임상간호연구 (Journal of Korean Clinical Nursing Research)

  • 제23권3호
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  • Pages.388-397
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  • 2017
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  • 1598-9186(pISSN)
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  • 2287-3694(eISSN)
병원간호사회 (Hospital Nurses Association)
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혈액투석 중 하지근력운동 프로그램이 혈액투석 환자의 하지근력과 낙상효능감에 미치는 효과

Effects of the Lower Limb Muscle Strength Exercise Program during Hemodialysis on the Leg Strength and Falls Efficacy of Hemodialysis Patients

  • Park, Ji Eun (Department of Nursing, Korea University Ansan Hospital) ;
  • Han, Hyun Sun (Department of Nursing, Korea University Ansan Hospital) ;
  • Lee, Kyung Hee (Department of Nursing, Korea University Ansan Hospital)
  • 투고 : 2017.09.30
  • 심사 : 2017.11.08
  • 발행 : 2017.12.31
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초록

Purpose: The purpose of this study was to explore the effects of the lower limb muscle strength exercise program during hemodialysis on the leg strength and falls efficacy (fall-related self-efficacy) of hemodialysis patients. Methods: The study was designed to be a quasi-experimental, nonequivalent control group pre and post test design. A total of 42 patients participated in the study. We applied lower limb muscle strength exercise program to the experimental group in every hemodialysis three times a week for 8 weeks. Data were analyzed using ${\chi}^2$ test, fisher's exact test, t-test and repeated measures ANOVA. Results: The mean age was 58 years old (t=-1.54, p=.132), the mean hemodialysis period was 67 months (t=1.949, p=.058) and there was no significant difference of dependent variable (t=1.17, p=.251)(t=-.89, p=.381) between the two groups before the experiment. After the experiment, leg strength was significantly improved in the experimental group compared to that of the control group (F=6.63, p=.004). However, falls efficacy was not significantly different between the experimental group and the control group (F=2.33, p=.104). Conclusion: The study results indicated that the lower limb muscle strength exercise program during hemodialysis may improve leg strength and potentially to prevent falls for hemodialysis patients. Further studies are warranted in which larger number of participants and longer duration of intervention are recommended.

