through Huantiao (GB30), Weizhbng (BL40), Yanglingquan (GB34), Shenshu (BL23), Sanyinjiao (SP6). Tonic acupuncture stimulation (2 Hz, 10 Hz, 10-30 uA) and dispersal acupuncture stimuation (10 Hz, 10 - 50 uA) were applied, with the therapy course of 30 min/episode, 1 time/day, for 10 days. The results showed that the rate of patients in both sexes were equal, which occurred at all ages, mostly at the age of over 60. The number of manual labour
patients accounted for 70.8%, which was higher than that of brain workers (29.2%).
After electroacupuncture treatment, the rate of patients reached at level A (excellent) was 80.77%, B (good) was 13.46%, C (moderate) 5.77%. According to Schober scale, there were 84.61% of patients recorved to normal level (0 score), and this ratio was 65.38% in Neh scale.
Key words: electroacupuncture, rheumatoid lumbago
TAC DUNG CUA TAP LUYEN THAI CUC QUYEN LEN MOT SO CHl TIEU SINH LY VA NANG LUC THE CHAT O NGUOI CAO TUOI
Hoang Thj Ai Khue, Nguyin Thj Kim Thoan, Dau Binh Huang
Trir&ng Bai hpc Vinh Muc tieu cua nghien cdu la tim hieu tac dung cua tap luyen thai cue quyen len mpt so chi tieu sinh ly va nang luc the chat d nguoi cao tuoi. Ket qua nghien ciru cho thay, tap luyen thai cue quyen cd tac dung cai thien chdc nang tuan hoan va hd hap nhw giam tan so tim va huyet dp; tang dung tich song va thoi gian nin thd toi da; nang cao nang lux: the chat d nguoi cao tudi nhu sue nhanh, sue manh co va thang bang; su khac biet cac chi tieu nay o thoi diem truoc va sau 3 thang tap luyen cd y nghia vdi p < 0,05-0,001.
TCr khoa: Thai Cue Quyen, nguoi cao tuoi 1.DATVAN OE
0 Viet Nam, theo dy bao ciia Vien nghien cdu ngu'di cao tuoi (NCT), den nam 2029 (theo [1]), ti le NCT se chiim 16,8 % va la mpt trong nhdng nude co ti le dan so hoa gia cao. Tai Thanh pho Vinh, theo so lieu dilu tra cua phong thong ke dan so, din nam 2009 co dan so 296.806 ngydi, trong do NCT co so lypng 25.007, chiim ti le 8,43% [2],
Tuoi cang cao cac bp phan trong co thi cang bj lao hoa va dl mlc cac benh tat. Theo thong ke ciia WHO td cac nghien cdu vi tinh
hinh benh tat d NCT da cho thay, hien nay NCT tren thi gidi dang gap cac benh phi biin nhir thiiu nang mach vanh, tang huyit ap (THA), Parkinson, Alzheimer, benh phoi tic nghen man tinh, hen phi quan, ung thir, loang xu>ong, thoai hoa khdp... [3], [5], [7], [9]. Trong do benh THA diroc xem la benh co ty le td vong hang diu va dupe vi nhir " ke gilt ngudi thlm lang". Tai Thanh pho Vinh, theo so lieu cong bo cua Hoang Thj Ai Khue nam 2009, co tdi 40,53% nam va 38,98 % nd cao tuoi bj tang huyit ap [1].
Nhieu tac gia khi nghien cdu tac dung cua luyen tap TDTT da dira ra nhan djnh:
luyen tap TDTT deu dan, hgp ly, khoa hgc khong nhung co tac dung tang cirdng sdc khoe ma con co tac dung phong, chda cac benh. Cac bai tap the due mang tinh dai chung va phii hgp vdi sdc khoe ngirdi cao tuoi la di bo, chay nhe, yoga, tam nang dirdng sinh, thai eye quyen dirdng sinh [2], [3], [5].
