運動介入對衰弱老年人健康促進之效益

The Effects of Exercise in Health Promotion for Frail Older Adults

陳采女勻(Tsai-Chun Chen) ； 陳慶餘(Ching-Yu Chen) ； 胡名霞(Ming-Hsia Hu)

《長期照護雜誌》 16卷2期 (2012/09) Pp. 107-120

https://doi.org/10.6317/LTC.201209_16(2).0001

摘要

隨著社會人口結構的快速老化，「衰弱」是目前老年醫學中最被重視的健康議題之一。身體衰弱其主要症狀為多重生理系統的衰退，包括肌肉質量與肌力、柔軟度、平衡和神經肌肉協調、以及心肺功能。衰弱不僅是一個複雜的健康問題，更容易導致如失能、罹患多重慢性疾病、跌倒、入住醫院或機構和死亡等不良健康結果，進而增加社會醫療的負擔。從預防醫學的角度來看，如何以運動介入有效維持或促進老年人的健康，延緩身體功能衰退所造成的失能程度，是物理治療在長期照護中所須扮演的重要角色。本文統整有關運動介入對於衰弱之實證研究文獻，探討運動介入對社區或機構中衰弱老人健康促進的效益。結果發現多元性、功能導向的運動設計（漸進式阻力運動、有氧運動、伸展運動、平衡訓練），可以有效增加不同衰弱程度老年人的肌力、心肺適能和身體功能表現，減少不良健康結果的發生。但仍需進一步研究探討不同運動種類最佳的訓練劑量來發展其臨床運動訓練指引。盼本文有助於提昇健康照護領域人員對於衰弱的預防與有效介入，協助達到活躍老化的社會目標。

關鍵字

衰弱 ； 老年人 ； 運動 ； 健康促進

並列摘要

With the rapid aging of socio-demographic structure, ”frailty” has become the particularly important health issue in geriatric medicine. Physical frailty is a syndrome characterized by declines in multiple physiological domains, including muscle mass and strength, flexibility, balance and neuromuscular coordination, and cardiopulmonary function. Frailty is a complex health state, associated with adverse outcomes such as: disability, morbidity, falls, hospitalization, institutionalization and death, and further increases the burden of society and medical treatment. From the viewpoint of preventive medicine, how to maintain or improve the health of older adults, and delay the disability resulted from physical function decline by exercise intervention is the main role played by physical therapy in the long term care system. This article reviewed the relevant evidence-based medical researchers to discuss the effect of exercise intervention in health promotion for community-dwelling or institutionalized older adults. The result showed that multicomponent, functional-oriented exercise programs (progressive resistance exercise, aerobic exercise, stretch exercise and balance training) can increase the muscle strength, cardiopulmonary fitness and physical function performance, and reduce adverse outcomes for older adults with different frail levels. However, it is still need further studies to investigate the optimal training dose for different exercise types and then to develop specific clinical exercise training guidelines. It is expected to help health care clinicians provide frailty prevention and effect intervention to achieve the social goal of active aging.

並列關鍵字

frailty ； older adults ； exercise ； health promotion