简化太极拳训练对轻度认知功能障碍患者害怕跌倒的影响

目的:研究分析简化太极拳训练对轻度认知功能障碍患者害怕跌倒（Fear of Falling,FOF）的影响。方法:选择78例轻度认知功能障碍患者,按随机分组法分为观察组（n=39例）和对照组（n=39例）,对照组接受基础药物治疗和健康宣教,观察组在对照组基础药物治疗、健康宣教的基础上,进行为期12周的简化太极拳训练,分别于干预前后比较两组老年患者跌倒自我效能水平,FOF人数和跌倒发生率。 结果:干预后,观察组老年患者MFES评分提高、FOF人数下降、跌倒发生率下降,结果比较差异均有统计学意义（P<0.05）。结论:简化太极拳训练可以提高老年轻度认知功能障碍患者的跌倒自我效能水平,降低跌倒发生率,从而改善患者的FOF状况。     

太极拳锻炼对防止老年人跌倒作用机制的研究

[目的]研究太极拳锻炼防止老年人跌倒的作用机制。[方法]社区中53名老年人被随机分配到太极拳组和对照组，太极拳组进行为期10周的简化24式太极拳的培训和锻炼，对照组依原常规生活；干预前后对老年人进行功能评估（包括单腿支撑时间、10m往返步行时间、直体前屈和反应能力）。[结果]太极拳组老年人单腿支撑时间、增强直体前屈和反应能力较对照组增加（P〈0．05），对10m往返步行时间无显著影响（P〉0．05）。[结论]太极拳锻炼能够增强老年人平衡能力、反应能力，改善身体柔韧性，从而达到防止老年人跌倒的目的。     

太极拳训练对帕金森患者平衡功能及害怕跌倒的影响

目的:探讨太极拳训练对帕金森患者平衡能力和害怕跌倒的影响。方法:选择60例帕金森患者为研究对象,随机分为干预组和对照组,各30例。对照组接受神经内科常规护理,干预组在此基础上进行12周的太极拳训练。采用修订版的跌倒效能量表(modified falls efficacy scale,MFES)、Berg平衡量表(Berg balance scale,BBS)和Fugl-Meyer平衡功能量表(Fugl-Meyer balance scale,FM-B)比较两组干预效果。结果:干预前,两组患者MFES、BBS、FM-B得分无差异(P0.05),干预后两组MFES、BBS、FM-B得分有差异(P0.05);干预前后自身对比,对照组无差异(P0.05),干预组差异明显(P0.05)。干预前对照组害怕跌倒(fear of falling,FOF)的PD患者为14例(46.67%),干预组为12例(40%);12周后,对照组FOF的PD患者为11例(36.67%),干预组为6例(20%),差异有显著性意义,P0.05。结论:太极拳训练可以提高帕金森患者的平衡能力和跌倒自我效能水平,对改善患者害怕跌倒的状况有积极的效果。     

农村老年人害怕跌倒与跌倒经历、躯体功能的相关性研究

目的 探讨农村老年人害怕跌倒与既往跌倒经历和躯体功能表现的相关性,为实施有效预防策略和实践提供借鉴。方法 2020年6-10月,便利抽样法选取在某二级医院体检中心参加老人年度免费体检项目的老年人1642名进行面对面调查,采集老年人的一般人口学资料、跌倒经历、躯体功能表现和害怕跌倒情况,比较不同跌倒经历和躯体功能状态对老年人害怕跌倒的影响。结果 12.85%的老年人害怕跌倒。是否害怕跌倒老年人在年龄、性别、合并疾病数量、近5年及1年跌倒史、跌倒次数、跌倒损伤程度、躯体功能表现上的差异均有统计学意义(均P<0.05)。多因素分析显示,跌倒损伤程度(OR=1.483)、四阶段平衡测试得分(OR=0.702)和30 s起坐测试个数(OR=0.956)与老年人害怕跌倒具有独立关联(均P<0.05)。结论 既往发生跌倒且跌倒损伤程度越高,平衡能力和下肢肌肉耐力不足,可能会增加老年人害怕跌倒的发生。应制定针对性措施预防老年人跌倒、降低跌倒损伤,提高躯体功能水平。     

