Date of Award

5-15-2011

Degree Type

Evidence-Based Project Report

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

First Advisor

Kristen L. Mauk

Abstract

Parkinson’s disease (PD) is a neurodegenerative disease that progresses to impair one’s gait and balance, often causing falls and subsequent disability. Current management of PD is aimed at treating the symptoms but is not effective in treating the underlying cause, nor does typical treatment effectively improve postural stability. Exercise can decrease symptoms of the disease and lessen disability. Providers need to find alternatives to the costly physical therapy that is prescribed to treat progressive and debilitating PD. Tai Chi (TC) has been shown to offer an enjoyable exercise routine that participants want to maintain. There is evidence to support the use of TC as a form of exercise as beneficial in improving balance, reducing falls and promoting quality of life in those with PD (Hackney & Earhart, 2008; Klein & Rivers, 2006; Li et al, 2007). The purpose of this evidence-based practice project was to establish a TC program for persons with PD in a small health system. The Stetler model and the Transtheoretical model of change were used to guide this project. The program developed was 12 weeks in length with two TC sessions of one hour per week. The 20 interested participants that met inclusion criteria were randomized into either the intervention or comparison group. Modified Yang Style TC was taught to 12 persons with PD ages 57 - 89 with Hoehn and Yahr Stages I - IV. All participants also kept an exercise and fall history during the 12 week project. Outcome measures to evaluate balance and quality of life were completed pre and post intervention on both groups and included: a) the Berg Balance Scale, b) the Functional Reach Test, c) the Timed Up and Go, and d) the Parkinson’s Disease Quality of Life Questionairre-39. The data was analyzed using the SPSS 18.0 statistical package. Paired t-tests demonstrated a significant difference in the intervention group for all three pre and post intervention balance measures but did not for falls and quality of life. Findings suggested that TC can be a safe, cost effective exercise for persons with PD to improve balance.

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