노인들의 건강상태에 따른 신체기능 및 건강관련 삶의 질과의 관계

배종욱 ( Jong Uk Back ) 한국노인의료복지학회 2010 노인의료복지연구 Vol.1 No.1

The purposes of this study were to categorize the elderly of a local community into the frail and non-frail groups based on the definitions of frailty and to compare the two groups in terms of physical functions, health-related quality of life and ego-integrity. It also aimed to examine the physical, emotional, and sociopsychological characteristics of the frail elderly and to provide basic data to prevent the state of frailty and monitor the frail elderly. Data were gathered from December23, 200S, to January 10. 2009, and research design followed that of a descriptive study. And a structured questionnaire was filled out by 1% elderly people that were aged 65 or older and visited one of 14 halls for aged in D Metropolitan City. The result of survey can be summarized as follows 1. Of the 191 subjects, 37.2% were categorized into the frail group and 62.S% into the non-frail group according to the definitions of frailty. 2. The mean numer of chronic diseaes the frai and non-frail elderly had was 2.17 and 1.59, respectively, which means the frail elderly had significantly more chronic diseases than the non-frai elderly(t=3,6S, p=O.OOO). And there were significant differences between the two groups in subjective health state(p=O.OOO), walking exercise(p=0.000), flexibility exercise(p=O.OOO) and muscle exercise(p=O.OOO). 3. As for the physical functions significant differences were also observed beween them in physical performance(p=0.000), grip strength(p=0.000), walking speed(p=0.000), eye sight(p=0.000), and chewing(p=0.000). The frail elderly significantly more ADL/LADL items than the the non-frail elderly(p=0.000). 4. As for health-related quality of life, statistically significant differences were also found between the two groups in mobility(p=0.000). The mean total scores of heath condition were 47.89 and 81.58 for the frail and non-frail elderly, respectively, which means the former group significantly lower than the 1atter group(p=0.000). In short,37% of the elderly of the local conunmuty turned out to be frail and were lower than the non-frail elderly in terms of health condition, physical functions, health-related quality of life, and ego-integrity. Thus there is a need to identify the frail elderly in a community, understand them in the physical, cmotiona1, and sociopsychological aspects, and provide them with proper interventions to prevent frailty and monitor the frail elderly.

