Compare the differences of outcomes between self-monitored and supervised walking program intervention for older adults

• Main Authors: Hsin Hsien Wu, 吳信賢
• Other Authors: P. S. Lin
• Format: Others
• Published: 2013
• Online Access: http://ndltd.ncl.edu.tw/handle/13540678347017572763

碩士 === 長庚大學 === 物理治療學系 === 101 === Background and purpose: In recent years, increasing elderly physical activity or regular exercise training has been proposed as a preventive strategy for frailty. Walking is a prime target for interventions in elderly because it is well accepted, inexpensive, functional, and effortlessly but with great effects. The purposes of this study are to compare the differences of outcomes, including physical status and total steps/week between self-monitored and supervised walking program intervention for older adults and to observe the effects of the two approaches on the walking behavior changes. Methods: Older adults were assigned into self-monitored walking (N=21) and supervised walking (N=21) according to their place of residence. All participants are community-dwelling elderly aged ≥ 65, walking independently without devices. A six-month walking program was conducted. The self-monitored group participates in a supervised walking session to establish their walking habit and target pace once a week and the supervised walking group three times a week. Both groups wore the pedometer and be encouraged to keep the walking time and pace every day for the rest of the week. The participants were followed up at 12 and 24 weeks. Outcome measures are the step counts, BMI, physical function status. Besides descriptive analyses, two-way repeated measure ANOVA by using the mean differences of pre-post-test was analyzed. Independent t test was used for between groups and Paired t test for pre-post-test mean difference comparisons (baseline-3 month, baseline-6 month data). Finally, trend plotting and analysis of the changes in the average weekly walking steps data were done. Results: Among all variables, only 6-minute walking distance showed group*time interaction. There was main effect of group in BMI. The 3-month pre-post test showed significant changes of knee extension and timed up and go test score in self-monitored group, and BMI, knee extension, 30-seconds sit to stand, and 5-meter gait speed in supervised group. The 6-month pre-post test showed significant changes of 5-meter gait speed test in self-monitored group, and 30-seconds sit to stand in supervised group. For subjects’ attendance ≥ 50% session, there was no group*time interaction in any other test items. But main effects of group in BMI score and main effects of time in knee extension, grip score and timed up and go test were found. The 3-month pre-post test showed significant changes of knee extension, timed up and go test, 2-minute step test score, and average daily steps in self-monitored group, and in supervised group, BMI, 30-seconds sit to stand, and 5-meter gait speed. And the 6-month pre-post test showed significant changes of 6-minute walk score, 2-minute step score, and average daily steps in self-monitored group, and in supervised group, BMI score, and 30-seconds sit to stand. Conclusions: The self-monitored walking program and supervised walking program for elderly had beneficial effects on their BMI and physical functions, especially the lower extremity performances such as muscle strength, balance, and mobility, but no between group differences were found. Considered the effects, resources consumption, and sustained exercise habits, self-monitored walking program assisted with pedometer would be recommended for the older adults.