population aging has increased public interest in maintaining a healthy and high - quality 
 life1 .
methods to prevent the functional 
 disorders of the elderly , lengthen the span of their healthy lives , and reduce their social 
 and economic burdens are needed2 , 3 . in recent years
, customized exercise 
 methods for the elderly , which can maintain and improve appropriate muscular strength , 
 muscular endurance , and cardiopulmonary functions , have drawn attention as opposed to 
 passive methods , such as medication4 , 5 . however , the rural elderly show low rates 
 of participation in sports activities due to poor access to sports centers or other 
 amenities that provide exercise programs , and heavy economic burdens .
in particular , the 
 rural elderly often experience physical pain in the back and knees due to farming for long 
 periods .
therefore , opportunities are urgently required to encourage them to improve their 
 physical abilities and quality of life6,7,8 .
the 
 purpose of this study was to examine the effects of regular exercise on changes in the 
 physical functions and quality of life of the rural elderly by designing an exercise program 
 for them that is appropriate for their physical condition and can be easily performed at 
 home .
the subjects of this study were 46 elderly people ( 8 males , 38 females ) aged 65 or older , 
 who resided in a rural area . on average , the subjects were 73.418.77  years of age and had 
 engaged in farming for 36.0815.73  years .
selection criteria were : subjects aged 65 or older 
 who managed their daily lives independently , who were capable of verbal communication , and 
 had the cognitive ability to listen to and follow explanations about the exercises . before 
 participation
, the procedures , risks , and benefits were explained to all the participants , 
 who gave their informed consent .
the participants rights were protected according to the 
 guidelines of the university of hanseo .
the exercise program was conducted 16 times in 80 minute sessions over an eight - week period 
 from june 25 to august 20 . the exercise program consisted of exercises to improve upper and 
 lower - extremity muscular endurance and balance based on exercises using thera - bands .
the 
 program was conducted in a local community hall and included a warm - up of ten minutes , main 
 exercises lasting 65 minutes , and a cool - down of five minutes . among the senior fitness test 
 items for the elderly developed by rikli and jones , arm curls ,
30-second standing up from a 
 sitting position on a chair , and two - minute step in place test were used to evaluate the 
 physical abilities of the participants9 . 

in addition , the distance between the two hands of each subject was measured during his / her 
 back scratching to measure flexibility .
one - leg standing with the eyes open and closed , and 
 functional reach were also measured to assess balance .
in addition , the timed up and go 
 test , tandem walk test , and foot stepping were performed to examine lower - extremity 
 agility10 . the korean version of the 
 world health organization quality of life ( whoqol)-bref questionnaire was used to assess the 
 effects on quality of life of the changes in the physical abilities of the elderly11 .
the evaluation items were divided into 
 four main areas of physical health , psychological relations , social relations , and 
 environment , which were further segmented into 26 lower - level items .
quality of life scores 
 were measured and recorded based on the subjects subjective perceptions of their quality of 
 life in the 26 lower - level items .
the experimental results were statistically analyzed using spss 22.0 ko ( ibm , il , usa ) . 