Thai eye quyen (TCQ) la mdn vd co truyen dan tdc ciia Trung Quoc cd td 2000 nam trudc, dirge ngudi gia dira vao tap luyen khoang 300 nam gan day. Thai cue quyen gom 2 loai: loai TCQ chien dau va TCQ dudng sinh. Nam 2006, UNESCO cdng nhan TCQ cua Trung Quoc la di san van hoa phi vat the cua the gidi. 6t Viet nam, TCQ dirge bien soan vdi cac ddng tac trirdng quyen uyen chuyen, cham rai ket hgp vdi dieu hoa hoi thd va khi huyet (dirong sinh) nen cdn dirge ggi la Thai eye quyen dirdng sinh.
Nha.m gdp phan cham sdc NCT ndi chung va sdc khoe NCT bj THA ndi rieng, chung tdi tien hanh nghien cdu nay vdi muc tieu danh gia tac dung cua tap luyen TCQ len mpt so chi so tim mach, hd hap va nang lyc the chat d ngirdi cao tuoi.
2. Bdi TITONG VA PHIFONG PHAP NGHIEN CU'U
2.1. Ddi tirgng nghien cdu
50 nir cao tuoi bj tang huyet ap giai doan I (phan loai theo WHO/ISH 2004) va dirge chia thanh 2 nhdm: nhdm doi chdng (DC) va nhdm thyc nghiem (TN), mdi nhdm 25 ngirdi; tuoi trung binh cua nhdm DC la 66,5 + 4,8, cda nhdm TN la 65,8 ± 4,2.
2.2. Phirong phap nghien cdu
- Phuong phap xac dinh mpt so chi so tim mach
+ Xac djnh tan so tim bang each bat mach d mach quay. Don vj: nhjp/phiit.
+ Xac djnh huyet ap bang phirong phap Korovkov. Don vj: mmHg.
- Phwong phap xac djnh mpt so chi so ho hap
+ Xac djnh tan so thd: dem d tir the nam bang each quan sat cd ddng bung va ngyc.
Don vj do: nhjp/phut.
+ Do dung tich song (Vital Capacity - VC) bang phe dung ke. Don vj do: lit.
+ Xac djnh thdi gian nhjn thd toi da (TGNTTO): doi tirgng hit vao that sau roi kep mui, nhjn thd toi da. Don vj do: giay (s).
- Phuong phap xac djnh sue nhanh bang test leo bac "8 foot up and go test" cua Jones va Rikli (My) [9]. Thanh tich tinh theo so giay (s).
- Phuong ph£p xac dinh sdc manh ch§n bang stair test [8] (hinh 1).
Trong luong
co1 the (kg) H: Chieu cao
(cm)
Hinh 1. So do test bac thang (Margaria staircase test) - Phuong phap xac dinh thang bang tTnh
bang test Romberg [6], Don vj (giay).
- Phirong phap xir ly so lieu: so lieu nghien cdu thu dugc xd ly tren phan mem Epi Info 6.0.
2.3. Thiet ke nghien cdu
- Nhom DC: tap luyen theo thoi quen ti>
trudc.
- Nhom TN: dugc hudng dSn tap Thai cue quyen 24 thdc, thdi gian thuc hien moi bai 24 thdc het 5 phut 30 giay den 5 phut 44 giay.
Bang 1. Mot so chi so tim mach cua nd
Thdi gian tap luyen 50 phut/lan/ngay; gom 10 phut khdi dong + 30 phut tap TCQ (5 lan lap lai va quang nghi 30 giay - 1 phut) + 10 phut tap cac dpng tac dieu hoa; tap 4 lan/tuan vao cuoi buoi chieu va tap trong thdi gian 3 thang.
3. KET QUA NGHIEN CU'U
Ket qua nghien cdu ve tac dung cua tap luyen TCQ len mpt so chi so tim mach, ho hap va nang luc the chat d NCT dugc trinh bay tren cac bang 1-3.
Ket qua trong bang 1 cho thay d thdi cao tuoi tai thdi diem trudc va sau 3 thang.