八段锦对社区老年人跌倒效能的影响研究

[目的]探讨八段锦对社区老年人跌倒效能的影响,为预防跌倒的干预措施奠定理论基础。[方法]采用便利抽样法按纳入排除标准在成都市某社区筛选95例老年人,并分成试验组和对照组,试验组进行12周的八段锦练习,对照组进行12周的散步练习。干预前采集一般资料并评估跌倒基线资料,干预前、干预后第12周采用修订版跌倒效能量表(MFES)评估跌倒效能。[结果]干预后12周试验组MFES评分与对照组比较总评分及室外条目得分差异具有统计学意义(P0.05)。[结论]八段锦练习能提高社区老年人的跌倒效能,增强其预防跌倒的信心,从而预防及减少跌倒及跌倒伤害。     

太极拳与其他运动降低老年人跌倒风险的Meta分析

目的 系统评价太极拳练习对降低老年人跌倒发生率、提高平衡能力和减少跌倒恐惧感的效果是否优于其他运动干预。方法 检索PubMed、EMBASE、Web of Science、The Cochrane Library、中国知网、万方数据库和维普数据库中太极拳练习干预老年人跌倒相关的文献,检索时限均为建库至2021年9月。由两名研究者独立筛选文献、提取资料并评价文献质量后,采用Review Manager 5.3软件进行Meta分析。结果 共纳入12篇随机对照试验,包括1 345例健康老年人。太极拳练习后跌倒发生率低于其他运动干预(RR=0.54, 95%CI 0.42～0.68, P <0.001)。关于跌倒危险因素的相关指标,太极拳练习者单腿站立时间(MD=9.57, 95%CI 6.19～12.94, P <0.001)、功能性伸展距离(MD=2.16, 95%CI 1.31～3.01, P <0.001)均优于其他运动干预。而太极拳练习对跌倒恐惧感、计时“起立-行走”测试时间的改善与其他运动干预方式相比无显著性差异(P> 0.05)。结论 太极拳练习在降低老年...     

社区老年人预防跌倒意识行为的调查研究

目的探讨社区老年人预防跌倒意识行为现状。方法 2014年1—10月采用方便抽样法抽取上海市浦东新区北蔡社区4个居委老年人265例,应用《老年住院患者预防跌倒意识行为问卷调查表》进行预防跌倒意识行为调查。结果 26.20%的老年人知晓所服药物可能会导致跌倒并知道防范方法,26.79%外出或者活动时需陪伴,38.49%的老年人害怕跌倒。结论社区老年人预防跌倒意识行为有待增强,应制定有针对性的健康教育和干预措施。     

群组运动预防社区老年人跌倒效果的系统评价

目的评价群组运动预防社区老年人跌倒的效果。方法计算机检索中外数据库中关于群组运动预防社区老年人跌倒效果的随机对照试验,由2名研究者对文献进行质量的严格评价、资料提取,对符合质量标准的文献使用RevMan 5.3软件分析及描述结局指标。结果共纳入7项临床随机对照研究,3 608例研究对象。Meta分析结果显示群组运动能降低社区居住老人运动期间的跌倒发生率[RR=0.90(0.83,0.99),Z=2.20,P=0.03],可未能改善其生命质量[M=0.89(-3.05,4.84),Z=0.44,P=0.66]。结论现有证据证明群组运动有助于预防社区老年人跌倒。     

太极拳运动对社区老年人身心功能的影响

[目的]探讨太极拳运动对社区老年人身心功能的影响.[方法]采用问卷调查法和测量法,于2013年1月对长春市4个公园65岁以上太极拳组老年人（57人）、对照组（47人）进行身体功能（握力左手、握力右手、睁眼单侧腿站立、5 m快速步行速度和10 m正常步行速度、老年活动能力指标）、幸福感、简易智能状态量表（MMSE）的测定.[结果]太极拳组在老年活动能力指标、MMSE、握力左手、握力右手、睁眼单侧腿站立、5 m快速步行速度方面与对照组比较差异有统计学意义（P＜0.05）.[结论]太极拳运动可以改善老年人的身心功能.     

