輕中度行動困難老人日常生活失能狀況及相關之身體功能

Activities of Daily Living Disability and Associated Physical Performances in Older Adults With Mild to Moderate Mobility Difficulty

楊越安(Yue-An Yang) ； 曹昭懿(Jau-Yih Tsauo) ； 李雪楨(Hsuei-Chen Lee) ； 蔡一如(Yi-Ju Tsai) ； 林志峰(Chin-Feng Lin) ； 王靜怡(Ching-Yi Wang)

《物理治療》 43卷3期 (2018/09) Pp. 203-214

https://doi.org/10.6215/FJPT.201809_43(3).0002

摘要

背景與目的：本研究探討輕中度行動困難老人最常發生困難或無法執行的日常生活活動(activities of daily living, ADLs)項目及其相關的身體功能，作為日後設計治療性運動的參考依據。方法：橫斷式研究設計。臺灣北、中、南部之社區關懷據點、安養院、日間照顧中心、護理之家，年滿65歲或以上，de Morton Mobility Index (DEMMI)量表得分在39～67分之間，且願意參與本研究者，但認知功能衰退至無法理解並配合口令執行測試者將被排除。每位受測者都接受結構式問卷、巴氏量表，以及身體功能測試。以發生失能頻率最高的3項ADLs，各別進行分組（失能、無失能），進行人口學及健康相關因子的雙變項分析，呈顯著差異的變數將進入邏輯式迴歸作為共變數，探討與ADLs失能相關的身體功能。結果：ADLs失能最頻繁的前3名分別是上下樓梯(54.3%)、洗澡(40.9%)、平地走動(33.1%)。邏輯式迴歸分析結果顯示，3 m計時起走(timed up and go test, TUG)（＞ 20秒）者有較大風險發生上下樓梯失能與平地行走失能；而洗澡失能則與心肺耐力（2分鐘踏步）與平衡（一腳足跟與另一腳大腳趾頂端靠攏站立，tandem站立）表現有關。結論：輕中度行動困難老人最常發生困難的ADLs是上下樓梯、洗澡、平地走動。TUG、2分鐘踏步測試、tandem站立的表現與這3項ADLs失能相關。

關鍵字

日常生活活動 ； 身體功能測試 ； DEMMI ； 老人

並列摘要

Background and Purpose: To explore the 3 most frequently disabled activities of daily living (ADLs) items and to investigate the associated physical performances with each item in older adults with mild to moderate mobility difficulty. These results can be used to guide disability prevention programs for this population. Methods: This was a cross-sectional study. Older adults eligible for inclusion (aged 65 years or over, de Morton Mobility Index [DEMMI] score of 39-67) from community centers, day care centers, or long-term care facilities from the northern, middle, and southern regions of Taiwan were invited to participate in this study. Participants were excluded if they could not understand and follow commands to perform the required tests. Participants were interviewed with a structured questionnaire and were assessed with the Barthel Index and physical performance tests. Bivariates analysis was done on demographic and health related variables between the able and the disabled groups based on each of the 3 identified ADLs items. Logistic regression analysis was conducted to investigate the physical performance tests significantly associated with disability items of ADLs, adjusted for significant covariates. Results: The 3 most frequently disabled ADLs items were stair climbing (54.3%), bathing (40.9%), and ambulation (33.1%). The results of logistic regression analysis showed that older adults who performed worse on the timed up and go test (TUG) (＞ 20 seconds) had a relatively high risk of being disabled in stair climbing and ambulation, whereas those who performed worse on 2-minute steps and tandem stance were associated with bathing disability. Conclusions: The 3 most often disabled ADLs items in older adults with mild to moderate mobility difficulty were stair climbing, bathing, and ambulation. After adjustment for the significant covariates, older adults who performed worse on the TUG (＞ 20 seconds), 2-minute steps, and tandem stance were more likely to be disabled on these 3 ADLs items.

並列關鍵字

ADL ； Physical performance ； DEMMI ； Older adults