Kuei-Min Chen

Sleep quality, depression state, and health status of older adults after silver yoga exercises: Cluster randomized trial

BACKGROUND Sleep disturbances, depression, and low perception of health status are commonly seen in elderly population; however, clinicians tend to underestimate or overlook the presence of these symptoms and assume them to be a part of normal aging. Non-pharmacological methods that promote a mind-body interaction should be tested to enhance the mental health of older adults. OBJECTIVE To test the effects of 6 months of silver yoga exercises in promoting the mental health of older adults in senior activity centers, especially their sleep quality, depression, and self-perception of health status. DESIGN Cluster randomized trial. SETTINGS Eight senior activity centers, southern Taiwan. PARTICIPANTS A sample of 139 participants was recruited, and 128 of them completed the study. INCLUSION CRITERIA (1) community-dwelling older adults ages 60 and over, (2) no previous training in yoga, (3) able to walk without assistance, (4) cognitively alert based on the Short Portable Mental Status Questionnaire (SPMSQ) score of eight or higher, and (5) independent or mildly dependent in self-care based on a Barthel Index (BI) score of 91 or higher. The mean age of the participants was 69.20 +/- 6.23 years, and the average number of chronic illness was 0.83 +/- 0.90. The average BI score of the participants was 99.92 +/- 0.62, and the mean SPMSQ score was 9.90 +/- 0.30. METHODS Participants were randomly assigned into either the experimental (n=62) or the control (n=66) group based on attendance at selected senior activity centers. A 70-min silver yoga exercise program was implemented three times per week for 6 months as the intervention for the participants in the experimental group. RESULTS Most of the mental health indicators of the participants in the experimental group had significantly improved after the silver yoga interventions, and many of the indicators improved after 3 months of intervention and were maintained throughout the 6 months study. The mental health indicators of the participants in the experimental group were all better than the participants in the control group (all p<.05). CONCLUSIONS After 6 months of silver yoga exercises, the sleep quality, depression, and health status of older adults were all improved.

Silver yoga exercises improved physical fitness of transitional frail elders.

Background:Promoting the health of transitional frail elders (e.g., through therapeutic-based yoga exercises) is essential to reduce healthcare expenditures caused by chronic health problems. Objective:The purpose of this study was to determine the efficacy of 24 weeks of the senior-tailored silver yoga (SY) exercise program for transitional frail elders. Methods:A convenience sample of 69 elders in assisted living facilities were assigned randomly to the SY group (n = 38) or to the control group (n = 31) on the basis of the facilities where they resided, and 55 of them completed this quasi-experimental pretest and posttest study. Intervention was conducted three times per week, 70 minutes per session, for 24 weeks. Physical fitness (body composition, cardiovascular-respiratory functions, body flexibility, muscle power and endurance, balance, and agility) were examined at baseline, at 12 weeks, and at the end of the 24th week of the study. Results:At the end of the study, the physical fitness indicators of participants in the SY group had improved significantly, and they had better physical fitness than participants in the control group (all p values < .05). Discussion:It was recommended that the SY exercises be incorporated as an activity program in assisted living facilities to promote the physical fitness of transitional frail elders.

A Model-Based Survey of Physical Health in Community-Dwelling Older Adults

Background: Having a better comprehension of older adults’ physical health can help healthcare professionals better design program activities to maintain and promote the health of this population. Purpose: This study investigated the physical health of community-dwelling older adults and compared physical health differences among different age subgroups, gender, and exercise habits. Methods: Using stratified random sampling, 384 Taiwanese community-dwelling older adults were recruited in this survey research. Researchers used the Health Model of Older Adults to measure activities of daily living (6 indicators) and physical status (14 indicators). Analysis of variance and independent t test analyzed the data. Results: Most participant physical health indicators were within normal ranges. Exceptions included central obesity (men: 42.90%, women: 80.30%), abnormal blood pressure (systolic: 47.10%, diastolic: 7%), and deteriorated lung capacity (men: 59.30%, women: 70.70%). Young-old subgroup participants (65–74 years old) and exercisers performed better in their activities of daily living and had better physical status than old-old subgroup participants (> 85 years old) and nonexercisers (all p < .05). Men had better physical status than women (all p < .05). Conclusions/Implications for Practice: Maintaining an active lifestyle and exercising regularly are essential to delaying or preventing the deterioration of natural aging. Physical tolerance, functional ability, educational level, and gender differences should be considered when designing a health promotion program for this population. It is essential for national health policy to enhance older adult health and promote active and healthy aging.

