Quedas no idoso pode ser um evento devastador. Deve ser estimulada a conscientização desse grupo quanto aos benefícios de se manterem ativos. O tai chi chuan é um exercício de prática esportiva moderada que demonstra aumento no equilíbrio, marcha e postura. O objetivo foi avaliar a influência dessa modalidade no equilíbrio, postura e marcha de idosos ativos e saudáveis. Foi realizado um estudo transversal controlado com 76 voluntários, com 51 participantes da atividade para o equilíbrio, idade média de76, 8 anos. Foram utilizados quatro testes do Sistema Balance Master da Neurocom. Para análise dos dados a comparação das idades nos dois grupos utilizou-se o teste de Mann-Whitney (Siegel, 2006). O mesmo teste foi utilizado para todas as comparações entre os dois grupos quanto ao Teste Clínico Modificado da Interação Sensorial para o Equilíbrio (TCISEM), Teste da Caminhada (TC), Teste da Transferência de Sentado para em Pé (TSP) e Teste da avaliação Unipodal (TUP). O grupo do tai chi chuan apresentou valores significativos no equilíbrio e maior capacidade de recuperação. / Falls in the elderly can be a devastating event. Should be encouraged awareness about the benefits of this group to remain active exercises. Tai-chi-chuan is an exercise in sports practice demonstrates that moderate increases in balance, gait and posture. The objective was to evaluate the influence of this modality in the balance, posture and gait of elderly people active and independent. Was conducted a cross-controlled study with 76 volunteers, with 51 participants in the activity for the balance, average age de76, 8 years. We used four tests of the system\'s Balance Master Neurocom.For analysis of the data to compare the two age groups using the Mann-Whitney test (. Siegel, 2006). The same test was used for all comparisons between the two groups on the Modified Clinical Test of Sensory Integration for the balance (TCISEM), the Walk Test (CT), Test of the Transfer of sitting for standing (TSP) and Test of the evaluation Leg (TUP). The group of tai chi chuan showed significant values in the balance and gait.

Part 1. Characteristics of foot movement in Tai Chi exercise. The performance of 16 experienced Tai Chi practitioners demonstrating a whole set of 42-form Tai Chi movements were recorded with two cameras. The APAS motion analysis system was used to identify the foot supporting and stepping characteristics during the practice. Seven foot support patterns and six step directions were identified. The results revealed that compared with normal walking, Tai Chi movement had more double support and less single support total duration. The duration of each support pattern was longer and movement from one pattern to the next was slow. The duration of each step direction was short, and changes of direction were frequent. It was expected that support patterns changed slowly, and combined with various step directions, they were found to be better than those of walking in simulating the gait challenges that may be encountered in daily activities. / Part 2: The plantar pressure distribution during Tai Chi exercise. The purpose of this study is to describe and quantify the plantar pressure distribution characteristics during Tai Chi exercise and to explain the beneficial effects of Tai Chi on balance control and muscle strength as compared with normal walking. Sixteen experienced Tai Chi practitioners participated in this study. Five typical Tai Chi movements represented by stepping forward, backward, sideways, up-down, and fixing could be isolated from the whole set of 42-form Tai Chi. The pressure-time integral, ground reaction force, displacement of center of pressure during the performance of the five typical movements were recorded and analyzed by the Pedar-X insole system (Germany). Results showed that during Tai Chi movements, the loading of the first metatarsal head and the great toe were significantly greater than in other regions (p<0.05). The ground reaction forces varied between the Tai Chi movements and normal walking. Compared with normal walking, the locations of the center of pressure in the Tai Chi movements were significantly more medial and posterior at initial contact (p<0.05), and were significantly more medial and anterior at the end of contact with the ground (p<0.05). The displacements of the center of pressure were significantly wider (p<0.05) in the mediolateral direction in the forward, backward and sideways Tai Chi movements. The displacement was significantly larger (p<0.05) in the anterposterior direction in the forward movement. The plantar pressure characteristics of Tai Chi movements found in this study may be one of the important factors for Tai Chi's improvement of balance control and muscle strength. / Part 3. The duration and plantar pressure distribution during one-leg stance in Tai Chi exercise. The aim of this study is to quantify the one-leg stance duration and plantar pressure distribution during the one-leg stance in Tai Chi and to try to elaborate on its probable effects on the ability to balance on one leg. Sixteen experienced Tai Chi practitioners participated in this study. The Novel Pedar-X insole system (Germany) was used to record the plantar forces during the execution of a set of 42-form Tai Chi movements and during normal walking. The one-leg stance duration