| Summary: | 碩士 === 南華大學 === 自然醫學研究所 === 100 === Background and Aims: Many previous studies have confirmed that physical function and quality of life in patients with hemodialysis are both low and physical function status not only affects the quality of life, but also plays an important role of predicting the hospitalization rate and mortality. Accumulated evidences suggested that the integration of Tai Chi improves the functional capacity of patients, thereby offering them a better quality of life in a variety of patient populations. To date, there are little data regarding the effect of Tai Chi on the physical function and quality of life in patients with hemodialysis. Thus, the purpose of this study was to evaluate the beneficial effects of Tai Chi integration on hemodialysis patients in terms of their physical functioning and quality of life.
Methods: This was a quasi-experimental study in which data was collected from hemodialysis units at a medical center in middle Taiwan. Purposive sampling was used to recruit regular follow-up outpatient participants who were assigned to an experimental group (participating in Tai Chi (TC) exercise sessions lasting from 50 to 60 minutes, three times per week for 12 weeks) and a comparison group (who continued with existing medical care and life style) according to their individual preferences. Outcome indicators included time to complete 5 sit-to-stand cycles (STS-5), time to complete 10 sit-to-stand cycles (STS-10), repetition of sit-to-stand cycles in one minute (STS-60), 6-minute walk distance (6-MW), gait speed, Karnofsky Performance Status and the quality of life for kidney disease scale (Kidney Disease Quality of Life; KDQOL-36TM). Tests were performed at four time points: baseline, fourth, eighth and twelfth weeks after the intervention. The analyses were performed using the Statistical Package for the Social Science (SPSS 18.0).
Results: 21 participants in the TC exercise group and 25 in the comparison group. The two groups were homogeneous in basic characteristics. In terms of STS-5, STS-10, STS-60, 6-MW and gait speed, the TC group showed significant reductions with time, along with increases in repetitions, distance and speed at the end of the intervention. Slight improvements were seen in the comparison group in duration (STS-5) and repetitions. Comparing TC group with comparison group, all physical functioning indicators significantly improved. In addition to physical functioning, the TC exercise resulted in significant improvements in the quality of life for the participants in every dimension of KDQOL-36TM at the end of the intervention. In a comparison of the measurements taken between TC group and comparison group, improvements were seen in symptom/ problem list and burden of kidney disease of quality of life (p < 0.05).
Conclusion: The results of the present study confirm the effectiveness of Tai Chi exercise as an intervention modality. It may suggest that Tai Chi exercise training can help patients with hemodialysis to strengthen physical functioning and enhance their quality of life. The results of the present study can be used as a reference for domestic health organizations and medical hospitals when formulating policies for dialysis treatment and guides for clinical therapy and care.
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