Chun-Jong Kim1, Kyo-Man Koo2*
1Department of Special Physical Education, Yeungnam Univ, 280 Daehak-Ro Gyeongsan Gyeongbk, ASI KR KSO11 Gyeongsan, South Korea
2Department of Adapted Physical Education, Baekseok Univ, 76, Munam-ro, Dongnam-gu, Cheonan-si, Chungcheongnam-do, ASI KR KS002, South Korea
ABSTRACT:
Background/Objectives: The purpose of this study was to investigate the effect of physical activity on the health-related quality of life among people with activity limitations for each type of physical activity.
Methods/Statistical analysis: The original data used in the research were the health survey data of the Korean National Health and Nutrition Examination Survey (KNHANES) conducted in 2013 and 2014. The research variables of this study were the frequency of participation in each type of physical activity and EQ-5D (Euro Quality of Life-5 Dimensions).
Findings: First, in the case of men, there was a difference in the health-related quality of life (HRQL) between the group that did not participate in walking exercise at all and the groups who did so for 3 or 4 days and 5 days or more. For the flexibility exercise, there was a difference in HRQL between the group who did not participate in the exercise at all and the group who participated in it for 1 or 2 days. Second, In the case of women, there was a difference in the HRQL between the group that did not participate in the muscular strength exercise at all and the group that participated in it for 5 days or more.
Improvements/Applications: Thus, proper participation in walking and flexibility exercises for males and adequate participation in muscular strength exercises for females are expected to help improve their HRQL.
KEYWORDS: Physical Activity, Health-Related Quality of Life, Activity Limitations, Exercise, KNHANES.
1 INTRODUCTION:
Today, people want to maintain a good quality life that is mentally rich and physically healthy beyond simple survival. Quality of life refers to one’s objective and subjective well-being from a physical, mental and social perspective1. Therefore, everyone wants a good quality of life.
Quality of life can be divided into non-health related quality of life (NHRQL) and health-related quality of life (HRQL). The HRQL of an individual is defined as his or her self-assessed physical and mental state of health2.
This HRQL has been shown to have an impact on daily life performance, health problems related to activity limitations, employment status, disability types, and marital status3. In contrast, physical activity has a positive effect on the HRQL4, and it has been found that there is a positive relationship between HRQL and the amount of physical activity5,6,7,8. In addition, it has been reported that there are some differences in the sub-factors of HRQL among the groups that participate in walking, flexibility exercises, and muscular strength exercises and those who do not9.
Therefore, adequate physical activity may help improve the HRQL for people with activity limitations. However, most of the studies to date have focused on comparing the participation and non-participation groups or evaluating the differences in the quality of life according to the intensity of physical activity. Furthermore, since a very limited number of studies have been conducted on disabled persons with activity limitations, little information is available on the best type of physical activity for them to participate in and how often they should do so. For this reason, it would be helpful to investigate what type of physical activity people with activity limitations should participate in and how often they should do so, in order to gain information on the effect of physical activity on the HRQL.
The purpose of this study was to investigate the effect of the frequency of participation in physical activity on the health-related quality of life among people with activity limitations for each type of physical activity. For this purpose, the Korean National Health and Nutrition Examination Survey (KNHANES) VI conducted from 2013 to 2014 was used for analysis10,11. These data are expected to serve as important basic data for improving the quality of life of people with activity limitations.
2. MATERIALS AND METHODS:
2.1. Subjects:
This study used the health survey data of the National Health and Nutrition Survey conducted in the first and second year (in 2013 and 2014) as part of the 6th Korean National Health and Nutrition Examination Survey conducted from 2013 to 2015. A total of 384 enumeration districts were extracted (192 enumeration districts per year). Within each enumeration district, twenty sample households were selected from among the appropriate households using the systematic sampling method after excluding facilities such as nursing homes, military facilities, prisons, and foreign households in the sampling areas. In the sample households, all of the household members who were over 1 year old and met the requirements for an appropriate household member were selected as the survey subjects.
The data of this study were complex sample design data, and the rolling sampling design method was applied in the sample design, so that the samples for each year would become independent probability samples representative of the whole country and have similar characteristics each year12. In this study, a total of 890 adults aged 20 years or older who had activity limitations were analyzed among those selected as the survey subjects, as described above. The population estimated through the subjects of this study was 2,594,422.90 people. The general characteristics of subjects are shown in Table 1 below.
