Development and Evaluation of a Senior-tailored Elastic Band (SEB) Exercise Program

Transcription

1 Development and Evaluation of a Senior-tailored Elastic Band (SEB) Exercise Program Kuei-Min Chen *, Tseng, W. S., Huang, H. T., Li, C. H., & Lin, Y. P. *Ph.D., RN., Professor College of Nursing, Kaohsiung Medical University Taiwan This study was funded by the National Science Council, Taiwan (NSC B MY3). 1

2 Background Six most common health weaknesses of seniors were: 1) poor cardiopulmonary fitness, 2) less body flexibility, 3) weak upper body muscle power, 4) reduced lower body muscle endurance, 5) poor balance, & 6) sleep disturbances (Chen et al., 2011). Scientific evidence supports that physical activity and exercise provide opportunities to add years of active independent living, reduce disability, and improve quality of life for seniors (Chodzko-Zajko, 2003). Selecting or developing appropriate exercise programs aims at strengthening those health weaknesses would be essential for seniors. Among various exercises, progressive resistance exercise using elastic band can increase muscle 2 strength in seniors (Brown et al., 1990).

3 Elastic Band Simple & effective way of strength training. Simple to use & easy to carry. With its feature-rich attribute, exercises can be designed according to different purposes, and the targeted parts of body muscles can be specifically trained (Newton et al., 2002). By changing the thickness and length of the elastic band, the level of resistance training can be flexibly increased or decreased. Can be designed and tailored for various populations with different levels of bodily functioning (Damush & Damush, 1999). 3

4 Literature Review Elastic band exercise has proven to be beneficial in both healthy and frail seniors (Dancewicz et al., 2003; Topp et al., 2002). Evidence-based research has supported the following beneficial effects of elastic band exercises: Built up muscle strength and endurance Increased flexibility and ROM Enhanced gait and balance Improved functional ability 4

5 Significance of the Study As supported by the literature, elastic band exercises are beneficial for seniors. However, among the reviewed studies, a senior-tailored elastic band exercise program less often addressed the physical weaknesses of seniors and the protocol of carrying out the elastic band exercises for seniors was not clearly presented. 5

6 Purpose To develop a senior-tailored elastic band exercise program to remedy the common physical weaknesses of seniors. To evaluate the feasibility of the elastic band exercise program for seniors from the users perspectives. To determine appropriate elastic band exercise frequencies and preferences of seniors. 6

7 Methods Phase I: Experts consultation Hard copy + DVD containing detailed descriptions and demonstrations of the SEB were sent to the experts. Phase II: Seniors evaluation Participants were interviewed after 1 month of the instructor-led SEB (3 times/week, 40 min./session). Setting: A senior day care center, southern Taiwan. Sampling: Convenience Sample: Phase I: 11 professional experts (3 senior exercise trainers, 2 physical education scholars, 2 gerontological nurse practitioners, 2 geriatric physicians, and 2 physical therapists) Phase II: 20 seniors 7

8 Selection Criteria for Seniors Inclusion criteria Community-dwelling seniors aged > 65 No previous training with elastic bands Ability to stand alone without assistive devices Cognitively alert (SMPSQ > 8) Independent or mild dependency for self-care (BI > 91) Exclusion criteria Dementia Wheelchair users Severe or acute cardiovascular, musculoskeletal, or pulmonary illnesses 8

9 Data Collection (Phase I) Evaluation criteria: simplicity, safety, suitability, and helpfulness. Scale: 1 to 4 1 = exercise is very difficult, very dangerous, extremely inappropriate, not good for health promotion, and should be deleted. 2 = major revisions should be made to the exercise. 3 = exercise is fine but warrants minor revision. 4 = exercise is simple, safe, suitable, good for health promotion, very essential, and should not be omitted. The experts were asked to provide suggestions for revisions if they rated < 3. Alpha for simplicity (.93), safety (.93), suitability (.94), and helpfulness (.94). 9

10 Data Collection (Phase II) Evaluation criteria: simplicity, safety, suitability, and helpfulness. Scale: 10-point Cantril ladder scale 0: very difficult, very dangerous, very inappropriate, and useless in contributing to the seniors health. 10: very easy, very safe, very appropriate, and very helpful to the seniors health. Alpha for the simplicity (.62), safety (.59), suitability (.79), and helpfulness (.91). 10

