The ผลของการสนับสนุนการเดินร่วมกับการแกว่งแขนต่อระดับน้ำตาลในเลือด ความดันโลหิต และเส้นรอบเอวของผู้สูงอายุที่มีภาวะเมตาบอลิกซินโดรม
คำสำคัญ:
การสนับสนุนการเดิน, การแกว่งแขน, ภาวะเมตาบอลิกซินโดรม, ผู้สูงอายุบทคัดย่อ
การวิจัยกึ่งทดลองนี้มีวัตถุประสงค์เพื่อศึกษาผลของการสนับสนุนการเดินร่วมกับการแกว่งแขนต่อระดับน้ำตาลในเลือดระดับความดันโลหิตและเส้นรอบเอวในผู้สูงอายุที่มีภาวะเมตาบอลิกซินโดรม กลุ่มตัวอย่างเป็นผู้สูงอายุที่มีภาวะเมตาบอลิกซินโดรมที่อาศัยในตำบลพรหมโลก อำเภอพรหมคีรี จังหวัดนครศรีธรรมราช ได้จากวิธีการสุ่มแบบหลายขั้นตอน จำนวน 66 คน แบ่งเป็นกลุ่มทดลองและกลุ่มควบคุม กลุ่มละ 33 คนกลุ่มทดลองได้รับโปรแกรมการสนับสนุนการเดินร่วมกับการแกว่งแขน กลุ่มควบคุมได้รับการดูแลตามวิธีการปกติ ประเมินผลลัพธ์การวิจัยก่อนและในสัปดาห์ที่ 12 วิเคราะห์ข้อมูลโดยใช้สถิติพรรณนา การทดสอบไคสแควร์ และสถิติการทดสอบ Paired และ Independent t-test ผลการวิจัยพบว่า
ภายหลังการทดลองในสัปดาห์ที่ 12 กลุ่มทดลองมีค่าเฉลี่ยระดับน้ำตาลในเลือด ระดับความดันโลหิต และเส้นรอบเอวลดลงกว่าก่อนการทดลองอย่างมีนัยสำคัญทางสถิติ (p<.05) เมื่อเปรียบเทียบระหว่างกลุ่มทดลองและกลุ่มควบคุมพบว่า ค่าเฉลี่ยระดับน้ำตาลในเลือดและระดับความดันโลหิตของกลุ่มทดลองลดลงกว่ากลุ่มควบคุมอย่างมีนัยสำคัญทางสถิติ (p<.05) ส่วนค่าเฉลี่ยของเส้นรอบเอวพบว่าไม่มีความแตกต่างอย่างมีนัยสำคัญทางสถิติ (p>0.05)
พยาบาลระดับปฐมภูมิควรสนับสนุนให้ผู้สูงอายุที่มีภาวะเมตาบอลิกซินโดรมมีการออกกำลังกายโดยการเดินร่วมกับการแกว่งแขนอย่างสม่ำเสมอ เนื่องจากเป็นวิธีที่สามารถปฏิบัติได้ง่ายสะดวกและมีประสิทธิภาพต่อผู้สูงอายุ
References
American Diabetes Association. (2016). Standards of Medical Care in Diabetes. Introduction. Diabetes Care, 39(Suppl.1), S1-S2. A.
American Heart Association [AHA]. (2000). Exercise Standards for Testing and Training a Statement for Healthcare Professionals from American Heart Association. Circulation, 104(2), 1694 - 1739.
Bakris, G. L. (2007). Current Perspectives On Hypertension And Metabolic Syndrome. Journal of Managed Care Pharmacy, 5(13), 3-5.
Bankoski, A., Harris, T. B., McClain, J. J., Brychta, R. J., Caserotti, P., Chen, K. Y., et al. (2011). Sedentary Activity Associated With Metabolic Syndrome Independent of Physical Activity. Diabetes Care, 34(2), 497-503.
Battersby, M., Von Korff, M., Schaefer, J., Davis, C., Ludman, E., Greene, S. M., et al. (2010). Twelve Evidence-Based Principles for Implementing Self-Management Support in Primary Care. Joint Commission. Journal on Quality and Patient Safety, 36(12), 561-570.