거주유형별 노인의 허약정도, 건강증진 행위 및 주관적 건강상태 비교

권상민(Sang Min Kwon),박정숙(Jeong Sook Park) 한국농촌의학 지역보건학회 2010 농촌의학·지역보건 Vol.35 No.1

본 연구는 재가노인과 시설거주노인의 허약노인 비율, 허약정도, 건강증진행위 및 주관적 건강상태를 비교하여, 거주유형에 따른 허약노인의 특성을 고려한 건강관리전략을 수립하는데 기여하고자 실시한 서술적 조사연구이다. 연구대상자는 65세 이상의 D광역시에 소재한 7개 노인정을 이용하는 재가노인 120명과 5개 무료 및 실비 요양시설에 거주하고 있는 시설거주노인 122명 총242명을 대상으로 2009년 6월 15일부터 8월 2일까지 자료를 수집하였다. 연구도구로는 허약노인선정도구로서 장기요양보험제도에서 사용하는 기초측정표 설문지, Walker 등[18]이 개발한 건강증진생활양식 측정도구를 기반으로 한 건강증진행위 측정도구, Lawston 등[19]이 개발한 주관적 건강상태 측정도구를 사용하여 측정하였다. 수집된 자료는 SPSS Win 15.0을 이용하여 빈도와 백분율, x 2-test, ANCOVA, Scheffe 사후검증으로 분석하였다. 본 연구의 결과는 다음과 같다. 첫째, 재가노인 중 허약노인은 20.8%, 시설거주노인 중 허약노인은 49.2%로 나타났다. 둘째, 시설거주노인의 허약정도는 9.41점으로 재가노인은 6.46점보다 더 심한 것으로 나타났다(p<.05). 재가노인의 건강증진행위점수는 2.12점으로 시설거주노인의 1.99점보다 높았으며(p=0.046), 건강증진행위 하위항목별로 보면 재가노인의 영적성장(p=.008)과 대인관계(p=.043)점수가 시설거주노인보다 높았다. 주관적 건강상태는 재가노인과 시설거주노인 간에 차이가 없었다. 셋째, 허약노인과 비허약노인의 거주유형별 허약정도를 보면, 재가 허약노인과 시설거주 허약노인이 비허약노인보다 허약정도가 심하고, 비허약노인 중에서는 시설거주 비허약노인이 재가 비허약노인보다 허약정도가 심한 것으로 나타났다(p<.05). 건강증진행위점수는 재가 비허약노인과 시설거주 비허약노인이 허약노인보다 높았고, 허약노인 중에서는 재가 허약노인은 시설거주 허약노인보다 높은 것으로 나타났다(p<.05). 주관적건강상태점수는 시설거주 비허약노인과 재가 비허약노인이 허약노인보다 높았고, 허약노인 중에서는 시설거주 허약노인이 재가 허약노인보다 높았다(p<.05). 결론적으로 재가노인과 시설거주노인을 비교해 보았을 때, 시설거주노인 중에서 허약노인의 비율이 높고 시설거주노인의 건강증진행위 수행이 부족하므로 이런 특성을 반영하여 거주유형에 따른 노인 허약예방프로그램의 개발과 적용이 필요하다. Objectives: The purpose of this study was to classify frail and non-frail elderly and to investigate health promoting behaviors and perceived health status in the elderly according to the type of residency. Methods: This was a descriptive study. Data collection was performed from June 15th, 2009 to August 2nd, 2009. The subjects were selected at D city in Korea. Data was analyzed by descriptive statistics, x 2-test, and ANCOVA test with SPSS/Win 15.0 program. Results: 20.8% of the elderly living at home and 49.2% of those living in institution were frail. Frailty of the elderly living in institution was severer than those living at home. Non-frail elderly according to the type of residency showed higher scores of health promotion behavior and perceived health status than frail elderly. The elderly living at home showed higher scores of health promotion behavior than those living in institution. Conclusions: In the comparison study between the elderly living at home and institution, ratio of frail elderly among the elderly living in institution is high and health promotion behaviors are deficient as well. Frail preventive program for the elderly is needed to develop and apply in consideration of these findings.

주간보호센터 시설 이용 인지장애 노인의 노쇠와 영양상태와의 관련성

나우리(Woori Na),김지유(Jiyu Kim),김혜지(Hyeji Kim),이예지(Yeji Lee),손정민(Cheongmin Sohn),장대자(Dai-Ja Jang) 한국식품영양과학회 2021 한국식품영양과학회지 Vol.50 No.1

본 연구는 주간보호센터의 인지장애 노인을 대상으로 노쇠예방 및 관리를 위해 노쇠와 관련된 요인을 도출하고 영양상태와의 관련성을 분석하였다. 노쇠에 유의하게 영향을 미치는 요인을 도출하기 위해 관련 요인을 성별, 연령, 일상생활능력, 욕창위험도(Braden scale), 낙상위험도(Huhn scale), 식욕부진(SNAQ), 영양상태(MNA)로 하여 다중회귀분석을 실시한 결과, 노쇠에 유의하게 영향을 미치는 요인은 연령(β=0.273, P=0.007), MNA(β=-0.244, P=0.047)로 나타났다. 영양상태에 따른 노쇠와의 관련성을 분석하기 위해 MNA 점수에 따라 성별, 연령, 만성질환 개수를 보정하여 전노쇠의 교차비를 분석한 결과 0.788배(95% confidence interval(CI): 0.643-0.965, P=0.021)로 나타났으며, 노쇠의 교차비는 0.654배(95% CI: 0.477-0.879, P=0.008)로 나타났다. 본 연구를 통해 노쇠에 영향을 미치는 주요한 요인이 영양상태임을 보였고, 이는 노쇠 정도에도 관련을 보였다. 따라서 상대적으로 낮은 수준의 돌봄 수준을 가진 주간보호센터의 인지장애 노인의 영양상태 개선을 위한 적극적인 영양관리 방안이 마련되어야 할 것으로 보인다. The cognitive disorder in elderly can cause various malfunctions, so it requires steady caring. Daycare centers for elderly are proper as a facility to take care of the elderly with cognitive disorders that are able to lead a normal life and that need relatively low level of caring. This study analyzed the relation with the frail of the elderly who have cognitive disorders among those who use adult daycare centers in order to provide basic resources of nutrition management to manage and improve their frail. The participants of the study were 88 persons whose Korean version of Mini-Mental State Examination (MMSE-K) is less than 19 among the elderly at three adult daycare centers in Jeollabuk-do. The questionnaire items were gender, age, number of chronic diseases, BMI, hand grip, nutritional status (mini nutritional assessment, MNA) and health status (activity of daily living (K-ADL), pressure ulcer (Braden scale), fall (Huhn scale), appetite assessment (simplified nutritional appetite questionnaire, SNAQ), and K-FRAIL is used for frail assessment. For statistical analysis, the logistic regression was used for the analysis of relation between frail and nutritional condition. The result of analyzing the odds ratio of pre-frail by revising gender, age and the number of chronic diseases according to MNA scores for analysis of frail by nutritional condition was 0.788 (95% confidence interval (CI): 0.643∼0.965, P=0.021), and the odds ratio of frail was 0.654 (95% CI: 0.477∼0.879, P=0.008). This indicates that it is necessary to establish an active nutrition management plan to improve health condition of the elderly with cognitive disorders in elderly care facilities.