frequency analysis and descriptive statistics were employed to identify the general 
 characteristics of the subjects .
changes in the physical abilities and the quality of life 
 after completion of the exercise program were analyzed using the paired t - test with a 
 statistical significance level of = 0.05 .
after the intervention the physical abilities of the subjects were compared with their 
 pre - intervention values .
it was found that muscular endurance showed improvements in arm 
 curls , sitting and standing up from a chair , and two - minute step in place test , and balance 
 ability ( one - leg standing , functional reach ) and agility ( foot stepping ) also improved 
 ( p<0.05 ) ( table 1table 1.a comparison of the physical abilities of the subjects before and after the 
 exercises ( n=46)itemsexercise programpre - trainingpost - trainingstrengthen muscular endurancearm curl - dominant side ( times)46.322.164.826.3*sitting and standing up from a chair ( times)39.718.449.723.4 * 2-minute step in place test ( times ) 94.937.0130.041.2*balance one - leg standing- eyes open ( sec)19.621.127.324.2*one - leg standing- eyes closed ( sec)5.36.88.410.5*functional reach- dominant side ( mm)302.892.4372.973.8*upper - extremity flexibility back scratch ( mm)147.7116.8132.8110.9lower - extremity agility timed up and go ( sec)9.82.89.23.5foot stepping ( times)21.47.324.78.4*tandem walk ( sec)9.94.69.04.6meansd , * p<0.05 ) .
the overall quality of life score increased by 7.31 points after the 
 intervention and more specifically the scores of psychological and social relations , and 
 environment exhibited statistically significant improvements after the exercises ( p<0.05 ) 
 ( table 2table 2.a comparison of the quality of life of the subjects before and after the 
 exercises ( n=46)domainexercise programpre - trainingpost - trainingphysical health 20.45.421.45.9psychological 17.84.519.83.9*social relationships10.31.611.21.7*environment23.64.726.93.9*total72.013.479.412.8*meansd , * p<0.05 ) .
this study conducted an exercise program for the rural elderly two times each week over an 
 eight - week period .
the resistance exercises using an elastic band effectively improved the 
 physical abilities and the quality of life of the rural elderly .
after the exercises , the 
 subjects showed improvements in their physical abilities : left and right upper - extremity arm 
 curls showed improvements , and the score for sitting and standing up from a chair also 
 increased .
in addition , lower - extremity balance was enhanced , as shown by improvements in 
 the two - minute step in place test , one - leg standing time with eyes open , and functional 
 reach .
the above results agreed with the outcome of the study 
 by so et al.12 , in which dumbbell 
 exercises were performed by the elderly for 12 weeks , twice each week .
they reported 
 statistically significant improvements in the two - minute step in place test , sitting and 
 standing up from a chair , and 244  cm walking back and forth after the exercises .
the present 
 study found there were statistically significant improvements in arm curls , sitting and 
 standing up from a chair , two - minute step in place test , one - leg standing time , functional 
 reach , and foot stepping .
therefore , the subjects may have improved their upper - extremity 
 muscular endurance , general endurance , balance , and agility .
the results were also similar 
 to the findings of the study by yu et al.13 , in which resistance exercises were performed using an elastic band 
 for 12 weeks , three times each week , leading to improvements in muscular endurance ( sitting 
 and standing up from a chair ) and balance ( functional reach ) . however , the results were 
 contrary to those of the study by kazumasa et al.14 , in which an easy and simple resistance exercise program was 
 implemented for the elderly of a local community .
the eight - week exercise program conducted 
 in the present study was found to be effective at enhancing the physical functions of the 
 elderly .
the assessment of changes in the quality of life using the whoqol - bref questionnaire before 
 and after the exercises found there was an overall improvement in qol after the intrvention . 

in particular , the quality of life scores in the areas of psychological and social 
 relations , and environment improved after the intervention .
however , although the quality of 
 life score in the area of physical health was improved after the exercises , this result was 
 not statistically significant .
the exercise program employed in this study was conducted in 
 a community hall to increase the social participation and performance of the elderly . 

therefore , the participation of the elderly in physical activities such as flexibility 
 exercises performed to their favorite music and muscle strengthening exercises may have 
 influenced their psychological and social relations and quality of life .
the results of the 
 present study may support the conclusions of existing research that the participation of the 
 elderly in exercise programs is effective at changing their psychological and social 
 relations .
the present study had the limitation that it targeted elderly people in a rural area , and 
 thus the results can not be generalized to all age groups or elderly people . despite this , 
 this study confirmed that an exercise program was effective at changing the physical 
 functions and the quality of life of the rural elderly .
most of the elderly in rural areas 
 are facing threats to their health , such as musculoskeletal diseases , due to their lifestyle 
 of farming for long periods of time .
moreover , they have fewer opportunities to participate 
 in exercise programs than do the elderly in urban areas . in this regard ,
based on the 
 findings of the present study , more diverse studies should be carried out in the future to 
 help the rural elderly improve their physical functions and social participation .
 [ purpose ] the purpose of this study was to examine the effects of a muscle strengthening 
 exercise program using an elastic band on changes in the physical abilities and quality of 
 life of the rural elderly . 
 [ subjects ] the subjects of this study were 46 elderly people ( 8 
 males , 38 females ) aged 65 or older , who lived in a rural area and managed their daily 
 lives independently . [ methods ] the study s exercise program was conducted 16 times for 80 
 minutes each session over an eight - week period . this program consisted of several 
 exercises to strengthen muscular endurance and improve balance ability based on exercises 
 using thera - bands . 
 the physical abilities of the subjects were divided into muscular 
 endurance , upper - extremity flexibility , balance , and low - extremity agility . 
 each ability 
 was measured to compare the effects of the exercise program . 
 in addition , the korean 
 version of the world health organization quality of life ( whoqol)-bref questionnaire was 
 used to examine changes in the subjects quality of life . 
 [ results ] the subjects showed 
 improvements in muscular endurance , balance , and low - extremity agility . 
 they also 
 exhibited an overall statistically significant improvement in quality of life scores after 
 the exercise program . in terms of the main items , 
 changes were observed in the areas of 
 psychological relations , social relations , and environment . 
 [ conclusion ] the 
 community - centered muscle strengthening exercise program using the elastic band was found 
 to improve muscular endurance , balance , agility , and quality of life of rural elderly 
 subjects . 
INTRODUCTION
SUBJECTS AND METHODS
RESULTS
DISCUSSION