Health Promotion Outcomes of a Newly Developed Elastic Band Exercise Program for Older Adults in the Community: A Pilot Test

Background: Studies indicate that the incidence of disease, the mortality rate, and medical costs are significantly higher in people aged 65 years and over who do not engage in physical activities than in their peers who do engage in these activities. Therefore, promoting appropriate physical activity among older adults in the community is essential to delaying the health implications of aging. Purpose: This pilot test was developed to assess the effectiveness of a newly developed Senior Elastic Band (SEB) exercise program on the health of older adults in community care stations. Methods: A quasiexperimental design was used. A convenience sample of 20 participants from a community care station was recruited. The SEB intervention included three phases (warm-up, aerobic motion, and static stretching) and was conducted three times per week, 40 minutes per session for 1 month. Twelve health indicators in three categories (functional fitness, self-perceived health status, and sleep quality) were examined before and immediately after 1 month of SEB exercises. Results: Participants showed improved performance at the end of the 1-month study for the following indicators: lung capacity, cardiopulmonary fitness, upper and lower body flexibilities, upper limb muscle power, lower limb muscle endurance, and self-perceived physical health status (all ps < .05). No significant differences were identified for the other indicators. Conclusions/Implications for Practice: The SEB exercise program shows preliminary and promising effects on improving the health of older adults in a community care station. Healthcare professionals who work with older adults living in the community may consider the SEB exercise program as a health promotion modality to recommend and implement with this population. However, we recommend further testing the long-term effects of this program on a larger population.

Community vs. institutional elders’ evaluations of and preferences for yoga exercises

AIMS To evaluate and compare the appropriateness of the Silver Yoga exercise programme for community and institutional elders and to determine their preferences towards yoga exercises. BACKGROUND Yoga has been used to promote the health of elders. The Silver Yoga was developed to accommodate the physical tolerance and body flexibility of elders and applied to community and institutional elders with positive health promotion benefits. DESIGN Descriptive design with quantitative programme evaluation and semi-structured interviews. METHOD A convenience sample of 97 participants (64 community elders; 33 institutional elders) was interviewed individually after six months of Silver Yoga exercises. Participants rated the level of difficulty, acceptability, feasibility and helpfulness of the Silver Yoga programme (four phases: warm-up, hatha yoga, relaxation and guided-imagery meditation) and the abdominal breathing technique, based on a 10-point Cantril ladder scale. Further, participants expressed their preferences of yoga exercises based on four open-ended questions. RESULTS The programme was fairly acceptable, feasible and helpful for community and institutional elders (means ranged from 8·33-9·70). The warm-up, relaxation, guided-imagery meditation and abdominal breathing are fairly easy to follow and perform (means ranged from 0·20-0·94). However, the postures in hatha yoga phase were relatively challenging but still manageable for the institutional elders (mean = 1·97, SD 2·33). Further, community elders preferred to practise yoga 61-90 minutes everyday in a group of 11-20, while the institutional elders preferred to practise yoga 31-60 minutes three times per week, in a group of <10. CONCLUSIONS The Silver Yoga exercise programme is acceptable, feasible, helpful and manageable for community and institutional elders. However, different exercise protocols, such as practice intensity and group size, could be applied to different older populations. RELEVANCE TO CLINICAL PRACTICE The Silver Yoga exercise programme could be applied to both community and institutional elders to promote their health.