The effects of a Simplified Tai-Chi Exercise Program (STEP) on the physical health of older adults living in long-term care facilities: A single group design with multiple time points

Background: Studies support the positive effects that Tai Chi has on the physical health of older adults. However, many older adults residing in long-term care facilities feel too weak to practice traditional Tai Chi, and a more simplified style is preferred. Objective: To test the effects of a newly-developed, Simplified Tai-Chi Exercise Program (STEP) on the physical health of older adults who resided in long-term care facilities. Design: A single group design with multiple time points: three pre-tests, one month apart; four post-tests at one month, two months, three months, and six months after intervention started. Settings: Two 300 - 400 bed veteran homes in Taiwan. Participants: The 51 male older adults were recruited through convenience sampling, and 41 of them completed six-month study. Inclusion criteria included: (1) aged 65 and over; (2) no previous training in Tai Chi; (3) cognitively alert and had a score of at least eight on the Short Portable Mental Status Questionnaire; (4) able to walk without assistance; and (5) had a Barthel Index score of 61 or higher. Participants who had dementia, were wheel-chair bound, or had severe or acute cardiovascular, musculoskeletal, or pulmonary illnesses were excluded. Methods: The STEP was implemented three times a week, 50min per session for six months. The outcome measures included cardio-respiratory function, blood pressure, balance, hand-grip strength, lower body flexibility, and physical health actualization. Results: A drop in systolic blood pressure (p=.017) and diastolic blood pressure (p <.001) was detected six months after intervention started. Increase in hand-grip strength from pre to post intervention was found (left hand: p <.001; right hand: p=.035). Participants also had better lower body flexibility after practicing STEP (p=.038). Conclusions: Findings suggest that the STEP be incorporated as a floor activity in long-term care facilities to promote physical health of older adults. (c) 2006 Elsevier Ltd. All rights reserved.