Table 1. Subjects’ characteristics
|
Characteristics |
Male |
Female |
|||
|
n (unweighted) |
% (weighted) |
n (unweighted) |
% (weighted) |
||
|
Age group |
20-29 |
21 |
13.0 |
21 |
8.0 |
|
30-39 |
16 |
8.1 |
24 |
6.2 |
|
|
40-49 |
28 |
11.7 |
55 |
13.5 |
|
|
50-59 |
65 |
24.5 |
109 |
22.1 |
|
|
60-69 |
87 |
18.7 |
149 |
22.9 |
|
|
70≦ |
128 |
24.0 |
187 |
27.4 |
|
|
Household income |
Low |
160 |
40.4 |
248 |
41.9 |
|
Middle-low |
78 |
20.9 |
142 |
26.7 |
|
|
Middle-high |
61 |
23.6 |
79 |
14.2 |
|
|
High |
44 |
15.2 |
74 |
17.3 |
|
|
Education level |
Elementary school and below |
134 |
32.1 |
312 |
49.2 |
|
Middle school |
56 |
14.8 |
77 |
13.6 |
|
|
High school |
97 |
31.7 |
102 |
25.3 |
|
|
College and over |
52 |
21.4 |
48 |
11.9 |
|
|
Occupation |
Manager or profession |
16 |
5.9 |
10 |
2.4 |
|
Office job |
6 |
2.2 |
7 |
1.2 |
|
|
Service and sales job |
22 |
7.8 |
37 |
9.2 |
|
|
Agriculture and fisheries job |
28 |
6.6 |
24 |
3.5 |
|
|
Labor worker |
29 |
10.8 |
10 |
2.1 |
|
|
Elementary occupation |
27 |
7.3 |
50 |
8.4 |
|
|
Not economically active population |
211 |
59.5 |
401 |
73.1 |
|
|
Marital status |
Married |
299 |
76.3 |
506 |
88.2 |
|
Unmarried |
46 |
23.7 |
39 |
11.8 |
|
|
Residence area |
Town |
252 |
79.0 |
408 |
77.8 |
|
Rural area |
93 |
21.0 |
137 |
22.2 |
|
2.2. Research Variables:
In this study, the frequency of participation in each type of physical activity and EQ-5D index were used as the research variables. The types of physical activity included walking, muscular strength and flexibility exercises, and the frequency of each type of physical activity was set as 'not at all', '1 or 2 days', '3 or 4 days' and '5 days or more' per week.
The EQ-5D is a comprehensive tool for measuring HRQL and is widely used in the healthcare field13. The HRQL consisted of five dimensions. The response for each item was given on a three-point scale, which included the options, '1-inconvenient', '2-slightly inconvenient', and '3-very problematic.' The data used in this study were based on the EQ-5D index, which was presented by the Center for the Disease Control & Prevention, taking into account the quality weighting of the results of the survey on the quality of life.
2.3. Statistical analysis:
The purpose of this study was to investigate the effect of the frequency of participation in physical activity on the health-related quality of life among people with activity limitations for each type of physical activity. In order to achieve this purpose, a complex sample design analysis was used. For this purpose, the data of the first and second years of the 6th KNHANES were combined vertically, and the planning file was created by specifying the strata for the stratification variable, the enumeration districts for the clusters, and the weight of the examination survey for the sample weight. The presence of disability was set as a subpopulation, and the analysis was carried out by distinguishing between the males and females.
In order to identify the characteristics of the subjects, a frequency analysis with a complex sampling design was conducted. In order to investigate the effect of the frequency of participation in physical activity on the HRQL for each type of physical activity, the data were analyzed using the Complex Sample General Linear Model. The significance level was set at α= .05. All statistical analyses were carried out using the SPSS 18.0 statistical package.
3. RESULTS AND DISCUSSION:
The results of the effect of participation in each type of physical activity on the HRQL for people with activity limitations are shown in Table 2. First, it was shown that for men, it was possible to explain 35.3% of the HRQL by means of the participation in each type of physical activity. The results of the frequency of participation in each type of exercise showed that there was a significant difference between the group that did not participate in walking exercise and the groups that participated in walking exercise for 3 or 4 days or for 5 days or more. For the flexibility exercise, a significant difference was observed between the group that did not participate in the exercise and the group that participated for 1 or 2 days. For women, it was possible to explain 23.9% of their HRQL by means of their participation in each type of physical activity. The results according to the frequency of participation in each type of exercise showed a significant difference in the group that did not participate in the muscular strength exercise at all and the group that participated in it for 5 days or more.
