Journal List > J Korean Acad Nurs > v.48(6) > 1111061

J Korean Acad Nurs. 2018 Dec;48(6):656-668. Korean.
Published online Dec 31, 2018.  https://doi.org/10.4040/jkan.2018.48.6.656
© 2018 Korean Society of Nursing Science
Development and Effects of Combined Exercise Program for Older Adults with Sarcopenia Based on Transtheoretical Model
Seoyoun Park,1 and Mee Ock Gu2
1Department of Nursing, Daegu Science University, Daegu, Korea.
2College of Nursing · Gerontological Health Research Center in Institute of Health Sciences, Gyeongsang National University, Jinju, Korea.

Address reprint requests to: Gu, Mee Ock. College of Nursing · Gerontological Health Research Center in Institute of Health Sciences, Gyeongsang National University, 816-15 Jinju-daero, Jinju 52727, Korea. Tel: +82-55-772-8226, Fax: +82-55-772-8222, Email: mogu@gnu.ac.kr
Received Jun 12, 2018; Revised Oct 24, 2018; Accepted Oct 24, 2018.

This is an Open Access article distributed under the terms of the Creative Commons Attribution NoDerivs License. (http://creativecommons.org/licenses/by-nd/4.0/) If the original work is properly cited and retained without any modification or reproduction, it can be used and re-distributed in any format and medium.


Abstract

Purpose

The purpose of this study was to develop and examine the effects of combined exercise program for older adults with sarcopenia based on transtheoretical model (TTM).

Methods

A non-equivalent control group with a pretest-posttest design was used. The subjects consisted of 43 older adults with sarcopenia in precontemplation stage, contemplation stage and preparation stage of TTM (experimental group: 22, control group: 21). The developed program consisted of 36 sessions for 12 weeks including combined exercise (60 minutes) and TTM based strategies for enhancing exercise behavior (10 minutes) per session. Data were collected before, immediately after the program between July 31 to October 27, 2017. The data were analyzed using independent t-test, Mann-Whitney U test with SPSS/WIN 18.0.

Results

Compared with their counterparts in the control groups, older adults with sarcopenia in the experimental group showed a significantly greater improvement in process of exercise behavior change, pros and cons of decisional balance for exercise behavior, exercise self-efficacy, parameters of muscle, and the level of physical performance.

Conclusion

The study findings indicate that this combined exercise program for older adults with sarcopenia based on TTM model was effective and can be recommended as a nursing intervention for older adults with sarcopenia.

Keywords: Sarcopenia; Aged; Exercise; Muscles; Self efficacy

Tables


Table 1
Combined Exercise Program for Older Adults with Sarcopenia Based on TTM
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Table 2
Homogeneity of General Characteristics between Groups (N=43)
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Table 3
Homogeneity of Dependent Variables between Groups (N=43)
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Table 4
Effects of Combined Exercise Program Based on TTM for Older Adults with Sarcopenia (N=43)
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Notes

This manuscript is based on a part of the first author' doctoral dissertation from Gyeongsang National University.

CONFLICTS OF INTEREST:The authors declared no conflict of interest.