Chi so Thdi diem Nhom DC
(n=25) (a) Nhom TN
(n=25) (b) Pa-b Tan so (TS) tim
(nhip/phiit)
Trudc 3 thang (1) 78,9 ±8,1 79,5 ±7,6 >0,05 Tan so (TS) tim
(nhip/phiit) Sau 3 thang (2) 78,5 ±8,0 76,7 ±7,9 < 0,05 Tan so (TS) tim
(nhip/phiit)
Pi -2 > 0,05 < 0,01
Huyet ap tam thu (HATT) {mmHg)
Trudc 3 thang (3) 152,5 ± 14,2 153,9 ± 13,0 > 0,05 Huyet ap tam thu
(HATT) {mmHg) Sau 3 thang (4) 153,1 ± 13,4 140,1 ± 13,8 < 0,001 Huyet ap tam thu
(HATT) {mmHg)
P3-4 >0,5 < 0,001
Huyet ap tam truong (HATTR) (mmHg)
Trwc 3 thang (5) 97,6 ± 10,2 96,2 ±9,7 > 0,05 Huyet ap tam truong
(HATTR) (mmHg) Sau 3 thang (6) 97,9 ±9,4 90,5 ± 10,3 < 0,001 Huyet ap tam truong
(HATTR) (mmHg)
P5-6 > 0,05 < 0,001
diem trudc 3 thang, TS tim, HATT, HATTR thang; con nhom DC cac chi tren hau nhir cua nhom DC va nhom TN tuong dirong thay ddi khong dang ke. Tai thdi diem sau 3 nhau (p > 0,05). Sau 3 thang, d nhom TN, thang, TS tim cua nhom TN thap hon nhom cac chi so tim mach trong nghien cdu deu DC vdi p < 0,05; con cac chi so HA deu thap giam vdi p < 0,01 - 0,001 so vdi trirdc 3 hon nhom DC vdi p < 0,001.
Bang 2. Mot so chi so ho hap cua nd cao tuoi tai thdi diem trirdc va sau 3 thang.
Chi so Thdi diem Nhdm DC
(n=25) (a) NhdmTN (n=25)
(b) Pa-b
TS thd (Ian/phut) Trirdc 3 thang (3) 19,01± 3,6 19,3 ±3,0 > 0,05 TS thd (Ian/phut) Sau 3 thang (4) 19,00 ±3,5 18,2 ±3,3 < 0,05 TS thd (Ian/phut)
P3-4 > 0,05 < 0,05
Dung tich song (lit) Trudc 3 thang (5) 2,81 ±0,44 2,82 ±0,49 > 0,05 Dung tich song (lit) Sau 3 thang (6) 2,81 ±0,45 3,04 ±0,43 < 0,05 Dung tich song (lit)
P4-5 > 0,05 < 0,05
Thdi gian nln thd toi da (giay)
Trirdc 3 thang (9) 26,8 ± 4,9 27,2 ±4,6 > 0,05 Thdi gian nln thd
toi da (giay) Sau 3 thang (10) 27,6 ±4,0 36,8 ±5,2 < 0,001 Thdi gian nln thd
toi da (giay) P9 - 10 > 0,01 < 0,001 Ket qua tren bang 2 cho thay d nhdm
DC, sau 3 thang, cac chi so trong nghien cdu thay doi khdng dang ke so vdi thdi diem trirdc 3 thang. Trong khi dd d nhdm TN, sau 3 thang tap TCQ, chi so dung tich song tang cd y nghTa vdi p < 0,05; tan so thd giam vdi p < 0,05; thdi gian nln thd toi da lai tang dac biet cd y nghTa vdi p < 0,001.
Tai thdi diem trirdc 3 thang, cac chi so nghien cdu ciia nhdm DC va TN tirong dirong nhau (p > 0,05); nhirng tai thdi diem sau 3 thang luyen tap, tan so thd va dung tich song nhdm TN cao hon nhdm DC vdi p
< 0,05; thdi gian nln thd toi da cua nhdm TN cd sir khac biet rd ret dac biet cd y nghTa vdi p < 0,001.
Bang 3. Mot so chi so ve nang lire the chat 0 nd cao tuoi tai thdi diem trirdc va sau 3 thang.