住院老年患者害怕跌倒心理状况的调查

目的探讨住院老年患者害怕跌倒心理的现状。方法使用跌倒效能量表对190例住院老年患者进行问卷调查,比较不同分组的评分差异。结果回收有效问卷185份。住院老年患者跌倒效能量表的平均分为（6.47±2.69）。随着年龄增加,跌倒效能量表评分明显下降,差异有统计学意义（P〈0.05）;有跌倒史患者评分显著低于无跌倒史患者（P〈0.05）;不同性别患者评分无差异（P〉0.05）;有抑郁史患者评分高于无抑郁史患者（P〈0.05）。结论害怕跌倒是住院老年患者的一种较为普遍的心理现象,在高龄、有跌倒史和有抑郁史的患者中更为明显。针对这些患者实施个性化的心理疏导和防范跌倒的指导,可减轻患者对跌倒的害怕,并有效预防跌倒的发生,提高生活质量。     

Effects of Tai Chi exercise on balance, functional mobility, and fear of falling among older women

The purpose of this study was to determine the effects of Tai Chi exercise among older women. Multiple regression analysis revealed statistically significant improvements in scores for balance (p <.001), functional mobility (p <.05), and fear of falling (p <.001) and associated demographic factors. Three months of twice weekly, 30-minute Tai Chi classes was associated with statistically significant improvements in balance and functional mobility and a reduction in the fear of falling in this sample of older women living in retirement communities. T'ai Chi exercises may be an age-appropriate and acceptable form of exercise for older women.     

Development of the simplified Tai Chi exercise program (STEP) for frail older adults

OBJECTIVE: To develop a simplified Tai Chi exercise program for frail older adults. DESIGN: For phase I, using a focus group, 40 frail Taiwanese older adults were interviewed to explore their viewpoints on Tai Chi and have been reported elsewhere. This paper emphasized on the phase II of the study in which the older adults' perspectives were validated by 10 experts using an evaluation survey. SETTING: Long-term care facilities. RESULTS: The newly developed simplified Tai Chi exercise program (STEP) included three stages-(1) warm-up: comprised nine exercises specifically designed to loosen up the body from head to toe; (2) Tai Chi movements: encompassed 12 easy-to-learn and easy-to-perform movements; (3) cool-down: included three activities to cease the chi and rest the body. CONCLUSIONS: The STEP should be further evaluated for its effectiveness in enhancing the relative well being and quality of life of frail older adults and its applicability as a floor activity in long-term care facilities.     

Characteristics of foot movement in Tai Chi exercise

BACKGROUND AND PURPOSE: The concept of proper foot movement is always emphasized in practicing Tai Chi (TC). The purposes of this study were to describe the foot movement characteristics of TC and to compare duration of single- and double-limb support time during TC and during walking. SUBJECTS: Sixteen experienced TC practitioners participated in the study. METHODS: The participants' performance of a whole set of 42-form TC movements was recorded with 2 cameras. A motion analysis system was used to identify the supporting and stepping characteristics of the foot during the practice. RESULTS: Seven foot support patterns and 6 step directions were identified. The results revealed that, compared with normal walking, TC movement had more double-limb support and less single-limb support in terms of total duration. The duration of each support pattern was longer, and movement from one pattern to the next was slow. The duration of each step direction was short, and changes of direction were frequent. DISCUSSION AND CONCLUSION: Support patterns changed slowly, and, combined with various step directions, they were found to be better than those of walking in simulating the gait challenges that may be encountered in daily activities.     