Use of the Frailty Index and FRAIL-NH Scale for the Assessment of the Frailty Status of Elderly Individuals Admitted in a Long-term Care Hospital in Korea

Hyuk Ga,Chang Won Won,정희원 대한노인병학회 2018 Annals of geriatric medicine and research Vol.22 No.1

Background: Numerous elderly individuals with multimorbidity and impaired function are admitted in long-term care hospitals (LTCHs) in Korea. In this study, we aimed to describe the frailty status of elderly patients admitted in a LTCH using the FRAIL-NH scale and to identify the clinical relevance of frailty status on clinical outcomes, including death. Methods: We retrospectively reviewed the medical records of 100 elderly patients who were hospitalized and died in an LTCH from March 2011 to February 2017. The monthly assessment results obtained from the inpatients’ data set (IDS) were used as main data sources for the 6-item FRAIL-NH scale and frailty index that was composed of 22 newly established items. Results: The mean frailty index of the patients included in the analysis (mean age, 81.5±7.2 years; men, 53%) was 0.60 (standard deviation [SD], 0.10; range, 0.28-0.80). The distribution of the FRAIL-NH score in this population was in accordance with the 22-item frailty index, which shows a standardized beta of 0.571 (p<0.001, R=0.572). When the patients were categorized based on the FRAIL-NH score, the mean survival durations of the more fail group (FRAIL-NH >10, n=49) and less frail group (FRAIL-NH ≤10, n=51) were 529.3 days (SD, 453.4) and 888 days (SD, 679.9), respectively. Similarly, the frailty index was associated with earlier mortality. Conclusion: Frailty is extremely common in elderly patients admitted in an LTCH and can be easily measured using the FRAIL-NH scale that utilizes the IDS of LTCHs in Korea. Since frailty is associated with earlier mortality, the assessment of frailty status in patients admitted in LTCHs may be helpful in clinical decision-making.

Assessing physical activity for frail elderly living in the community

YueLin Li,Ahyun Ryu,Xing Fan,Jisu Seo,Kyoungok Joo,Moonkyoung Park,Rhayun Song 한국성인간호학회 2021 성인간호학회 학술대회 Vol.2021 No.8

Background: Physical activity (PA) measurement for the frail elderly is essential, yet existing assessment tools are difficult t apply for this population. Objective methods of monitoring PA would be accurate, but costly and limited to a small number of participants. Subjective methods of measuring PA among the elderly often lead to less reliable information, especially among frail elderly. The newly developed Assessment of Physical activity in Frail Older People (APAFOP) focuses on items that have different intensity ratings and better represent typical forms of activity in frail elderly, and closely guarded the occurrence of system error through prevents floor and ceiling effects, which other measurements failed in this regard. Aim(s): The purposes of this study were to translate and validate the APAFOP scale into Korean and Chinese and to find the adaptability of the tool through preliminary research in a sample of frail elderly living in the community. Method(s): The APAFOP was translated into Korean and Chinese versions based on the established guideline for cross-cultural adaptation of self-report measures from Beaton et al. Kendall’s coefficient of concordance W was used to assess the consistency of activity scores between the translated version and the original English version. Result(s): The initial version of APAFOP applied to the sample of frail elderly with translated versions showed a consistency W=0.912 (c2= 9.118, R=0.104) for the Chinese version and W=0.362 (c2=3.261, R=0.660) for the Korean version. The following adjustments were suggested for translated version to improve the consistency: (1) the definition of related activities is required to be more specific, (2) the time line of previous 24 hours should be strictly regulated, (3) a user manual was required to the translated versions to help researchers understand and apply the scale with the standardized protocol. Conclusion(s): This preliminary study was conducted for the first validation and adaptation of the APAFOP in the Korean and Chinese settings and found that the translated version revealed the potential applicability as the modified objective measure of PA among frail elderly living in the community. The further process of cultural adaptation of the APAFOP would be warranted to compare the scale with current objective measures (e.g., pedometer) to establish criterion valigity.