and plantar pressure distribution during the one-leg stance were analyzed. Results showed that in Tai Chi, the total duration spent in the one-leg stance was less (p<0.05), the duration of each one-leg stance was longer (p<0.01) and the medial-lateral displacement of the center of pressure was greater (p<0.05) than during normal walking. The peak pressure and pressure-time integral of the second and third metatarsal heads and the fourth and fifth metatarsal heads were significantly greater (p<0.05) than those of other plantar regions during the one-leg stance in normal walking; whereas the peak pressure and pressure-time integral of the first metatarsal head and the great toe were significantly greater (p<0.05) than those of other plantar regions during the one-leg stance in Tai Chi. The longer duration of each one-leg stance and the plantar pressure distribution characteristics during the one-leg stance in Tai Chi may be associated with an improved ability to balance on one leg. / Part 4. The muscle contraction characteristics of the lower extremities during Tai Chi exercise. The objective of this study is to examine the muscle contraction characteristics of the lower extremities during Tai Chi exercise and to explain the beneficial effect of Tai Chi on the improvement of muscle strength. Sixteen experienced Tai Chi practitioners participated in this study. Five typical Tai Chi movements, represented by stepping in forward, backward, sideways, up-down and fixing were selected. The electromyographic activity of the rectus femoris, semitendinosus, gastrocnemius, and anterior tibialis muscles were recorded by Delsys electromyography measurement system (USA) during the performance of five typical Tai Chi movements. (Abstract shortened by UMI.) / Mao Dewei. / "August 2006." / Adviser: Youlian Hong. / Source: Dissertation Abstracts International, Volume: 68-03, Section: B, page: 1598. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2006. / Includes bibliographical references (p. 102-112). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in English and Chinese. / School code: 1307.

Quedas no idoso pode ser um evento devastador. Deve ser estimulada a conscientização desse grupo quanto aos benefícios de se manterem ativos. O tai chi chuan é um exercício de prática esportiva moderada que demonstra aumento no equilíbrio, marcha e postura. O objetivo foi avaliar a influência dessa modalidade no equilíbrio, postura e marcha de idosos ativos e saudáveis. Foi realizado um estudo transversal controlado com 76 voluntários, com 51 participantes da atividade para o equilíbrio, idade média de76, 8 anos. Foram utilizados quatro testes do Sistema Balance Master da Neurocom. Para análise dos dados a comparação das idades nos dois grupos utilizou-se o teste de Mann-Whitney (Siegel, 2006). O mesmo teste foi utilizado para todas as comparações entre os dois grupos quanto ao Teste Clínico Modificado da Interação Sensorial para o Equilíbrio (TCISEM), Teste da Caminhada (TC), Teste da Transferência de Sentado para em Pé (TSP) e Teste da avaliação Unipodal (TUP). O grupo do tai chi chuan apresentou valores significativos no equilíbrio e maior capacidade de recuperação. / Falls in the elderly can be a devastating event. Should be encouraged awareness about the benefits of this group to remain active exercises. Tai-chi-chuan is an exercise in sports practice demonstrates that moderate increases in balance, gait and posture. The objective was to evaluate the influence of this modality in the balance, posture and gait of elderly people active and independent. Was conducted a cross-controlled study with 76 volunteers, with 51 participants in the activity for the balance, average age de76, 8 years. We used four tests of the system\'s Balance Master Neurocom.For analysis of the data to compare the two age groups using the Mann-Whitney test (. Siegel, 2006). The same test was used for all comparisons between the two groups on the Modified Clinical Test of Sensory Integration for the balance (TCISEM), the Walk Test (CT), Test of the Transfer of sitting for standing (TSP) and Test of the evaluation Leg (TUP). The group of tai chi chuan showed significant values in the balance and gait.

No / Dementia is a common illness that is increasing in frequency and set to challenge the resources and expertise of health and social care services over the coming years. Increasingly, there has been interest in the management of behavioural and psychological symptoms of dementia (BPSD), as they are both common and associated with a range of negative outcomes. BPSD are associated with the admission of people with dementia to care homes. Limited resources and lack of knowledge in permanent care settings often lead to BPSD being managed with antipsychotic medications, which are associated with significant morbidity and mortality. There is evidence for the benefits of exercise within care home settings, although only a few studies include those with cognitive impairment. Tai Chi is a mind-body exercise combining relaxed physical movement and meditation, and has been suggested to have many health benefits. This article discusses the rationale and available options for treating BPSD and the current practice and reviews the literature regarding the benefits of exercise and, in particular, Tai Chi in the management of BPSD.