Coordination exercise and postural stability in elderly people: Effect of Tai Chi Chuan

OBJECTIVE: To evaluate the effects of coordination exercise on postural stability in older individuals by Chinese shadow boxing, Tai Chi Chuan (TCC). DESIGN: Cross-sectional study. SETTING: Research project in a hospital-based biomechanical laboratory. PARTICIPANTS: The TCC group (n = 25) had been practicing TCC regularly for 2 to 35 years. The control group (n = 14) included healthy and active older subjects. INTERVENTION: Static postural stability test: progressively harder sequential tests with 6 combinations of vision (eyes open, eyes closed, sway-referenced) and support (fixed, sway-referenced); and dynamic balance test: 3 tests of weight shifting (left to right, forward-backward, multidirectional) at 3 speeds. MAIN OUTCOME MEASURES: Static and dynamic balance of Sensory Organization Testing (SOT) of the Smart Balance Master System. RESULTS: In static postural control, the results showed no differences between the TCC or control group in the more simple conditions, but in the more complicated SOT (eyes closed with sway surface, sway vision with sway surface), the TCC group had significantly better results than the control group. The TCC group also had significantly better results in the rhythmic forward-backward weight-shifting test. Duration of practice did not seem to affect the stability of elder people. CONCLUSION: The elderly people who regularly practiced TCC showed better postural stability in the more challenged conditions than those who do not (eg, the condition with simultaneous disturbance of vision and proprioception). TCC as a coordination exercise may reduce the risk of a fall through maintaining the ability of posture control.     

Joint kinetics during Tai Chi gait and normal walking gait in young and elderly Tai Chi Chuan practitioners

BACKGROUND: Tai Chi Chuan is becoming a popular exercise among elders. This study measured the inter-segmental forces and moments at the lower extremity joints during a Tai Chi gait as compared to those during normal walking gait, in both apparently healthy young and elderly Tai Chi Chuan practitioners. METHODS: Three-dimensional inter-segmental joint reaction force and moment were computed using the Inverse Dynamic Approach based on the kinematics and ground reaction force measurements in a laboratory setting in six young (two females, mean age 28; SD 6 years) and six elderly (five females, mean age 72; SD 8 years) subjects who had previous training of Yang style Tai Chi Chuan. FINDINGS: The results showed significant gait differences in both age groups, with significantly smaller peak compressive forces, larger peak shear forces in the ankle, knee and hip joints, and larger peak moments in the knee and hip joints during Tai Chi gait as compared to normal gait. Moreover, the peak shear force was oriented more in the medial-lateral direction at the ankle and knee joints, and the peak moment was in the frontal plane at the knee and hip joints. The results also showed significant age differences, with significantly smaller peak shear forces in all three joints in the elderly group than in the young group during Tai Chi gait. INTERPRETATION: Tai Chi gait has an increased shear force and frontal plane torque at lower extremity joints than normal gait. The shear force at all three lower extremity joints during Tai Chi gait is lower in the elderly subjects than young subjects. This data suggest that, in Tai Chi Chuan training, elderly people with degenerative joint diseases in the lower extremity should use caution when practicing Tai Chi Chuan.     

The effects on sensorimotor performance and balance with Tai Chi training

OBJECTIVES: To compare the effects of short-term and long-term Tai Chi training on the sensorimotor and balance performance of able-bodied subjects. DESIGN: A nonrandomized cross-sectional controlled trial. SETTING: Sport laboratory. PARTICIPANTS: Forty-eight healthy subjects, 16 with 3 months of experience in Tai Chi training, 16 with 1 to 3 years of experience in Tai Chi training, and 16 with no experience in Tai Chi training. INTERVENTION: Experimental. MAIN OUTCOME MEASURES: The reflex contraction latencies (reaction time) of medial hamstrings and gastrocnemius after perturbation, the active knee joint angle-repositioning error, and the balance time on a tilt board were measured and analyzed with 1-way analysis of covariance. Significant results were further analyzed with post hoc linear contrasts. RESULTS: Long-term Tai Chi practitioners had a significantly faster reflex reaction time in hamstrings (P<.000) and gastrocnemius (P=.043) muscles and a longer balance time on a tilt board (P<.000) than short-term Tai Chi practitioners and nonpractitioners. Both long- and short-term Tai Chi practitioners had significantly less knee joint angle-repositioning error than nonpractitioners (P=.001 and P=.027, respectively). CONCLUSIONS: Tai Chi training of more than 1 year might have the benefits of faster hamstrings and gastrocnemius reflex reaction and improved knee joint position sense (JPS). These changes might be associated with an improved dynamic standing balance. Better knee JPS was shown in subjects with 3 months of Tai Chi practice, but this had not led to a significant improvement in balance.