Boonariyatep, T., Oba, N., & Sirilak, S. (2007). Effect of Planned Fast Walking on HbA1C among Patients with Diabetes Mellitus Type II. Journal of Community Development Research 2007, 1(2), 17-29. (in Thai)
Boonyavarakul, A., Choosaeng, C., Supasyndh, O., & Panichkul, S. (2005). Prevalence of The Metabolic Syndrome, and Its Association Factors Between Percentage Body Fat and Body Mass Index in Rural Thai Population Aged 35 Years And Older. Journal of the Medical Association of Thailand Chotmaihet thangphaet, 88, S121-130.
Buathongjun, J. Suttineam, U., & Teerawatskul, S. (2013). The Effect of a Self-Management Program on Health Behaviors among Individuals Who are at Risk for Metabolic Syndrome. The Journal of Boromarajonani College of Nursing, Nakhonratchasima, 19(2), 46-58. (in Thai)
Cao, Z. J., Wang, S. M., & Chen, Y. (2015). A Randomized Trial of Multiple Interventions for Childhood Obesity in China. American Journal of Preventive Medicine, 48(5), 552-560.
Cho, E. R., Shin, A., Kim, J., Jee, S. H., & Sung, J. (2009). Leisure-Time Physical Activity is Associated with a Reduced Risk for Metabolic Syndrome. Annals of Epidemiology, 19(11), 784-792.
Eakpalakorn, W. (2010). Thai People's Health Survey Report by 4th Physical Examination 2008-2009. Nonthaburi, Thailand: Graphic System. (in Thai)
Golbidi, S., Mesdaghinia, A., & Laher, I. (2012). Exercise in the Metabolic Syndrome. Oxidative Medicine and Cellular Longevity, 2012, Article ID: 349710.
Greene, B. R., Donovan, A. O., Romero-Ortuno, R., Cogan, L., Scanaill, C. N., & Kenny, R. A. (2010). Quantitative Falls Risk Assessment Using the Timed Up and Go Test. Biomedical Engineering. IEEE Transactions On, 57(12), 2918-2926.
Hopp L, Walker J. (2009). Effectiveness of Arm Exercise on Dyspnea in Patients with Chronic Obstructive Pulmonary Disease: A Systematic Review. JBI Library of Systematic Reviews, 7(31), 1352-1371.
Jewpattanakul, Y., Reungthongdee, U., & Tabkeaw, T. (2012). The Effect of The Arm Swing Exercise with Family Participation Program on Exercise Behavior in Elderly with Essential Hypertension.Journal of Nursing Science, 30(2), 46-57. (in Thai)
Jittaphankul. S. (2001). Principles of Elderly Medicine. Bangkok, Thailand: Chulalongkorn University Publisher. (in Thai)
Kaenphueak, Y., Junprasert, S., & Asawachaisuwikrom, W. (2014). The Results of Self Directed Diet and Fast-Pace to Control Weight of Overweight Women.The Public Health Journal of Burapha University, 9(1), 104-116. (in Thai)
Kaplan, N. M. (2006). Kaplan’s Clinical Hypertension (9thed.). Philadelphia: Lippincott Williams & Wilkins.
Leelayuwat, N. (2009). Effects of Arm Exercise on Metabolic Parameters in Type 2 Diabetic Patients. Bangkok, Thailand: The Thailand Research Fund. (in Thai)
Lim, E. S., Ko, Y. K., & Ban, K. O. (2012). Prevalence and Risk Factors of Metabolic Syndrome in the Korean Population-Korean National Health Insurance Corporation Survey 2008. Journal of Advanced Nursing, 69, 1549-1561.
Lusardi, M. M., Pellecchia, G. L., & Schulman, M. (2003). Functional Performance in Community Living Older Adults. Journal of Geriatric Physical Therapy, 26(3), 14-22.
