.00±1.10 1.62 .092
Flexibility (cm) 8.55±7.24 7.05±6.36 0.88 .380
Bone mineral density (BMD) Lumbar BMD 0.76±0.09 0.71±0.11 2.03 .046
Lumbar T score -2.52±0.86 -2.97±0.94 1.98 .051
Femur BMD 0.68±0.08 0.65±0.09 1.51 .135
Femur T score -2.15±0.62 -2.41±0.72 1.54 .128

Exp.=experimental group; Cont.=control group.

Table 3.
Mean Group Comparisons in Muscle Strength, Balance, Flexibility, and Bone Mineral Density at the Posttest (N=64)
Variable Categories Posttest Mean difference t p
Exp. (n=30) Cont. (n=34) Exp. (n=30) Cont. (n=34)
M±SD M±SD M±SD M±SD
Knee strength (Nm/kg) Flexor 73.48±26.56 76.27±35.19 14.07±16.91 0.37±16.62 3.26 .002
Extensor 148.08±51.21 167.26±72.09 17.63±43.19 13.28±31.36 0.45 .644
Knee endurance (W/kg) Flexor 62.94±20.33 66.22±30.15 -26.07±23.38 -33.80±20.38 1.41 .163
Extensor 96.52±28.52 102.65±40.56 7.49±18.65 2.62±17.66 1.07 .288
Balance (sec) 2.86±2.06 2.02±1.16 0.20±2.79 0.02±1.44 0.30 .756
Flexibility (cm) 5.18±6.57 7.92±6.42 -3.36±6.34 0.87±5.22 -2.93 .005
Bone mineral density (BMD) Lumbar BMD 0.76±0.09 0.71±0.11 -0.00±0.03 -0.00±0.01 -0.18 .852
Lumbar T score -2.49±0.88 -3.03±0.95 0.03±0.38 -0.05±0.17 1.20 .233
Femur BMD 0.68±0.08 0.64±0.10 -0.00±0.01 -0.01±0.03 2.20 .032
Femur T score -2.11±0.67 -2.45±0.73 0.03±0.16 -0.03±0.16 1.83 .071

Exp.=experimental group; Cont.=control group.

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    Effects of Tai Chi Exercise on Muscle Strength, Balance, Flexibility and Bone Mineral Density of Community Dwelling Elderly Women
    Korean J Adult Nurs. 2013;25(1):105-112.   Published online February 28, 2013
    DOI: https://doi.org/10.7475/kjan.2013.25.1.105
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    Effects of Tai Chi Exercise on Muscle Strength, Balance, Flexibility and Bone Mineral Density of Community Dwelling Elderly Women
    Korean J Adult Nurs. 2013;25(1):105-112.   Published online February 28, 2013
    DOI: https://doi.org/10.7475/kjan.2013.25.1.105
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    Effects of Tai Chi Exercise on Muscle Strength, Balance, Flexibility and Bone Mineral Density of Community Dwelling Elderly Women
    Effects of Tai Chi Exercise on Muscle Strength, Balance, Flexibility and Bone Mineral Density of Community Dwelling Elderly Women

    Homogeneity Test for General Characteristics of the Subjects by Group (N=64)

    Characteristics Categories Total Exp. (n=30) Cont. (n=34) x2 or t p
    n (%) or M±SD n (%) or M±SD n (%) or M±SD
    Education(year)   4.85±3.34 4.30±3.81 5.35±2.83 -1.23 .221
    Body mass index(kg/m2)   24.55±3.53 25.24±2.77 23.93±4.03 1.52 .133
    Number of chronic disease   1.60±1.16 1.60±1.06 1.61±1.25 -0.06 .951
    Age (year)   74.89±6.73 74.36±6.90 75.35±6.66 3.14 .208
    ＜70 17 (26.6) 11 (36.7) 6 (17.6) -0.58 .563
    70~79 29 (45.3) 11 (36.7) 18 (52.9)    
    ≥80 18 (28.1) 8 (26.6) 10 (29.5)    
    Marital status Married 28 (43.8) 12 (40.0) 16 (47.1) 0.32 .570
    Others 36 (56.3) 18 (60.0) 18 (52.9)    
    Type of family members Alone 17 (26.6) 13 (43.3) 4 (11.8) 8.14 .017
    With spouse only 22 (34.4) 8 (26.7) 14 (41.2)    
    With family 25 (39.0) 9 (30.0) 16 (47.1)    
    Regular exercise Yes 39 (60.9) 14 (46.7) 25 (73.5) 4.83 .028
    No 25 (39.1) 16 (53.3) 9 (26.5)    
    Chronic disease† Osteoarthritis 22 (34.4) 14 (46.7) 8 (23.5)    
    RA 5 (7.8) 1 (3.3) 4 (11.8)    
    Diabetes 9 (14.1) 4 (13.3) 5 (14.7)    
    Heart disease 12 (18.8) 5 (16.7) 7 (20.6)    

