Fall preventing effects of the Korean Martial art, TaeKwon-Do, in senior citizens

Townsend Letter for Doctors and Patients, April, 2003 by Mark A. Brudnak, Drew Dundero, Fred M. van Hecke

Abstract

Falls are a leading cause of death in the elderly. Associated with aging is a loss of muscular strength, flexibility and coordination. Regular exercise is widely believed to be of benefit for the elderly. To this end, various exercise regimes have been employed to battle the associated problems of aging. One such has been the Chinese martial art, Tai Chi Chuan (TC). TC as an exercise system uses slow smooth movements to train the body in balance, endurance, and strength. For this reason, it is known as a "soft" martial art in that it is very non-impact oriented. There have been a variety of studies in the West examining the beneficial effects of TC. However, to date, there have been no studies with senior citizens using other martial arts, of which TC is but one. The present study was designed to examine the appropriateness and effects of a Korean marital art known as Tae Kwon-Do (TKD), a "hard" martial art, on an elderly population measuring similar parameters reported for TC. Results: increases in balance, strength, and flexibility were all observed. Conclusion: TKD proved effective at increasing several parameters correlated with fall prevention. The elderly are capable of participating in a hard marital art and they have an interest in it as a viable alternative to other forms of exercise. The present study suggests that TKD as a form of exercise for an elderly population is both viable and potentially popular and warrants further study.

Introduction

Martial arts can be defined as any of several arts of combat and self-defense (as karate and judo) that are widely practiced as sport. While the origins of the martial arts are subject to controversy, it is generally agreed that they can be traced back thousands of years. While originally developed as a means of self-defense, those motivations have given way to the sport and health-promoting aspects in recent years.

At present, the martial arts are often divided into two classes or types; hard and soft. The "soft" martial arts are named so because their theory of self-defense is based on redirecting the opponent's energy/attack and using more, but less powerful punches and kicks. Tai Chi Chuan (TC), a widely practiced martial art in the East (especially China), is an example of such an art and has become increasingly popular in the West over the last decade. The "hard" martial arts, such as Tae Kwon-Do (TKD), are based on using blocks and punches that can crush bones or body parts of an enemy. The hard martial arts try to use fewer strikes and punches, but deliver significantly more power with each one. There are benefits and drawbacks of each approach but those are beyond the scope of this paper. However, both hard and soft martial arts are purported to have great health benefits.

TC, as a soft art, has been reasonably well-studied over the past two decades by Western science trying to determine the mechanism(s) responsible for the observed and anecdotal health benefits. (3) Such benefits have included the following: movement force variability, (2) balance control, flexibility, cardiorespiratory, (4) fall risk reduction in the prevention of osteoporosis, (5,6) to improve muscular strength and endurance in elderly individuals, (7) and even on cardiorespiratory function in patients with coronary artery bypass surgery. (8)

The importance of the study and practice of the martial arts to the health and well-being of the senior population is exemplified by the fact that for over 20 years, falls have been reported as the main cause of accidental death in the elderly. (9) The present study is designed to measure the contribution that the Korean martial art TaeKwon-Do may have on several measurements commonly used to determine susceptibility of the elderly to falls. Additionally, the present study examines the feasibility of educating an elderly population to practice a hard martial art. Further, the appropriateness of an elderly population practicing a hard martial art is compared with that of other forms of exercise including soft martial arts.

Twenty-seven participants were initially recruited as volunteers for the study. Ages ranged from 63 to 81 years with a mean of 71. A survey conducted prior to initiation of the study ensured that all participants were independently ambulatory and had no severe musculoskeletal or/and neurophysiological disorders that would subject the participants to increased chance of injury or prevent participation. Informed consent forms were provided and signed before initiation of the study. (1)

After the initial screening, it was determined that twelve of the original volunteers should continue with the study. Those final participants (FP's) were assessed by several methods for several relevant measurements. First, FP's were paired and trunk flexibility was determined according to the standard protocol of the American College of Sports Medicine, 6th ed., with the following modifications. Because not all the FP's were willing to sit on the ground for the test, FP's were allowed to stand, with straight legs, while holding a yardstick and their distance from the ground to the fingertips was recorded. This number was normalized to those who were able and willing to sit on the ground to obtain the measurements according to standard protocols. One FP recorded the measurements while the other performed the test.