Chi so Thdi diem Nhdm DC
(n=25) (a)
Nhdm TN
(n=25) (b) Pa-b Sdc nhanh
{Qiay)
Trirdc 3 thang (1) 5,45 ± 1,2 5,42 ±1,3 > 0,05 Sdc nhanh
{Qiay) Sau 3 thang (2) 5,44 ±1,1 4,17 ± 1,0 < 0,001 Sdc nhanh
{Qiay)
P1-2 > 0,05 < 0,001
Sdc manh chan (Watt)
Trudc 3 thang (3) 214,37 ±22,6 212,84 ±21,8 > 0,05 Sdc manh chan
(Watt) Sdc manh chan Sau 3 thang (4) 212,56 ±21,7 245,92 ±20,0 < 0,001 (Watt)
P3-4 > 0,05 < 0,001
Thang bang tTnh (Qiay)
Trirdc 3 thg (5) 7,31 ±1,15 7,25±1,14 > 0,05 Thang bang tTnh
(Qiay) Sau 3 thg (6) 7,29 ±1,09 9,65 ±1,08 < 0,001 Thang bang tTnh
(Qiay)
P4-5 > 0,05 < 0,001
So lieu d bang 3 cho thay d thai diem trudc 3 thang, thanh tich sdc nhanh, manh va thang bang tTnh cua nhom DC va nhom TN khac nhau khong dang ke. Sau 3 thang tap TCQ, sdc nhanh, sdc manh chan va thang bang tTnh cua nhom TN duoc cai thien dang ke, tat ca su khac biet so vdi thdi diem trudc tap luyen vdi p < 0,001.
4. BAN LUAN
Thai cue quyen la mpt mdn vd vda la mdn vu the due, vda la thien ddng vdi cac dpng tac nhjp nhang va uyen chuyen. Vdi dac diem ddng hinh hpc cua men TCQ dirdng sinh, mpt chd dpng thi tat ca mpi chd deu dpng, lam cho khi huyet dugc liru thdng toan co the, cac mach mau cua dpng mach se hoat dpng dieu dp, thiic day qua trinh tuan hoan mau. Sir co dudi cua cac dpng tac lam nen dng suat cue bp ben treng cac mach mau giup cp rda mach mau mpt each tir nhien lam cho liru thdng khi huyet va giam ap lire mau tac ddng vao thanh mach nen HA giam. Va chinh sir tang lu'u thdng khi huyet cung dong nghTa vdi tang dudng chat nen tim khdng can tang nhjp dap. Them vao dd, tap luyen TCQ lam cho con ngu'di thir gian, khac phuc diroc cang thang than kinh do vay gdp phan lam giam huyet ap [3], [10]. Ket qua nghien cdu d bang 1 ciia chung tdi da lam sang td han cac nhan djnh tren.
Trong mpt nghien cdu nglu nhien cua Tsai va cs [7] ve huyet ap va lipid mau d nhdm t§p TCQ va nhdm it van dpng che thay nhdm tap TCQ 3 lin/tuln trong thai gian 12 tuan che thay HATT giam 15,6 mmHg va HATTR giam 8,8 mmHg: ham lirgng lipid huyit tuang giam, cdn HDL - C tang; day la nguyen nhan gay giam HATTR d bai tap TCQ. Do dd, TCQ cd thi dirpc sd
dung nhir mdt phirong thdc thay thi trong dilu trj benh nhan tang huyit ap nhe, vdi mpt hieu qua diy hda hen.
Theo quy luat lao hda, tuoi cang cao thi xirong long ngire bj vdi hoa, co hd hap teo lai, lam cho kich thirdc long ngire va dp gian nd ciia long ngire giam di, lam che sir van dpng ciia phoi ngay cang them khd khan khiln khdng khi dl liru lai trong phoi, gay ra khd thd. Them vao dd cac ti bao cua dirdng hd hip va cua phoi diu bj xa hoa, phi nang giam dan hpi, giam dp sau hd hip va dung tich song [1], [3]. Vdi dac dilm cua phirong phap tap luyen TCQ, ngirdi tap phai phoi hop cac dirdng quyln vdi each thd, chii yiu hit thd sau bing bung, tang kha nang co gian cua co hoanh, td dd tang sir dan hoi thanh phi nang nen dung tich song va thdi gian nin thd ciing dirge tang len. Chinh vi vay, d Trung Quoc, TCQ dirge dng dung tap luyen cd hieu qua tang cirdng chdc nang phoi d benh nhan bj ung thu phoi va hen phi quan.