허약노인의 정의 및 허약 선별 평가도구에 관한 체계적 고찰

이경아(Lee, Gyeong A),박지혁(Park, Ji-Hyuk) 대한신경계작업치료학회 2021 재활치료과학 Vol.10 No.3

목적 : 본 연구에서는 허약노인의 정의를 정리하고, 허약노인 선별 시 사용되는 도구들을 분석함으로써허약의 구성 요소를 제시하고자 한다. 연구방법 : 고령자에게 허약 선별 평가가 실시된 문헌을 검색하기 위해 CINAHL, Embase, Medline Complete, PubMed를 사용하였다. 검색어는 “assess” AND “frailty” AND “screening” AND (“frail elderly” OR “elderly”)를 사용하였다. 결과 : 검색 결과로 얻은 539편의 문헌 중 선정기준에 부합하는 11편의 연구가 최종적으로 도출되었다. 본 고찰을 통해 허약은 다차원적 요인의 기능 저하로 인해 발생하며, 허약노인은 ‘건강 악화·기능손상·장애 발생의 가능성이 높고, 생명에 대한 위협 수준이 높은 사람’으로 정의되었다. 11편의 문헌중 허약 선별 평가도구는 총 7종류로 Phenotype of frailty가 5편(45.4%)으로 가장 많이 사용되었다. 7개의 선별 평가도구에서 제시된 허약의 구성 요소는 신체적 요소(신체적 기능), 활동참여(일상생활활동, 수단적 일상생활활동), 영양상태(체중감소, 체질량 지수), 정신적 요소(인지, 정서), 사회적 요소(사회적 상호작용, 사회적지지, 사회적 환경), 전반적 건강 및 나이로 나타났다. 결론 : 본 연구를 통해 허약의 정의 및 구성 요소를 제시하였다. 이는 향후 허약노인 선별을 위한 표준화된선별 평가도구 및 중재 프로그램 개발에 대한 기초자료가 될 것으로 사료된다. Objective : The objective of this study was to present the components of frailty by organizing the definitions of frail elderly and analyzing the tools used to screen them. Methods : This study searched for articles at involved frailty screening assessments in the elderly. Databases including CINAHL, Embase, Medline Complete, and PubMed were searched. The search terms were “assess” AND “frailty” AND “screening” AND (“frail elderly” OR “elderly”). Results : A total of 539 articles were identified by the search and 11 articles were selected. Frailty occurs due to the depressed function of multidimensional factors, and a frail elderly person is defined as one at high risk of health degeneration, functional impairment, and occurrence of disability, and having a high level of threat to life. Seven tools were selected from 11 articles. The most frequently used tool was the frailty phenotype, which was used in five articles (45.4%). The identified components of frailty were physical, activity participation, nutrition, psychological, social, overall health, and age. Conclusion : The results confirmed the definition and components of frailty. This study is expected to contribute to the future development of standardized evaluation tools for screening frail elderly individuals and intervention programs for the management of the frail elderly.

중량부하물 착용 운동이 허약노인의 인체기능, 활동체력 및 삶의 질에 미치는 영향

양정수 ( Jung Su Yang ),황부근 ( Boo Geun Hwang ),고대규 ( Dae Gyu Ko ) 한국운동생리학회(구-한국운동과학회) 2010 운동과학 Vol.19 No.1