Pakdevong, N., Pongprapa, R. (2012). Effects of Self-Management Program on Health Behavior, Body Weight, Body Mass Index and Waist Circumference of Persons at Risk of Type 2 Diabetes. Journal of Nurses’ Association of Thailand, North-Eastern Division, 30(2), 40-47. (in Thai)
Park, Y.-W., Zhu, S., Palaniappan, L., Heshka, S., Carnethon, M. R., & Heymsfield, S. B. (2008). The Metabolic Syndrome: Prevalence and Associated Risk Factor Findings in the US Population From the Third National Health and Nutrition Examination Survey, 1988-1994. Archives of internal medicine, 163(4), 427-436.
Pascual, J. C., Belinchón, I., & Ramos, J. M. (2015). Use of the Barthel Index, Activities of Daily Living, in Dermatologic Surgery in Patients Aged 80 Years and Older. International Journal of Dermatology, 54(2), 222-226.
Petchroung, N., & Homtes, T. (2011). The Effect of Participatory Promotion Exercise Behavior in the Elderly in Rural Area. Journal of the Royal Thai Army Nurses, 12(2), 7-13. (in Thai)
Pittas, A. G., Joseph, N. A., & Greenberg, A. S. (2004). Adipocytokines and Insulin Resistance. The Journal of Clinical Endocrinology & Metabolism, 89(2), 447-452.
Polit, D. F., & Beck, C. T. (2004). Nursing Research: Principles and Methods (7th ed.). NY: Lippincott Williams & Wilkins.
Praphasil, O. (2009). Effects of Promoting Self-Efficacy in Self-Management Program among Personswith Metabolic Syndrome. Bangkok, Thailand: Thammasat University. (in Thai)
Resnick, B., Orwig, D., Magaziner, J., & Wynne, C. (2002). The Effect of Social Support on Exercise Behavior in Older Adults. Clinical Nursing Research, 11(1), 52-70.
Saelao, K., & Kanungsukkasem, V. (2012). Effects of Arm Swing Exercise and Walking and Walking Exercise Combined with arm Swing Exercise on Health-Related Physical Fitness of the Elderly Women. Journal of Sports Science and Health, 13(1), 92-103.
Sun, D.-L., Wang, J.-H., Jiang, B., Li, L.-S., Li, L.-S., Wu, L., et al. (2012). Metabolic Syndrome vs. Its Components for Prediction of Cardiovascular Mortality: A Cohort Study in Chinese Elderly Adults. Journal of Geriatric Cardiology: JGC, 9(2), 123-129.
Sung, K., & Bae, S. (2012). Effects of a Regular Walking Exercise Program on Behavioral and Biochemical Aspects in Elderly People with Type II Diabetes. Nursing & Health Sciences, 14(4), 438-445
Terathongkum, S. (2017). Arm Swinging ExerciseFor Control Diabetes.Thai Journal of Nursing and Midwifery Practice, 1(4), 36-44. (in Thai)
Van Rooijen, A. J., Rheeder, P., Eales, C. J., & Becker, P. J. (2004). Effect of Exercise Versus Relaxation on Haemoglobin A1C in Black Females with Type 2 Diabetes Mellitus. JM: An International Journal of Medicine, 97(6), 343–351. doi: 10.1093/qjmed/hch061.
Wagner, E. H., Davis, C., Schaefer, J., Von Korff, M., & Austin, B. (1999). A Survey of Leading Chronic Disease Management Programs: Are They Consistent with The Literature?. Managed Care Quarterly, 7, 56-66.
Warburton, D. E. R., Nicol, C. W., & Bredin, S. S. D. (2006). Health Benefits of Physical Activity: The Evidence. CMAJ: Canadian Medical Association Journal, 174(6), 801-809.
American Heart Association [AHA]. (2000). Exercise Standards for Testing and Training a Statement for Healthcare Professionals from American Heart Association. Circulation, 104(2), 1694 - 1739.
Bakris, G. L. (2007). Current Perspectives On Hypertension And Metabolic Syndrome. Journal of Managed Care Pharmacy, 5(13), 3-5.