Tuoi cang cao sir nhanh nhen cang giam, cac khdp bj khd cdng cd ddng khd khan do bj thoai hoa [3], Tap TCQ tang cirdng dirge sir deo dai, sir linh hoat ciia cac khdp xirong, nhlt la ciia cot song va cua cac khdp d tay chan. Them vao dd, khi tap TCQ, toan bp ca blp phai buong long, day chinh la ca sd phat thin sdc nhanh cua ca thi; cong vdi trang thai thir gian thoai mai vi tri nao va co thi lam cho trang thai tinh thin khi tap TCQ, tang dp linh hpat thin kinh va tic dp cc co [2], Nhan djnh nay thiy rd trong kit qua nghien cdu cua chiing tdi, sau 3 thang, nhdm TN tap TCQ cd thanh tich sdc nhanh xac djnh theo test ngoi - di bp nhanh - ngoi dirge nang len dang ki vdi p < 0,001.
Trong nghien cdu cua chiing toi thu dirge thanh tich sire manh cua nhom TN sau 3 thang dirge nang len dac biet co y nghTa (p < 0,001). Chung toi cho rang, sd dT tap TCQ lam tang sdc manh co chan la do trong bai tap TCQ 24 thdc co nhieu dpng tac quyen chan va nhieu thdc phai ddng tren mot chan; day la co sd de phat trien sdc manh cua cac co d chan. Lan va cs. [4]
trong mot nghien cdu thi diem da cho thay, TCQ co tac dung de cai thien sdc manh co blp, dac biet la co chan, dong thdi tang sdc chiu dirng trong cac ca nhan cao tuoi.
Nghien cdu cua chung tdi mot lan nira khang djnh tac dung cua TCQ len sdc manh chan bing test bac thang d bang 3.
Ket qua nghien cdu ciia chiing tdi tirong tir cua Khasnis va Gokula [6], khi nghien cdu TCQ len kha nang thang bing cua NCT. Chiing tdi cho ring, sd dT tap TCQ cd tac dung tang kha nang thang bang cua NCT la do ngirdi tap phai xoay chuyin co thi theo nhiiu gdc dp khac nhau va cd nhdng liic chi phai ddng tren mot chan; cac ddng tac thudng cd vong trdn va xoay trdn 6c. Dilu nay giup cho ren luyen tiln dinh nao, eg quan thang bing cua eg thi, lam giam nguy co mat thang bing, chong mat te nga d ngu'di Idn va tang phan xa nhanh cho ngu'di Idn tuoi. Gan day Hackneya va Earhart [5] da ap dung bai TCQ tap cho NCT bj benh Parkinson cung da dua ra nhan djnh kha quan, ngirdi bj benh Parkinson co thi cai thien hoat dpng di ddng thang bing va phdng te nga bang each tap thai circ quyen.
5. KET LUAN
Ngudi cac tuoi tap luyen TCQ trong thdi gian 3 thang cc tac dung:
- Cai thien chdc nang tuin hoan va ho hap, thi hien d giam tin so tim, huyit ap va tang dung tich song, thdi gian nin thd toi da.
- Cai thien nang luc thi chat nhu tang thanh tich sdc nhanh, sdc manh chan va thang bang tTnh; sir khac biet cac chi so nay trirdc va sau 3 thang cc y nghTa vdi p < 0,05 - 0,001.
TAI LIEU THAM KHAO
1. Hoang Thj Ai Khue (2009), Xay dirng mpt SP chupng trinh tap luyen TDTT phii hgp vdi sdc khoe ngudi cao tuoi, De tai NCKH Cap Bp B2009 - 27 - 63.