Yeung, Pui Yee. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2009. / Includes bibliographical references (leaves 131-145). / Abstract and some appendixes also in Chinese. / ABSTRACT --- p.i / ABSTRACT (in Chinese) --- p.iii / DECLARATION OF ORIGINALITY --- p.iv / ACKNOWLEDGEMENTS --- p.v / RESEARCH-RELATED PRESENTATIONS AND AWARD --- p.vi / TABLE OF CONTENTS --- p.vii / LIST OF ABBREVIATIONS --- p.xi / LIST OF FIGURES --- p.xii / LIST OF TABLES --- p.xiii / Chapter CHAPTER 1 --- INTRODUCTION --- p.1 / Chapter CHAPTER 2 --- LITERATURE REVIEW --- p.3 / Chapter 2.1 --- Incidence and prevalence of falls in older people --- p.4 / Chapter 2.1.1 --- Incidence and prevalence in western countries --- p.4 / Chapter 2.1.2 --- Incidence and prevalence in Hong Kong --- p.4 / Chapter 2.2 --- Causes and risk factors for falls --- p.5 / Chapter 2.2.1 --- Causes for falls --- p.5 / Chapter 2.2.2 --- Risk factors for falls --- p.6 / Chapter 2.3 --- Consequences of falls --- p.7 / Chapter 2.3.1 --- Individual perspective --- p.7 / Chapter 2.3.2 --- Impact on health service and society --- p.9 / Chapter 2.4 --- Intervention and prevention strategies --- p.10 / Chapter 2.4.1 --- Effective interventions and preventive approaches --- p.10 / Chapter 2.4.2 --- Areas of uncertainty for interventions and prevention approaches --- p.19 / Chapter 2.5 --- Existing efforts in intervention and prevention --- p.20 / Chapter 2.5.1 --- Worldwide levels and collaborations among various countries --- p.20 / Chapter 2.5.2 --- Current services for falls prevention in Hong Kong --- p.23 / Chapter 2.6 --- Criteria contributing to successful intervention and risks modification --- p.27 / Chapter 2.6.1 --- Identification of elderly fallers at Accident & Emergency Department --- p.28 / Chapter 2.6.2 --- Selection of the proved effective programme to those likely to benefit --- p.29 / Chapter 2.6.3 --- Uptake and adherence of the target fallers to the selected programmes --- p.30 / Chapter 2.7 --- Current gaps in study of services for elderly fallers in Hong Kong --- p.31 / Chapter CHAPTER 3 --- METHODOLOGY --- p.32 / Chapter 3.1 --- Research objectives --- p.33 / Chapter 3.2 --- Operational definition of falls --- p.33 / Chapter 3.3 --- Study design --- p.34 / Chapter 3.3.1 --- Diagrammatic illustration of the study design --- p.35 / Chapter 3.3.2 --- "Subjects, assessors and setting" --- p.37 / Chapter 3.3.3 --- Sources of data collection --- p.38 / Chapter 3.3.4 --- Questionnaire and assessment instruments --- p.39 / Chapter 3.3.5 --- Referrals and interventions --- p.49 / Chapter 3.4 --- Plan of data analysis --- p.52 / Chapter CHAPTER 4 --- RESULT --- p.55 / Chapter 4.1 --- Progression of elderly fallers --- p.56 / Chapter 4.2 --- Characteristics of all elderly fallers presented to A&E --- p.58 / Chapter 4.2.1 --- Demographics --- p.58 / Chapter 4.2.2 --- Rate of hip fracture --- p.58 / Chapter 4.2.3 --- Seasonal variation for occurrence of falls --- p.58 / Chapter 4.2.4 --- Subsequent one-year mortality --- p.59 / Chapter 4.2.5 --- Subsequent one-year occurrence of falls with presentation to A&E --- p.59 / Chapter 4.2.6 --- Subsequent one-year hospitalization and length of stay --- p.59 / Chapter 4.3 --- Profile of elderly fallers who received comprehensive falls assessment --- p.63 / Chapter 4.3.1 --- Demographics --- p.63 / Chapter 4.3.2 --- "Circumstances, consequences and past history of falls" --- p.67 / Chapter 4.3.3 --- Health and functional profile --- p.75 / Chapter 4.4 --- Uptake of interventions or referrals by elderly fallers --- p.89 / Chapter 4.4.1 --- Uptake rate of various interventions or referrals --- p.89 / Chapter 4.4.2 --- Reasons for refusing interventions or referrals --- p.89 / Chapter 4.5 --- Comparison between recurrent fallers and non-recurrent fallers --- p.91 / Chapter 4.5.1 --- Co-morbidity between recurrent fallers and non-recurrent fallers --- p.91 / Chapter 4.5.2 --- Functional profile between recurrent fallers and non-recurrent fallers --- p.91 / Chapter 4.6 --- Comparison between injurious falls and non-injurious falls --- p.93 / Chapter 4.6.1 --- Co-morbidity between fallers with resultant injury and fallers without injury --- p.93 / Chapter 4.6.2 --- Functional profile between fallers with resultant injury and fallers without injury --- p.93 / Chapter 4.7 --- Comparison of the profiles between the elderly fallers and the general older population in Hong Kong --- p.95 / Chapter 4.7.1 --- Comparison in demographics --- p.95 / Chapter 4.7.2 --- Comparison in self-perceived health --- p.95 / Chapter 4.7.3 --- Comparison in lifestyle factors --- p.95 / Chapter 4.7.4 --- Comparison in BMI --- p.96 / Chapter 4.7.5 --- Comparison