본 연구의 목적은 일상생활의 활동이 저하된 허약노인에게 중량부하물 착용 운동이 인체기능, 활동체력 및 삶의 질에 어떠한 영향을 미치는지 알아보고자 하는데 있다. 연구에 참여한 대상은 65~84세의 허약 여성노인 총 32명(운동군: 16명, 대조군: 16명)이었으며, 운동군은 12주 동안 주3회씩 운동을 실시하였다. 이를 통해 얻어진 자료는 SPSS 프로그램을 이용하여 허약노인을 벗어난 인체기능 변화율은 빈도분석과 χ2 검증을, 활동체력 및 삶의 질 변화에 대한 기술통계량(평균, 표준편차)과 이에 대한 평균차 검증은 대응 T-검증 및 독립 T-검증을 실시하였다. 분석결과 운동프로그램 적용 후 인체기능 향상 노인은 62.5%였고, 악력은 우세쪽이 31.9%, 비우세쪽이 31.8%, 눈뜨고 한발들고 서있기는 111.7%, 의자에서 일어나 빠른 걸음으로 돌아오기는 21.9%로 각각 유의하게 향상되었으며, 대조군과 유의한 차이가 있었다. 또한 삶의 질은 비록 대조군과 유의한 차이는 아니었으나, 운동프로그램 적용 후 21.5% 유의하게 향상되었다. 이와 같은 결과로 미루어 볼 때 허약노인의 경우도 운동프로그램 적용을 통해 신체적 기능상태의 개선효과가 뚜렷하게 있음을 알 수 있다. The purpose of this study was to investigate the effects of exercise program with added weight on human function, active fitness and quality of life in the frail elderly. Thirty-two frail female elderly were participated in this study(exercise group: sixteen, control group: sixteen). The exercise program was carried out three per week for 12weeks. Data were analyzed with χ2-test, paired t-test and independent t-test using SPSS program. The results were as follows; Exercise program for the frail elderly showed statistically significant effects on improving human function(62.5%), grip strength(dominant: 31.9%, non-dominant: 31.8%), single leg stand(111.7%), timed up & go(21.9%). Quality of life(21.5%) also showed statistically significant improvement after exercise training, but not statistically significant compared to the control group. From what has been discussed above, exercise program for the frail elderly people was very effective on improving function and quality of life.

지역사회 거주 허약 노인의 우울, 주관적 건강상태가 건강증진행위에 미치는 영향

권상민(Sang Min Kwon),권려원(Ryeo Won Kwon),이혜란(Hye Ran Lee) 한국산학기술학회 2020 한국산학기술학회논문지 Vol.21 No.12

본 연구는 지역사회 거주 허약 노인을 대상으로 우울, 주관적 건강상태, 건강증진행위 정도를 알아보고, 건강증진행위에 영향을 미치는 요인을 확인하기 위해 시도되었다. 연구대상은 D지역 재가 방문 서비스를 받는 대상자 중 65세이상의 허약 노인 164명이었으며, 2020년 1월부터 2월 21일까지 설문조사를 실시하였다. 분석방법은 SPSS/WIN 23.0프로그램을 이용하여 연구대상자의 일반적 특징 분석, independent t-test, one-way ANOVA분석, Scheffe test 사후검정, 상관관계 분석, 단계적 다중회귀분석(stepwise multiple regression)을 실시하였다. 연구결과는 다음과 같다. 우울은 10.67점, 주관적 건강상태는 6.71점, 건강증진행위는 2.59점으로 나타났고, 건강증진 하위영역별 점수는 영양이 2.83점으로 가장 높았고, 스트레스 관리가 2.06점으로 가장 낮았다. 건강증진행위에 대한 우울은 유의한 음의 상관관계가 있었으며, 주관적 건강상태는 양의 상관관계가 있었다. 대상자의 건강증진행위에 영향을 주는 요인은 연령, 교육수준, 우울로 나타났고 이 변인들은 건강증진행위를 73.6% 설명하였다. 본 연구를 통해 우울이 허약 노인의 건강증진행위에 영향을 미치는 요인임을 규명함으로써 허약 노인이 장애 노인으로 진행되는 것을 예방하기 위해 우울 중재가 포함된 다양한 프로그램 통한 허약 노인의 건강증진행위를 지속시키는 것이 중요할 것이다. The purpose of this study was to examine the relationship between depression, perceived health status, and health promotion behavior of frail elderly. The subjects were 164 frail elders aged over 65 registered with the home visiting services of two welfare centers in D city. Data was collected using structured questionnaires from January 2 to February 21, 2020. Data was analyzed using the t-test, ANOVA, Scheffe test, Pearson"s correlation coefficients and stepwise multiple regression with the SPSS/WIN 23.0 program. The mean depression score was 10.67, perceived health status was 6.71, health promotion behavior score was 2.59. Health promotion behavior and depression were negatively correlated and perceived health status was positively correlated . Factors influencing health promotion behavior were age, education level, and depression. These variables accounted for 73.6% of health-promoting behaviors. Based on these results, we conclude that it is important to continue health promotion for the frail elderly through various programs including interventions for depression to prevent the elderly from progressing to disability.

