不同運動訓練對精神科中老年個案生理功能指標及預防跌倒成效之探討

Exploration of Different Exercise Training Influence on Physiological Function Index and Fall Prevention Effect of Middle-aged and Senile Clients of Department of Psychiatry

陳雨欣(Yu-hsin Chen)

指導教授 ： 黃心樹

中臺科技大學/護理學院/護理研究所/碩士(2012年)

https://doi.org/10.6822/CTUST.2012.00064

摘要

研究目的：本研究探討解釋影響精神科中老年個案生理功能指標的屬性變項，及有氧運動訓練介入與否對個案生理功能指標及預防跌倒改善成效之比較。
研究方法：本研究為實驗研究設計雙組前後測量方法，研究對象為精神科中老年個案，有氧運動訓練為介入措施，隨機分配研究對象至實驗組與對照組，實驗組除維持精神科病房之常規運動外，尚接受有氧健身操之運動訓練，每週進行3次，每次40分鐘共8週，對照組僅維持常規運動。以多元逐步迴歸分析所有研究對象基本屬性（性別、年齡、疾病診斷-亞型、藥物、過去一年跌倒經驗）對生理指標及跌倒人次的解釋力，以卡方檢定兩組人口統計類別變項，以獨立樣本 t 檢定及卡方檢定分析兩組八週後生理功能指標差異及預防跌倒成效。使用成對t 檢定分析比較兩組運動訓練介入前後生理指標差異及預防跌倒成效。
研究發現：第二代抗精神病藥物對「BMI」的解釋力為7.9％（F=4.956*，p=0.030），實驗組個案進行運動訓練後柔軟度及平衡力有顯著改善（p＜.05），肌力方面雖沒有達到統計水準上的顯著差異，但運動訓練後肌力有進步，平均值增加0.1（次），對照組個案肌力、柔軟度及平衡力未有顯著改善。實驗組個案在接受運動訓練八週後的跌倒人次減少與對照組個案相較達顯著差異。證實本研究之有氧運動訓練介入之實驗組較對照組個案有顯著預防跌倒成效。
對臨床護理的建議：實驗組因運動訓練改善肌力、平衡能力及柔軟度，顯示本研究的有氧運動介入，在維持及提升生理指標方面有正向成效且值得推廣，建議有氧運動訓練，成為醫院精神科每日例行活動，甚至推廣至社區，以團體運動訓練介入方式為主，給予預防跌倒相關衛教為輔，以促進中老年人的生理功能與健康。

關鍵字

精神科中老年個案 ； 運動訓練 ； 生理功能指標 ； 預防跌倒成效

並列摘要

This study is aimed to predict the psychiatric elder indicators in physiological function,and the effect on how an aerobic exercise training program prevents the incidence on falling and improving physical function.
Psychiatric seniors aged 45-65 or above who met our selecting criteria were recruited to participate in a randomized controlled fall-prevention trial. Participants in the intervention group had received exercise training of aerobic sessions(40 minutes)within 8 weeks. By contract, the control group has kept regular daily exercise. The data of this study processed by SPSS12.0 package. The statistics methods included descriptive statistics and inferential statistics.
The result of the study has influence on the second-generation antipsychotics and BMI level( F=4.956*，p=0.030). After 8 weeks of aerobic exercise training,the intervention group had significant improvements in flexibility and balance (p<0.05). Intervention group had improved in muscle strength (t=-0.501). The average increase 0.1 times. Control group had no significant improvements in muscle strength, flexibility and balance (t=1). After 8 weeks of aerobic exercise training, the intervention group proved the number of falls had decreased significantly. The study confirm aerobic exercise training had great effect in fall prevention.
After 8-week of aerobic exercise training, the intervention group had large improvements in muscle strength, flexibility and balance. The study showed intervention group had positive effectiveness in maintaining and promoting physical function index. Researchers hoped this exercise training program can be extended to clinical setting, and suggested hospitals to offer fall prevention exercise training programs; moreover to extend to communities. The training contains the main exercise training, and falling prevention health education. By doing so, the physiological function and health of the elderly can be upgrade.

並列關鍵字

Indicators of physiological function ； fall prevention effectiveness. ； Exercise training ； Psychiatric elderly

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