11 Data Collection (Phase II) Five open-ended questions How do you feel after 1 month of SEB? How many times/week of SEB is appropriate? How long per exercise session is appropriate? How many people/group are appropriate in doing SEB? What type of instructor do you prefer to learn SEB from? 11

12 Results 12

13 Demographics of the Experts 13

14 Age 60% 45.45% years old years old years old years old years old 40% 20% 18.18% 18.18% 9.09% 9.09% 0% Age M = 49.96; SD =

15 Gender 36.40% Male Female 63.60% 15

16 Education 60% High school College Master Doctor 40% 20% 18.18% 18.18% 36.36% 27.27% 0% Education 16

17 Demographics of the Senior Participants 17

18 Age 60% 80.00% Young-old (65-74 years old) Middle-old (75-84 years old) Old-old ( 85 years old) 40% 20% 15.00% 5.00% 0% Age M = 72.00; SD =

19 Gender 10.00% Male Female 90.00% 19

20 Marital Status 30.00% Married Widowed 70.00% 20

21 Education 60% 45.00% Illiterate Six-year elementary High school and above 40% 35.00% 20.00% 20% 0% Education 21

22 Exercise Habit 60% 70.00% 40% 30.00% Yes No 20% 0% Yes Exercise Frequency (day/week): M = 4.55; SD = 3.19 Exercise Duration (min./day) : M = 41.25; SD = No 22

23 Preliminary SEB Warm-up 7 movements to loosen up the body and elevate their energy for a safe transition to the next phase. Aerobic motions 7 low-to-medium speed exercises to enhance the cardiovascular-respiratory workout. Static stretching 7 low-speed, gentle stretching exercises to build up muscle power/endurance and increase range of motion and flexibility. 40 minutes 23

24 Experts Evaluation (N = 11) Phases/ Movements Criteria Simplicity (M SD) Safety (M SD) Suitability (M SD) Helpfulness (M SD) Warm-up Turning the wrists Pulling the arms Taking a bath Lifting a weight Drawing a circle Stepping on floor Twisting the waist

25 Experts Evaluation (N = 11) Phases/ Movements Criteria Simplicity (M SD) Safety (M SD) Suitability (M SD) Helpfulness (M SD) Aerobic Motions Spreading the wings Boxing Swinging the arms Squeezing the belly Twisting the hips Shaking the body Jumping and waving

26 Experts Evaluation (N = 11) Phases/ Movements Criteria Simplicity (M SD) Safety (M SD) Suitability (M SD) Helpfulness (M SD) Static Stretching Directing traffic Picking an apple Attacking the front Turning eight Opening arms Touching knees Rotating shoulders

27 Seniors Evaluation (N = 20) Phases Criteria Simplicity (M SD) Safety (M SD) Suitability (M SD) Helpfulness (M SD) Warm-up Aerobic Motions Static Stretching

28 Seniors Preferences (N = 20) Variable f Exercise frequency (times / week) Exercise duration (minutes / session)

29 Seniors Preferences (N = 20) Variable f Group size (number of people) Gender of the instructor Female 11 No preference 9 29

30 Seniors Preferences (N = 20) Variable f Age of the instructor Characteristics of the instructor Patience 20 Someone familiar 12 30

31 Conclusions Experts were consistent in evaluating SEB for its simplicity, safety, suitability, & helpfulness. The senior participants rated the SEB highly and commented that the program was feasible, safe, suitable, & helpful. Final SEB (3 phases, 20 exercises, 40 min.): Warm-up (7 exercises, 12 min.) Aerobic motions (7 exercises, 10 min.) Static stretching (6 exercises, 18 min.) The senior participants suggested practicing SEB 3 times/week, 60 min./session, 20-29/group. 31

32 Study Limitations While an evaluation survey was used to gather the opinions of experts on the SEB program, revisions made to the program were not validated by the experts. A small convenience sample, rather than a large probability sample, was used in phase II of the study, which may have resulted in selection bias and limited generalizability of results. 32

33 Clinical Implications & Further Research Since the SEB is fairly accepted by this group of seniors, it could be considered to be used as a complementary health practice for seniors. The beneficial effects of the SEB should be further tested in a large random sample of community seniors before it is disseminated internationally. 33

34 Comments & Questions 34