노인 허약 예방프로그램이 경로당 이용 노인의 주관적 건강상태, 우울, 체력 및 삶의 질에 미치는 효과

장경오(Koung-Oh Chang) 한국산학기술학회 2017 한국산학기술학회논문지 Vol.18 No.5

본 연구는 J시 보건소의 노인 허약 예방프로그램이 지역사회 경로당 이용 노인의 주관적 건강상태, 우울, 체력 및 삶의 질 에 미치는 효과를 검증하기 위한 비동등성 대조군 전․후 시차 설계를 이용한 유사실험연구이다. 프로그램에 참여한 대상자는 경로당을 이용하는 노인으로 총 43명으로 이 중 실험군 22명, 대조군 21명 이었으며, 연구기간은 2015년 9월 1일부터 10월 16일까지 8주간, 주 2회 허약노인 예방프로그램을 운영하였다. 자료 분석은 SPSS/WIN 21.0 프로그램을 이용하여 χ2-test와 t-test 등으로 분석하였다. 허약노인 예방프로그램 적용 후 주관적 건강상태(t=-0.35, p=.024), 우울(t=2.76, p=.035), 체력 중 오른손의 압력(t=-3.10, p=.004)과 허리 유연성(t=-2.13, p=.039) 그리고 삶의 질(t=4.36, p<.001)이 차이가 있는 것으로 나타났으며, 두 군 간에 통계적으로 유의한 차이가 있는 것으로 나타났다. 따라서 지역사회 경로당을 이용하는 노인들을 위한 허약 예방프로그램이 노인들의 주관적 건강상태, 우울, 체력 및 삶의 질을 향상시킬 수 있는 유용한 간호중재 프로그램임을 확인 할 수 있었다. This study examined the effects of elderly people’s frail prevention program performed in a senior center located in J-si. The most interesting were the effects on the subjective health status, depression, physical fitness, and quality of life for the senior center participation of the elderly. The nonequivalent control group pre-post-test design was employed. A total of 43 people living in J-si were assigned to either the experimental group (n=22) or control group (n=21). The experimental group was provided with the 8-weeks frail elderly prevention program from September 1 to October 16 in 2015. The data were analyzed with SPSS/WIN 21.0 using descriptive statistics, χ2-test, Fisher’s exact test, and t-test. The results indicated a significant difference between the experimental group and control group with respect to the scores of the subjective health status (t=-0.35, p=.024), depression (t=2.76, p=.035), physical fitness, including right grip strength (t=-3.10, p=.004) and flexibility of the waist (t=-2.13, p=.039), and the quality of life (t=4.36, p<.001). In conclusion, an elderly people’s frail prevention program has a significant effect on the change in subjective health status, depression physical fitness, quality of life, and self-care behavior for senior center participation.

허약한 노인을 위한 고유수용성 신경근 촉진법과 타이치의 적용에 관한 고찰

조정선,배성수,박래준,Cho, Jeong-Sun,Bae, Sung-Soo,Park, Rae-Joon 대한고유수용성신경근촉진법학회 2007 PNF and Movement Vol.5 No.1

Purpose : The purpose of this study was investigated to find the approach in the PNF and TC for frail elder Method : This is a literature study with books, articles, seminal note and books for PNF and TC international course. Result : Neural mechanisms contribute significantly to the gains that occur in the range of motion about a joint with stretching exercises. The participation in a stretch-training program decreases tonic reflex activity and increases flexibility and decreases in force production and muscle activation. Also the stretching-induced decreases may be due to a central nervous system inhibitory mechanism. PNF stretch techniques can increase ROM in older adults. These results may differ from those of studies performed with younger populations because of age-related physiologic changes. TC exercise improves balance control and muscle strength and were associated with reorganized lower extremity neuromuscular patterns. Conclusions : The stretch training program of the PNF and TC contribute to increase the balance and coordination for frail elder. Therefore, The frail elder prevent falling. Further study, The PNF and TC be introduced as the new therapeutic intervention for frail elder.