Table 2. The effect of the frequency of participation in physical activity on the health-related quality of life for each type of physical activity
|
Parameter |
Male |
Female |
|||||
|
Estimates |
SE |
t |
Estimates |
SE |
t |
||
|
Walking exercise |
5 ≦ |
.119 |
.030 |
3.993*** |
.036 |
.037 |
.963 |
|
3 ~ 4 day |
.117 |
.037 |
3.201** |
.033 |
.027 |
1.204 |
|
|
1 ~ 2 day |
.040 |
.040 |
1.005 |
.054 |
.034 |
1.614 |
|
|
non-participation |
.000 |
.000 |
|||||
|
Muscular strength exercise |
5 ≦ |
.032 |
.060 |
.526 |
.103 |
.035 |
2.922** |
|
3 ~ 4 day |
.001 |
.039 |
.014 |
.020 |
.050 |
.396 |
|
|
1 ~ 2 day |
.036 |
.030 |
1.213 |
-.009 |
.036 |
-.265 |
|
|
non-participation |
.000 |
.000 |
|||||
|
Flexibility exercise |
5 ≦ |
.035 |
.048 |
.737 |
.026 |
.030 |
.879 |
|
3 ~ 4 day |
-.040 |
.034 |
-1.164 |
.005 |
.033 |
.136 |
|
|
1 ~ 2 day |
.059 |
.029 |
1.999* |
.010 |
.029 |
.330 |
|
|
non-participation |
.000 |
.000 |
|||||
|
R²=.353 p<.000 |
R²=.239 p<.000 |
||||||
* p<.05, ** p<.01, *** p<.001
Adjusted for age, education level, household income, occupation, marital status, residence area
The purpose of this study was to investigate the effect of participation in each type of physical activity on HRQL of people with activity limitations. This study aimed to provide meaningful basic data for improving the quality of life of people with activity limitations. For this purpose, the discussion in this section will be focused on the analysis of the results.
In this study, for men, as compared to those who did not participate in any exercise, a statistically significant difference was observed in the HRQL in the case of the walking and flexibility exercises. For women, as compared to those who did not participate in any exercise, a statistically significant difference was observed in the case of the muscular strength exercise. The results of this study are consistent with a previous study which showed that physical activity had a positive effect on the HRQL among disabled people4, and a study which reported that participation in physical activity causes a difference in the HRQL among elderly people with chronic diseases9, and a study which reported that the quality of life was increased by participation in walking exercise14.
However, this study intended to examine the effect of each type of physical activity. For men, the walking and flexibility exercises had an effect on the HRQL, but in the case of women, only the muscular strength exercise did so. These results suggest that the types of physical activity which affect the HRQL may be different between males and females. In this respect, they were consistent with the results of a previous study which reported that there was a difference in the level of physical activity that affects the HRQL of elderly men and women15 and another previous study which reported that there were differences in the practice rates of walking, flexibility exercise, and muscular strength exercise according to gender9. In particular, for men, it is thought necessary for them to perform flexibility exercises, since flexibility can be lacking in the case of men, and for women, muscular strength training is believed to have an effect on their HRQL, due to the relatively weak muscular strength of women. Moreover, since it was found to be desirable for men to participate in walking exercises for at least three days a week, it is considered necessary to take this result into account in planning and practicing such exercise. Furthermore, given the results of this study, which showed that walking for leisure or as a sport has a positive relationship with quality of life, unlike walking as a means of transportation16, it is thought desirable for men to participate in walking for leisure or as a sport for at least three days a week for the sake of their HRQL, in order to perform the exercise properly.
In the case of women, there was a significant difference between the group who did not participate in muscular strength exercises at all and the group that participated in it for 5 days or more. Therefore, women are required to perform muscular strength exercises regularly for at least 5 days a week, in order to improve HRQL.
4. CONCLUSION:
For men with activity limitations, walking and flexibility exercises were found to affect their HRQL, while for women with activity limitations, only muscular strength exercises were found to have such an effect. Therefore, in order to improve their HRQL, men are required to perform walking exercises for at least three days a week and flexibility exercises for at least one day a week. For women, they are required to perform muscular strength exercises for at least 5 days a week.
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Received on 22.06.2017 Modified on 25.06.2017
Accepted on 05.07.2017 © RJPT All right reserved
Research J. Pharm. and Tech. 2017; 10(7): 2260-2264.
DOI: 10.5958/0974-360X.2017.00400.0