Bankoski, A., Harris, T. B., McClain, J. J., Brychta, R. J., Caserotti, P., Chen, K. Y., et al. (2011). Sedentary Activity Associated With Metabolic Syndrome Independent of Physical Activity. Diabetes Care, 34(2), 497-503.
Battersby, M., Von Korff, M., Schaefer, J., Davis, C., Ludman, E., Greene, S. M., et al. (2010). Twelve Evidence-Based Principles for Implementing Self-Management Support in Primary Care. Joint Commission. Journal on Quality and Patient Safety, 36(12), 561-570.
Boonariyatep, T., Oba, N., & Sirilak, S. (2007). Effect of Planned Fast Walking on HbA1C among Patients with Diabetes Mellitus Type II. Journal of Community Development Research 2007, 1(2), 17-29. (in Thai)
Boonyavarakul, A., Choosaeng, C., Supasyndh, O., & Panichkul, S. (2005). Prevalence of The Metabolic Syndrome, and Its Association Factors Between Percentage Body Fat and Body Mass Index in Rural Thai Population Aged 35 Years And Older. Journal of the Medical Association of Thailand Chotmaihet thangphaet, 88, S121-130.
Buathongjun, J. Suttineam, U., & Teerawatskul, S. (2013). The Effect of a Self-Management Program on Health Behaviors among Individuals Who are at Risk for Metabolic Syndrome. The Journal of Boromarajonani College of Nursing, Nakhonratchasima, 19(2), 46-58. (in Thai)
Cao, Z. J., Wang, S. M., & Chen, Y. (2015). A Randomized Trial of Multiple Interventions for Childhood Obesity in China. American Journal of Preventive Medicine, 48(5), 552-560.
Cho, E. R., Shin, A., Kim, J., Jee, S. H., & Sung, J. (2009). Leisure-Time Physical Activity is Associated with a Reduced Risk for Metabolic Syndrome. Annals of Epidemiology, 19(11), 784-792.
Eakpalakorn, W. (2010). Thai People's Health Survey Report by 4th Physical Examination 2008-2009. Nonthaburi, Thailand: Graphic System. (in Thai)
Golbidi, S., Mesdaghinia, A., & Laher, I. (2012). Exercise in the Metabolic Syndrome. Oxidative Medicine and Cellular Longevity, 2012, Article ID: 349710.
Greene, B. R., Donovan, A. O., Romero-Ortuno, R., Cogan, L., Scanaill, C. N., & Kenny, R. A. (2010). Quantitative Falls Risk Assessment Using the Timed Up and Go Test. Biomedical Engineering. IEEE Transactions On, 57(12), 2918-2926.
Hopp L, Walker J. (2009). Effectiveness of Arm Exercise on Dyspnea in Patients with Chronic Obstructive Pulmonary Disease: A Systematic Review. JBI Library of Systematic Reviews, 7(31), 1352-1371.
Jewpattanakul, Y., Reungthongdee, U., & Tabkeaw, T. (2012). The Effect of The Arm Swing Exercise with Family Participation Program on Exercise Behavior in Elderly with Essential Hypertension.Journal of Nursing Science, 30(2), 46-57. (in Thai)
Jittaphankul. S. (2001). Principles of Elderly Medicine. Bangkok, Thailand: Chulalongkorn University Publisher. (in Thai)
Kaenphueak, Y., Junprasert, S., & Asawachaisuwikrom, W. (2014). The Results of Self Directed Diet and Fast-Pace to Control Weight of Overweight Women.The Public Health Journal of Burapha University, 9(1), 104-116. (in Thai)
Kaplan, N. M. (2006). Kaplan’s Clinical Hypertension (9thed.). Philadelphia: Lippincott Williams & Wilkins.
Leelayuwat, N. (2009). Effects of Arm Exercise on Metabolic Parameters in Type 2 Diabetic Patients. Bangkok, Thailand: The Thailand Research Fund. (in Thai)
Lim, E. S., Ko, Y. K., & Ban, K. O. (2012). Prevalence and Risk Factors of Metabolic Syndrome in the Korean Population-Korean National Health Insurance Corporation Survey 2008. Journal of Advanced Nursing, 69, 1549-1561.