    Exp.=experimental group; Cont.=control group; RA=rheumatoid arthritis.

    †Multiple response.

    Homogeneity Test for Muscle Strength, Balance, Flexibility, BMD between the Experimental and Control Groups at the Pretest (N=64)

    Variable Categories Exp. (n=30) Cont. (n=34) t p
    M±SD M±SD
    Knee strength (Nm/kg) Flexor 59.41±26.73 75.90±29.99 -2.30 .024
    Extensor 130.45±49.66 153.97±60.79 -1.68 .098
    Knee endurance (W/kg) Flexor 58.97±22.21 67.46±24.65 -1.43 .155
    Extensor 89.02±28.44 100.03±34.38 -1.38 .171
    Balance (sec) 2.66±1.98 2.00±1.10 1.62 .092
    Flexibility (cm) 8.55±7.24 7.05±6.36 0.88 .380
    Bone mineral density (BMD) Lumbar BMD 0.76±0.09 0.71±0.11 2.03 .046
    Lumbar T score -2.52±0.86 -2.97±0.94 1.98 .051
    Femur BMD 0.68±0.08 0.65±0.09 1.51 .135
    Femur T score -2.15±0.62 -2.41±0.72 1.54 .128

    Exp.=experimental group; Cont.=control group.

    Mean Group Comparisons in Muscle Strength, Balance, Flexibility, and Bone Mineral Density at the Posttest (N=64)

    Variable Categories Posttest Mean difference t p
    Exp. (n=30) Cont. (n=34) Exp. (n=30) Cont. (n=34)
    M±SD M±SD M±SD M±SD
    Knee strength (Nm/kg) Flexor 73.48±26.56 76.27±35.19 14.07±16.91 0.37±16.62 3.26 .002
    Extensor 148.08±51.21 167.26±72.09 17.63±43.19 13.28±31.36 0.45 .644
    Knee endurance (W/kg) Flexor 62.94±20.33 66.22±30.15 -26.07±23.38 -33.80±20.38 1.41 .163
    Extensor 96.52±28.52 102.65±40.56 7.49±18.65 2.62±17.66 1.07 .288
    Balance (sec) 2.86±2.06 2.02±1.16 0.20±2.79 0.02±1.44 0.30 .756
    Flexibility (cm) 5.18±6.57 7.92±6.42 -3.36±6.34 0.87±5.22 -2.93 .005
    Bone mineral density (BMD) Lumbar BMD 0.76±0.09 0.71±0.11 -0.00±0.03 -0.00±0.01 -0.18 .852
    Lumbar T score -2.49±0.88 -3.03±0.95 0.03±0.38 -0.05±0.17 1.20 .233
    Femur BMD 0.68±0.08 0.64±0.10 -0.00±0.01 -0.01±0.03 2.20 .032
    Femur T score -2.11±0.67 -2.45±0.73 0.03±0.16 -0.03±0.16 1.83 .071

    Exp.=experimental group; Cont.=control group.
    Table 1. Homogeneity Test for General Characteristics of the Subjects by Group (N=64)

    Exp.=experimental group; Cont.=control group; RA=rheumatoid arthritis.

    Multiple response.

    Table 2. Homogeneity Test for Muscle Strength, Balance, Flexibility, BMD between the Experimental and Control Groups at the Pretest (N=64)

    Exp.=experimental group; Cont.=control group.

    Table 3. Mean Group Comparisons in Muscle Strength, Balance, Flexibility, and Bone Mineral Density at the Posttest (N=64)

    Exp.=experimental group; Cont.=control group.

    Table 1.

    Table 2.

    Table 3.

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