Research Of The Application Of Baduanjin In Institutionalized Elderly Frailty

ObjectiveTo evaluate the impact of Baduanjin on frailty status,physical activities,negative emotions,cognitive status and quality of life in institutionalized frail older adults.To explore an affordable,enforceable and effective way to prevent frailty.To promote the application of Baduanjin in frail elderly.To leverage the strengths of traditional health care exercise.MethodWe conducted a randomized controlled trial in institutionalized frail older adults in a nursing home in Chengdu,Sichuan province.According to the inclusion and exclusion criteria,80 frailty elderly were recruited from March to September 2017.Using random number table,the patients were randomly divided into the experimental group(Baduanjin group)and the control group(resistance training group).The Baduanjin group practiced Baduanjin according to the standard issued by General Administration of Sport of China in 2003;the resistance training group did resistance training consulted a large number of reviews and experts.Both groups were guided by the qualified members of our research group.Baduanjin group:The study period was 12 weeks,and ?5 times per week and 35~45 minites each time;resistance training group:The study period was 12 weeks,and 3 times per week and 35~45 minites each time.Before the intervention and 12 weeks after intervention,the frail status of the patients were evaluated by Frailty Phenotype(FP)and Frailty Index(FI).The physical activity status of the patients were evaluated by Activity of Daily Living Scale(ADL)and Activity in Lower Limb.The activity in lower limb of the patients were evaluated by Six Minute Walk Test(6MWT),One Leg Standing Test(OLST),Timed Up and Go Test(TUGT),and Five Times Sit to Stand Test(FTSST).The negative emotions,cognitive status and quality of life of the patients were evaluated respectively by Self-rating Depression Scale(SDS),Mini-mental State Examination(MMSE)and 36-item Short-Form Health Survey(SF-36).At the same time,we observed whether there were any adverse clinical events during the study.ResutlsIn this study,80 frail elderly patients were included,in the experimental group during the intervention,2 cases were lost,2 cases were excluded,36 patients completed the experiment and data collected.In the control group during the intervention,3 cases were lost,2 cases were excluded,35 patients completed the experiment and data collected.A total of 71 cases finished all the study,the experimental group were 36(2 lost,2 excluded)while the control group were 35(3 lost,2 excluded).In this study,SPSS21.0 statistical software was used to complete the data analysis,and the two-sided test standard was selected,and the difference was statistically significant with(P<0.05).The metering data is used to describe the mean number of plus or minus standard deviation(sx ±)and median(quartile spacing)[M(P25,P75)].The measurement data is subject to normal distribution and homogeneity of variance,and two independent sample t tests are adopted.Non-parametric statistical mann-whitneyu rank and test were used for data failure.The counting data was calculated by using the chi 2 test.The results are as follows: 1.Frailty status(1)FP :After the intervention,the score of FP in the experimental group were lower than those in the control group and the difference was statistically significant(P<0.05).Experimental group compared with control group after intervention FP.The incidence of grip strength and slow walking speed 2 entries in the FP differences were statistically significant(P < 0.05).The incidence of unconscious weight loss,fatigue,low physical activity three entries in the FP differences were not statistically significant(P > 0.05).Also,the score of FP in experimental groups was lower than pre-intervention and the difference was statistically significant(P<0.05).The incidence of grip strength and slow walking speed 2 entries in the FP differences were statistically significant(P < 0.05).The incidence of unconscious weight loss,fatigue,low physical activity three entries in the FP differences were not statistically significant(P > 0.05).(2).FI:After the intervention,the score of FI in the experimental group were lower than those in the control group and the difference was statistically significant(P<0.05).Also,the score of FI in experimental groups was lower than pre-intervention and the difference was statistically significant(P<0.05).2.Physical activities(1)ADL : The total score of ADL and its two dimensions(basic or physical activity of daily living and instrumental activitiey of daily living,abbreviated as PSMS and IADL)in the experimental group were lower than which in the control group.And the difference of ADL and PSMS were statistically significant(P<0.05),but the difference of IADL was not statistically significant(P>0.05).Also,the score of ADL,PSMS,IADL in experimental group were lower than pre-intervention,and the difference of the score of ADL,PSMS,IAD were statistically significant(P<0.05).(2)Functional activity of lower limbs:The time of OLST,TUGT and FTSST in the experimental group were higher than control groups.And the difference of the time of OLST,TUGT and FTSST were statistically significant(P<0.05).The distance of 6MWT in the experimental group was far than control groups,but the difference of was not statistically significant(P>0.05).Also,the time of OLST,TUGT and FTSST were lower than pre-intervention,and the difference were statistically significant in the experimental group(P<0.05).The distance of 6MWT was far than pre-intervention,and the difference was statistically significant in the experimental group(P<0.05).3.Negative EmotionsThe total score of SDS in the experimental group was lower than which in the control group,but the difference was not statistically significant(P>0.05).Compared with pre-intervention,the total score of SDS was lower in experimental group and the difference was statistically significant in the experimental group(P<0.05).4.Cognitive StatusThe score of MMSE in the experimental group was higher than the resistance training group and the difference was statistically significant(P<0.05).Also,the score of MMSE was higher than pre-intervention in experimental group and the difference was statistically significant(P<0.05).5.Quality Of LifeAfter the intervention,the total score and each dimension of SF-36 in the experimental group were higher than those of the control group.Except the dimension of body pain,the others were statistically significant(P<0.05).The total score and each dimension of SF-36 in the experimental group were higher than pre-intervention and the difference were statistically significant(P<0.05).6.SafetyThere was no clinical adverse events like fall or hospitalized during the whole study in two groups.ConlusionBaDuanJin could effectively and safely improve the frailty status,physical activities,negative emotions,cognitive status and the quality of life in frailty.Therefore,as an effective-affordable-safe traditional health care exercise,BaDuanJin is worthy of promote further popularization and application in frail older adults.