키워드

참고문헌

  1. Current renal replacement therapy in Korea-Insan memorial dialysis registry, 2015. ESRD Registry Committee, Korean Society of Nephrology. Available from: http://www.ksn.or.kr/rang_board/list.html?code=sinchart.
  2. Kouidi EJ. Central and peripheral adaptations to physical training in patients with end-stage renal disease. Sports Medicine. 2001;31(9):651-665. https://doi.org/10.2165/00007256-200131090-00002
  3. Chen CT, Lin SH, Chen JS, Hsu YJ. Muscle wasting in hemodialysis patients: New therapeutic strategies for resolving an old problem. The Scientific World Journal. 2013; 2013. http://dx.doi.org/10.1155/2013/643954
  4. Li M, Tomlinson G, Naglie G, Cook WL, Jassal SV. Geriatric comorbidities, such a falls, confer an independent mortality risk to elderly dialysis patients. Nephrology, Dialysis Transplantation. 2008;23(4):1396-1400. https://doi.org/10.1093/ndt/gfm778
  5. Cook WL, Jassal SV. Prevalence of falls among seniors maintained on hemodialysis. International Urology and Nephrology. 2005)37(3):649-652. https://doi.org/10.1007/s11255-005-0396-9
  6. Headley S, Germain M, Mailloux P, Mulhern J, Ashworth B,Burris J, et al. Resistance training improves strength and functionalmeasures inpatients with end-stage renal disease. AmericanJournal of Kidney Diseases. 2002;40(2):355-364. Citedby Park KS, Choi SH, Park MJ. Comparison of muscle strengthand gait ability between hemodialysis patients and healthyadults. Journal of Korean Public Health Nursing. 2012;26(1):82-90. https://doi.org/10.1053/ajkd.2002.34520
  7. Yoo EJ, Jun TW, Park H. The effects of fall fracture experiences of fall-related fitness components, bone density, fear of falls, and falls efficacy among elderly women. Journal of Korean Physical Education Association for Girls and Women. 2008;22(4):101-115.
  8. Health Education Authority. Physical activity and the preventionan management of falls and accidents among older peoplea frame work for practice. London, HEA. 1999. Cited byHong JY. Effects of 12 weeks aerobic resistance combined exercisetraining on physiological factors in obese elderly women- focused on the sarcopenia and fall efficacy - [dissertation].Yongin; Dankook University; 2012. p. 1-81.
  9. Yoo IY. Effect of fall prevention program applying HSEP on physical balance and gait, leg strength, fear of falling and falls efficacy of community-dwelling elderly. Journal of the Korean Gerontological Society. 2009;29(1):259-273.
  10. Petridou ET, Manti EG, Ntinapogias AG, Negri E, Szczerbinnska K. What works better for community- dwelling older people at risk to fall?: A meta-analysis of multifactorial versus physical exercise-alone interventions. Journal of Aging and Health. 2009;21(5):713-729. https://doi.org/10.1177/0898264309338298
  11. Lord SR, Castell S. Physical activity program for older persons: Effect on balance, strength, neuromuscular control, and reaction time. Archives Physical Medicine Rehabilitation. 1994;75(6):648-652. https://doi.org/10.1016/0003-9993(94)90187-2
  12. Jung TD, Park SH. Intradialytic exercise programs for hemodialysis patients. Chonnam Medical Journal. 2011;47(2):61-65. https://doi.org/10.4068/cmj.2011.47.2.61
  13. Delgado C, Johansen KL. Barriers to exercise partcipation among dialysis patients. Nephrology Dialysis Transplant. 2012;27:1152-1157. http://dx.doi.org/10.1093/ndt/gfr404
  14. Parsons TL, Toffelmire EB, King-VanVlack CE. Exercise training during hemodialysis improves dialysis efficacy and physical performance. Archives of Physical Medicine and Rehabilitation. 2006;87(5):680-687. https://doi.org/10.1016/j.apmr.2005.12.044
  15. Jung YS. The effects of an intradialytic exercise on the physiological and psychological responses in hemodialysis patients [master's thesis]. Seoul: Korea University; 2007. p. 1-59.
  16. The Society of Korean Language and Literature. Korean LanguageDictionary. Seoul: Minjungseogwan; 2011. Cited byJang EJ, Kim HS. Effects of exercise intervention on physicalfitness and health-relalted quality of life in hemodialysis patients.Journal of Korean Academy of Nursing. 2009;39(4):584-593.
  17. Kim MH. Effects of strength exercise during hemodialysis on fall related factors, depression scale and dialysis adequacy [master's thesis]. Seoul: Seoul University; 2016. p. 1-91.
  18. Manz RL, Carnes RL, Carnes VB. Hydrafitness manual foromnikinetic training. Hydrafitness ind. Texas. 1983. Cited byNieman DC. Exercise testing and prescription, 5th ed, NewYork: McGraw-Hill; 2003.
  19. Park KS, Choi SH, Park MJ. Comparision of muscle strength and gait ability between hemodialysis patients and healthy adults. Journal of Korean Public Health Nursing. 2012;26(1): 82-90. https://doi.org/10.5932/JKPHN.2012.26.1.082
  20. Hill KD, Schwarz JA, Kalogeropoulos AJ, Gibson SJ. Fear offalling revisited. Archives of Physical Medicine and Rehabilitation.1996;77(10):1025-1029. Cited by Lee SW. The effectsof a virtual reality exercise program on physical function andfalls efficacy in elderly persons with type 2 diabetes [dissertation].Seoul: Ewha Womans University; 2011. p. 1-109. https://doi.org/10.1016/S0003-9993(96)90063-5
  21. Jang SN, Cho SI, Ou SW, Lee ES, Baik HW. The validity and reliability of Korean Fall Efficacy Scale (FES) and Activitiesspecific Balance Confidence Scale(ABC). The Journal of Korean Geriatrics Society. 2003;7(4):255-268.
  22. Choi EA. The effect of a combined aerobic and resistance exercise program during hemodialysis on dialysis efficacy [master's thesis]. Ulsan: The Graduate School of Industrial Technology; 2014. p. 1-69.
  23. Kim DS, Choi IS, Kim SY. The impact of lower extremity strengthening exercise with step box and elastic band on balance ability and lower extremity muscular strength in community- living elderly individuals. Journal of the Korean Society of Physical Medicine. 2016;11(1):11-21. https://doi.org/10.13066/kspm.2016.11.1.11
  24. Borg G. Physical training. 3. Perceived exertion in physicalwork. Lakartidningen. 1970;67(40):4548-4557. Cited by KimMH. Effects of strength exercise during hemodialysis on fallrelated factors, depression scale and dialysis adequacy [master'sthesis]. Seoul: Seoul University; 2016. p. 1-91.
  25. Painter P, Carlson L, Carey S, Paul SM, Myll J. Physical functioning and health-related quality-of- life changes with exercise training in hemodialysis patients. American Journal of Kidney Disease. 2000;35(3):482-492. https://doi.org/10.1016/S0272-6386(00)70202-2
  26. Hill KD, Moore KJ, Dorevitch MI, Day LM. Effectiveness of falls clinical: An evaluation of outcomes and client adherence to recommended interventions. Journal of the Amercian Geriatrics Society. 2008;56(4):600-608. https://doi.org/10.1111/j.1532-5415.2007.01626.x
  27. Schoenfelder DP, Van Why K. A fall prevention educational program for community dwelling seniors. Public Health Nurse. 1997;14(6):383-390. https://doi.org/10.1111/j.1525-1446.1997.tb00308.x
  28. Sohng KY, Moon JS, Kang SS, Choi JH. The survey of activities and fear of falling in the community dwelling elderly. Journal of Korean Academy of Community Health Nursing. 2001;15(2):324-333.
  29. Shin YI, Lee HS, Jang YS. The effect of group exercise program on the activities of daily living and muscle strength in the spinal cord injury person. Journal of Rehabilitation Research. 2007;11(3):77-95.