Lusardi, M. M., Pellecchia, G. L., & Schulman, M. (2003). Functional Performance in Community Living Older Adults. Journal of Geriatric Physical Therapy, 26(3), 14-22.
Pakdevong, N., Pongprapa, R. (2012). Effects of Self-Management Program on Health Behavior, Body Weight, Body Mass Index and Waist Circumference of Persons at Risk of Type 2 Diabetes. Journal of Nurses’ Association of Thailand, North-Eastern Division, 30(2), 40-47. (in Thai)
Park, Y.-W., Zhu, S., Palaniappan, L., Heshka, S., Carnethon, M. R., & Heymsfield, S. B. (2008). The Metabolic Syndrome: Prevalence and Associated Risk Factor Findings in the US Population From the Third National Health and Nutrition Examination Survey, 1988-1994. Archives of internal medicine, 163(4), 427-436.
Pascual, J. C., Belinchón, I., & Ramos, J. M. (2015). Use of the Barthel Index, Activities of Daily Living, in Dermatologic Surgery in Patients Aged 80 Years and Older. International Journal of Dermatology, 54(2), 222-226.
Petchroung, N., & Homtes, T. (2011). The Effect of Participatory Promotion Exercise Behavior in the Elderly in Rural Area. Journal of the Royal Thai Army Nurses, 12(2), 7-13. (in Thai)
Pittas, A. G., Joseph, N. A., & Greenberg, A. S. (2004). Adipocytokines and Insulin Resistance. The Journal of Clinical Endocrinology & Metabolism, 89(2), 447-452.
Polit, D. F., & Beck, C. T. (2004). Nursing Research: Principles and Methods (7th ed.). NY: Lippincott Williams & Wilkins.
Praphasil, O. (2009). Effects of Promoting Self-Efficacy in Self-Management Program among Personswith Metabolic Syndrome. Bangkok, Thailand: Thammasat University. (in Thai)
Resnick, B., Orwig, D., Magaziner, J., & Wynne, C. (2002). The Effect of Social Support on Exercise Behavior in Older Adults. Clinical Nursing Research, 11(1), 52-70.
Saelao, K., & Kanungsukkasem, V. (2012). Effects of Arm Swing Exercise and Walking and Walking Exercise Combined with arm Swing Exercise on Health-Related Physical Fitness of the Elderly Women. Journal of Sports Science and Health, 13(1), 92-103.
Sun, D.-L., Wang, J.-H., Jiang, B., Li, L.-S., Li, L.-S., Wu, L., et al. (2012). Metabolic Syndrome vs. Its Components for Prediction of Cardiovascular Mortality: A Cohort Study in Chinese Elderly Adults. Journal of Geriatric Cardiology: JGC, 9(2), 123-129.
Sung, K., & Bae, S. (2012). Effects of a Regular Walking Exercise Program on Behavioral and Biochemical Aspects in Elderly People with Type II Diabetes. Nursing & Health Sciences, 14(4), 438-445
Terathongkum, S. (2017). Arm Swinging ExerciseFor Control Diabetes.Thai Journal of Nursing and Midwifery Practice, 1(4), 36-44. (in Thai)
Van Rooijen, A. J., Rheeder, P., Eales, C. J., & Becker, P. J. (2004). Effect of Exercise Versus Relaxation on Haemoglobin A1C in Black Females with Type 2 Diabetes Mellitus. JM: An International Journal of Medicine, 97(6), 343–351. doi: 10.1093/qjmed/hch061.
Wagner, E. H., Davis, C., Schaefer, J., Von Korff, M., & Austin, B. (1999). A Survey of Leading Chronic Disease Management Programs: Are They Consistent with The Literature?. Managed Care Quarterly, 7, 56-66.
Warburton, D. E. R., Nicol, C. W., & Bredin, S. S. D. (2006). Health Benefits of Physical Activity: The Evidence. CMAJ: Canadian Medical Association Journal, 174(6), 801-809.
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