2. Luang Trong Nhan (2005), Phuong phap tap luyen hieu qua, Thai cue quyin dudng sinh, NXB Tre.
3. Adler PA., Roberts B.L. (2006), The use of tai chi to improve health in older adults, Orthopaedic, Nursing, 25(2):122- 126.
4. Lan E.C., Lai J.S., Chen S.Y. et al.
(2000), Tai Chi Chuan to improve muscular strength and endurance in elderly individuals: a pilot study, Arch.
Phys Med Rehabil JID., 81(5):604-607.
5. Hackneya M.E., Earhart G.M. (2008), Tai Chi Chuan to improve in people with Parkinson disease: Posture and Gait, Published online 01 April.
6. Khasnis A., Gokula R.M. (2003).
Romberg's test, J Postgrad Med 49(2):
169-172
7. Tsai J.C., Wang W.H., Chan P. et al.
(2003), The beneficial effects of Tai Chi Chuan on blood pressure and lipid profile and anxiety status in a randomized controlled trial, J Altern Complement Med, 9(5)747-754.
8. Margaria R., Aghemo P., Rovelli E.
(1966), Measurement of muscular power, J Appl Physiol. ,21:1661-1664.
9. Rikli R.E., Jones C. (2001), Senior Fitness Test Manual, Publisher: Human Kinetics Publishers.
10.Yeh G.Y., Wang C, Wayne P.M. et al (2008), The effect of tai chi exercise on blood pressure: a systematic review, Prev. Cardiol. ;11:82-89.
SUMMARY
The effect of training by Tai Chi Chuan on physiological indicators and physical
ability in the elderly
Hoang Thi Ai Khue, Nguyen Thi Kim Thoan, Dau Binh Huong Vinh University
This study aimed at evaluating the effects of Tai Chi Chuan training on some physiological indices and physical ability in the elderly having hypertension. The results showed that training of Tai Chi exercise had improved circulatory and respiratory functions as reducing heart's rate and blood pressure, increased vital capacity and time holding one's breath, enhancing physical ability in the elderiy such as agility, muscular strength, standing balance control. The differences of these indices between before and after three traning months are significant (p < 0.05-0.001).
Key words: Tai Chi Chuan, aged people
TAC DUNG LUYEN TAP QUYEN DUONG SINH VO CO TRUYEN BiNH DjNH LEN CHUC NANG THAN KINH- TAM LY O NGUOI CAO TUOI Dang Quoc Bao1, Nguyin Ngoc Sen2
1Hpc vien Quan y
2Dai hpc Quy Nhom Muc tieu cua nghien cdu nay la gop phan chdng minh co so khoa hpc tac dung cai thien sue khoe ngwoi cao tuoi cua bai tap duong sinh vd co truyen Binh Dinh. Doi tuong duoc chon de luyen tap la 100 ngwoi cao tuoi (dp tudi trung binh la 60 tuoi). Cac bai tap dwoc sir dung bao gdm bai Hung ke quyen, Thien sw va Thai son. Ket qua nghien ciru tren chirc nang than kinh tam ly cho thay sau 6 thang tap, chirc nang van dpng tang ro, thoi gian cam giac van dpng rut ngan (phan xa nhanh hon), toe do xir ly thong tin va tri nhd goc khop tang ro ret, cdn do run tay giam xuong voi p < 0,05. Dieu nay cho thay, cac bai tap cd tac dung cai thien chirc nang he than kinh trung wong d ngwoi cao tuoi
TCr khoi: quyen dwong sinh, vo cd truyen Binh Dinh, than kinh tam ly nguoi cao tuoi 1. DAT VAN BE
Luyen t^p quyln duong sinh trong v6 co truyen Binh Dinh la ren luyen mpt each toan dien y — khi — luc, kit hpp nhuan nhuyln
cac dpng tac van dpng voi thd sau deu dan va tap trung chu y trong suit thai gian luyen tap. Chinh vi vay, ngoai tac dung cai thien cac chuc nang ho hap, tuan hoan, he van