in morbidity --- p.96 / Chapter 4.7.6 --- Comparison in number of disease --- p.97 / Chapter 4.7.7 --- Comparison in medication use --- p.97 / Chapter 4.8 --- Comparison between fallers attended and those who did not attend the falls assessment clinic in terms of the subsequent one-year results --- p.102 / Chapter 4.8.1 --- Comparison in subsequent one-year mortality --- p.102 / Chapter 4.8.2 --- Comparison in subsequent one-year recurrent falls with presentation to A&E --- p.102 / Chapter 4.8.3 --- Comparison in subsequent one-year hospitalization and LOS --- p.103 / Chapter 4.9 --- Validation of a simple screening tool adopted from the Mr. Os (Hong Kong) study by the result of this study --- p.106 / Chapter CHAPTER --- 5 DISCUSSION --- p.108 / Chapter 5.1 --- Profile of elderly fallers presenting to A&E and its implications to health care planning for the elderly --- p.110 / Chapter 5.1.1 --- Profile of fallers in terms of subsequent one-year results --- p.110 / Chapter 5.1.2 --- Profile of fallers compared with general older population --- p.111 / Chapter 5.1.3 --- Implications on health care planning for the elderly --- p.113 / Chapter 5.2 --- Acceptability of various interventions and referrals by fallers and its implications to health care planning for the elderly --- p.116 / Chapter 5.2.1 --- Uptake rates for various interventions and referrals --- p.116 / Chapter 5.2.2 --- Views towards various interventions and referrals by fallers --- p.117 / Chapter 5.2.3 --- Implications on health care planning for the elderly --- p.117 / Chapter 5.3 --- Discussion of other findings --- p.120 / Chapter 5.3.1 --- Seasonal variation in occurrence of falls --- p.120 / Chapter 5.3.2 --- "Circumstances, consequences and past history of falls" --- p.122 / Chapter 5.3.3 --- Comparison between recurrent fallers and non-recurrent fallers in terms of co-morbidity and functional profile --- p.123 / Chapter 5.3.4 --- Comparison between fallers with resultant injury and fallers without injury in terms of co-morbidity and functional profile --- p.123 / Chapter 5.3.5 --- Comparison between fallers attended and those who did not attend the falls assessment clinicin terms of subsequent one-year results --- p.124 / Chapter 5.3.6 --- Usefulness of the risk profile of recurrent falling adopted from Mr. Os (Hong Kong) Studyin screening the fallers with high risk of falling --- p.125 / Chapter 5.4 --- Limitations --- p.126 / Chapter 5.5 --- Recommendations for further research --- p.128 / Chapter CHAPTER 6 --- CONCLUSION --- p.129 / REFERENCES --- p.131 / APPENDICES / Appendix 1 Assessment Form used in Falls Assessment Clinic --- p.146 / Appendix 2a Scale for Subjective Socioeconomic Status -English version --- p.151 / Appendix 2b Scale for Subjective Socioeconomic Status -Chinese version --- p.152 / Appendix 3a Simple Physical Activity Questionnaire -English version --- p.153 / Appendix 3b Simple Physical Activity Questionnaire -Chinese version --- p.155 / Appendix 4 Modified Barthel Index --- p.157 / Appendix 5 Rating Form for Impairment in IADL --- p.159 / Appendix 6 Mini-Mental State Examination -Cantonese version (CMMSE) --- p.160 / Appendix 7 Geriatric Depression Scale - Four-item short form (GDS-4) --- p.162 / Appendix 8 Berg Balance Scale - short form (BBS short form) --- p.163

Before the main study commenced, empirical work was conducted to establish and validate the Chinese version of the Satisfaction with the Nursing Home Instrument (SNHI-C), which was an instrument used to measure resident satisfaction in the main study. Testing was conducted on a cluster sample of 330 residents from 16 elderly residential care homes in Hong Kong. Findings demonstrated that the SNHI-C had good content validity with an index of .93. It also demonstrated high construct validity by having significant correlation with depression (r = -.42, p < .001), the physical component of health-related quality of life (r = .16, p < .05), the mental component of health-related quality of life (r = .41, p < .001), and global quality of care (r = .49, p < .001). The SNHI-C also demonstrated satisfactory internal consistency and good stability by having a Cronbach's alpha of .79 and intra-class correlation coefficient of .94, respectively. / Current study adds new knowledge to the psychosocial health benefits of Tai Chi for the residents living in elderly residential care homes. Findings were discussed in relation to previous research findings and in the context of elderly residential care setting. The present study has the strength of evaluating the health benefit of Tai Chi using a more stringent research design, in comparing with the previous studies. Limitations of this