References
1. Statistics Korea. 2015 Statistics on the aged [Internet]. Daejeon: Statistics Korea; c2015 [cited 2017 Jul 22].
2. Statistics Korea. 2017 Average remaining life expectancy [Internet]. Daejeon: Statistics Korea; c2017 [cited 2017 Jun 22].
3. Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, et al. Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age and Ageing 2010;39(4):412–423. [doi: 10.1093/ageing/afq034]
4. Chen LK, Liu LK, Woo J, Assantachai P, Auyeung TW, Bahyah KS, et al. Sarcopenia in Asia: Consensus report of the Asian Working Group for Sarcopenia. Journal of the American Medical Directors Association 2014;15(2):95–101. [doi: 10.1016/j.jamda.2013.11.025]
5. Janssen I, Heymsfield SB, Ross R. Low relative skeletal muscle mass (sarcopenia) in older persons is associated with functional impairment and physical disability. Journal of the American Geriatrics Society 2002;50(5):889–896. [doi: 10.1046/j.1532-5415.2002.50216.x]
6. Sardeli AV, Tomeleri CM, Cyrino ES, Fernhall B, Cavaglieri CR, Chacon-Mikahil MPT. Effect of resistance training on inflammatory markers of older adults: A meta-analysis. Experimental Gerontology 2018;111:188–196. [doi: 10.1016/j.exger.2018.07.021]
7. Kim WS, Kang SJ, Kang HJ, Kim MH, Kim YS, Park DH, et al.American College of Sports Medicine. ACSM's guidelines for exercise testing and prescription. 9th Kor ed. Seoul: Hanmibook; c2014. pp. 189-300.
8. Korea Institute for Health and Social Affairs. 2014 Survey of the aged. Sejong: Korea Institute for Health and Social Affairs; 2014 Dec.
Report No.: 11-1352000-001426-12.
9. Kwon YJ. Development and evaluation of a stage matched exercise intervention program for elders: Application of the tran theoretical model. Journal of Korean Community Nursing 2002;13(2):205–215.
10. Lee MH, Park YH. Prevalence and factors related to sarcopenic obesity among community-dwelling elderly women. Journal of Korean Biological Nursing Science 2017;19(1):30–37. [doi: 10.7586/jkbns.2017.19.1.30]
11. Han SS, Hyun KS, Kim WO, Won JS, Kim KB. The effects of a health promotion program for elderly. Journal of Korean Academy of Nursing 2005;35(6):1054–1062. [doi: 10.4040/jkan.2005.35.6.1054]
12. Hong JY, Cho JH. Effects of combined exercise on the skeletal muscle mass index and balance scale of elderly women with sarcopenia. The Asian Journal of Kinesiology 2015;17(3):17–24. [doi: 10.15758/jkak.2015.17.3.17]
13. Park SK, Park JK, Kwon YC, Kim EH. The effect of combined training on self-reliance physical fitness, IL-6, TNF-α and carotid artery in older women with sarcopenia. Journal of Sport and Leisure Studies 2011;45(2):771–781.
14. Kim HK, Suzuki T, Saito K, Kojima N, Hosoi E, Yoshida H. Long-term effects of exercise and amino acid supplementation on muscle mass, physical function and falls in community-dwelling elderly Japanese sarcopenic women: A 4-years follow-up study. Geriatrics Gerontology International 2016;16(2):175–181. [doi: 10.1111/ggi.12448]
15. Park SK, Kim EH, Kwon YC, Min SK, Park JH, Hong GR, et al. Effects of combined exercise on health-related physical fitness, muscle mass, fat mass and risk factors of cardiovascular disease in sarcopenic obesity elderly women. The Korean Society of Sports Science 2013;22(6):1381–1395.
16. So YS. The effect of combined exercise on body composition, functional fitness and muscle protein synthesis related hormone in sarcopenic obesity elderly women. Journal of the Korea Convergence Society 2016;7(3):185–193. [doi: 10.15207/JKCS.2016.7.3.185]
17. WHO Expert consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. The Lancet 2004;363(9403):157–163. [doi: 10.1016/S0140-6736(03)15268-3]
18. Nigg CR, Norman GJ, Rossi JS, Norman SB. Process of exercise behavior change: Redeveloping the scale; Poster session presented at 20th Annual Meeting of the Society of Behavioral Medicine; 1999 Jan; San Diego, CA.
19. Kim CJ. Development of a exercise intervention program based on stage of exercise using the transtheoretical model in patients with type 2 diabetes mellitus. Journal of Korean Academy of Fundamentals of Nursing 2002;9(1):123–132.
20. Nigg CR, Rossi JS, Norman GJ, Benisovich SV. Structure of decisional balance for exercise adoption. Annals of Behavioral Medicine 1998;20:S211.
21. Kang SJ, Park JH. The transtheoretical model of exercise behavior change: Applications to decisional balance and stages of exercise change. The Korean Journal of Measurement and Evaluation in Physical Education and Sports Science 2001;3(2):1–12.
22. Marcus BH, Selby VC, Niaura RS, Rossi JS. Self-efficacy and the stages of exercise behavior change. Research Quarterly for Exercise and Sport 1992;63(1):60–66. [doi: 10.1080/02701367.1992.10607557]
23. Lee PS, Chang SO. The study on the effect of stage based exercise motivational intervention program for the elderly. Journal of Korean Academy of Nursing 2001;31(5):818–834. [doi: 10.4040/jkan.2001.31.5.818]
24. Hofmann M, Schober-Halper B, Oesen S, Franzke B, Tschan H, Bachl N. Effects of elastic band resistance training and nutritional supplementation on muscle quality and circulating muscle growth and degradation factors of institutionalized elderly woman: The Vienna Active Aging Study (VAAS). European Journal of Applied Physiology 2016;116(5):885–897. [doi: 10.1007/s00421-016-3344-8]
25. Guralnik JM, Ferrucci L, Pieper CF, Leveille SG, Markides KS, Ostir GV, et al. Lower extremity function and subsequent disability: Consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery. The Journals of Gerontology: Series A, Biological Sciences and Medical Sciences 2000;55(4):M221–M231. [doi: 10.1093/gerona/55.4.M221]
26. Lee NY, Kim SH, Kim TY. The effect of proprioceptive neuromuscular facilitation and traditional trunk stabilization training on the rectus abdominis muscle contraction. Journal of the Korean Academy of Clinical Electrophysiology 2009;7(1):43–48. [doi: 10.5627/KACE.2009.7.1.043]
27. Glanz K, Rimer BK, Viswanath K. In: Health behavior and health education: Theory, research, and practice. 4th ed. San Francisco (CA): John Wiley & Sons, Inc; 2008. pp. 98-118.
28. Oh HJ. In: Development and the effects of transtheoretical model exercise program for elderly women with chronic back pain [dissertation]. Daegu: Kyungpook National University; 2017. pp. 1-83.
29. Bandura A. In: Self-efficacy: The exercise of control. New York: W. H. Freeman; 1997. pp. 1-604.
30. Findorff MJ, Stock HH, Gross CR, Wyman JF. Does the transtheoretical model (TTM) explain exercise behavior in a community-based sample of older women? Journal of Aging and Health 2007;19(6):985–1003. [doi: 10.1177/0898264307308341]