study included the use of convenience sampling, without random assigning participants into groups, and inadequacy in quantifying Tai Chi learning. The implications of the findings support incorporating Tai Chi training in routine elderly residential care. Based on the study experience, recommendations for a successful implementation of a Tai Chi program were provided. Future research is advised to further explore the most beneficial mode of a Tai Chi program particularly for the elderly residential care home residents. Evaluation of its effect over a longer period of time and using various approaches are also suggested for obtaining a more comprehensive picture of the health benefit of Tai Chi. Finally, it is also worthwhile to investigate the experience of practicing Tai Chi through a qualitative approach to complement present findings. / Like many areas in the world, Hong Kong is facing an aging population. To accommodate the increasing elderly population, particularly those who are frail and have limited family support, elderly residential care homes are growing in size and number. Despite of the escalating demand, it has been documented repeatedly that the nature of residential living can predispose the residents to a number of psychosocial challenges. Study findings highlight consistently that residents are prone to experience lowered self-esteem, poor social support, and poor health-related quality of life. Providing psychosocial support to the residents is an important dimension in elderly residential care. It is because older residents, despite of their deteriorating physical functions that cannot be cured, can still have the potential to live with optimum psychosocial well-being. Even though a number of interventions have been considered in the past to address the residents' psychosocial needs, evaluation on the effectiveness of these interventions is inconclusive. There is still a paucity of evidence suggesting a promising intervention that can promote psychosocial health for the residents. Given the general consensus that exercise is beneficial for the psychosocial health, and considering that the characteristics of Tai Chi are particularly suitable for the elderly population, Tai Chi is considered as a possible means to promote psychosocial health for the residents. This study aimed to examine the psychosocial effects of a Tai Chi program on the residents of the elderly residential care homes. / The main study adopted a non-equivalent pretest-posttest control group design to examine the psychosocial effect of Tai Chi on residents of elderly residential care homes. Residents were recruited from six elderly residential care homes in Hong Kong by convenience sampling. The experimental group (n = 66) joined a 26-week Tai Chi program three times per week with each session lasted for one hour. The control group (n = 73) continued their daily activities as usual. Outcome variables encompassing state self-esteem, the physical component of health-related quality of life, the mental component of health-related quality of life, social support network, and social support satisfaction were assessed at baseline, the 13th and 26th week of the intervention period. Doubly multivariate analysis of covariance was performed to examine the effect of the Tai Chi program. / With the confounding effect of resident satisfaction controlled, findings demonstrated that participants in the experimental group experienced greater improvement in the psychological composite outcome of state self-esteem, the physical component of health-related quality of life, and the mental component of health-related quality of life (p < .05). No significant changes were detected in any of the three individual psychological outcome variables. Non-significant result was also found regarding the social effect of Tai Chi program on the participants. / Lee Yin King. / "May 2006." / Advisers: Diana Lee; Jean Woo. / Source: Dissertation Abstracts International, Volume: 68-03, Section: B, page: 1558. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2006. / Includes bibliographical references (p. 249-269). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in English and Chinese. / School code: 1307.

Chan, Wai Kiu. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2011. / Includes bibliographical references (leaves 233-256). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract and appendix also in Chinese.

Hong Wai Lin. / "July 2004." / Thesis (Ph.D.)--Chinese University of Hong Kong, 2004. / Includes bibliographical references (p. 181-211) / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Mode of access: World Wide Web. / Abstracts in English and Chinese.