台灣青少年學生手握力及指捏力常模的建立與研究

Grip and Key Pinch Strength: Norms for 7 to 22-Year-Old Students in Taiwan

張顯洋(Shien-Young Chang)

《慈濟醫學雜誌》 14卷4期 (2002/08) Pp. 241-252

https://doi.org/10.6440/TZUCMJ.200208.0241

摘要

目的：針對台灣6歲至22歲之青少年學生，以握力測定器及指捏力測定器測量其手部肌肉握力及指捏力，以建立國內尚缺乏之基礎健康發展比較數據，並提供醫學臨床運用之參考資料。依據國外文獻顯示，手部肌肉握力及指捏力之測量統計分析，係為另一種一國人民健康發展的重要指標(除身高、體重…之外)。基於我國至目前為止尚缺乏該項常模之數據，能做為醫學臨床研究上之參考，乃提出本研究以連續性之測量結果，分析測量標的手部握力及指捏力發展的趨勢。此一趨勢在有關文獻上也顯示，係與人之年齡、健康狀況、飲食習性、生活消費水準…等極有關連。而我國正由開發中國家邁向已開發中國家之林，無論在所得水準、消費習慣、生活飲食習慣轉變，皆與數十年前大不相同，已不可同日而語，故建立國人基礎健康發展資料尤需完整，以為未來國家建設發展方向提供健全資訊。此一資料的建立，不但可與行政院衛生署已具備之國人健康標準表並列，且可供目前及未來醫學臨床上研究發展之參考基礎。材料與方法：本研究係長期連續性計劃，目前暫以二年度為先期測量，測量之對象以青少年學生(6歲至22歲)為先期目標，係因其客觀實驗基礎條件相似，故測量工作比較容易進行，不像成年人已進入社會工作，其居住環境、生活方式、工作條件…等，不易一致，而造成測量工作的困難。測量期間一共測量了來自北、中、南部各級學校的4,882位青少年學生，二者除了接受握力及指捏力之測量外，並記錄其年齡、性別、身高、體重、慣用手、居家、外宿等，以做為統計分析之依據。另外，還調查受測者的健康狀況、患病受傷情形、參加軍事訓練、上學方式與參加運動校隊等影響手握力及指捏力之因子，以便進一步了解其相關性。但在進行統計分析時，發現因使用的握捏力器儀器有誤差而造成測量資料有異常現象，為求慎重與精確起見，本研究放棄第一階段所測量的3,280筆資料，再以二年的時間重新使用定期校正的握捏力器測量2,982位15歲到22歲的學生。結果：最後根據4,844筆資料進行分析，其中男生3,347位，女生1,497位(包含260位23歲及24歲的學生)，從建立的捏握力常模及成長曲線來觀查，男生的握力約在20歲達到高峰，女生約在17歲達到高峰；而男女捏力的成長都在22歲才達到高峰，甚至22歲之後仍有上升之可能。另外，分別比較6歲至14歲及15歲至22歲二個年齡層群組，其握捏力與年齡、身高、體重…等相關系數亦稍有不同。而根據測量結果對照美國1985年所發表之統計數據，針對6歲至22歲的比較，可看出男女生左右手的捏力都不在美國之下，而握力則互有高低。結論：依據整個執行結果的分析比較，確實值得繼續研究調查，再將調查對象的年齡層次擴大涵蓋6歲至22歲以外之民眾，並依所得水準、飲食習慣、工作特性…等，據以分類，進行測量，以建立我國完整之全民手握力及指捏力常模的參考資料。此項國內首創的先導研究所調查的樣本，可說是目前最大最完整的保健資料庫，乃本研究最為珍貴的貢獻。另外，配合此研究之進行，同步開發完成的電腦輔助作業系統及個人數位助理查詢系統，除可提供國人基礎健康發展的完整資訊外，亦將擴大為具臨床諮詢功能的醫療診斷專家系統雛型，做為未來協助醫師提昇醫療品質的參考工具。

關鍵字

手握力及指捏力 ； 常模 ； 醫療資訊 ； 醫療診斷專家系統 ； 個人數位助理

並列摘要

Objective: Reports in the literature have suggested that the norms for hand grip and key pinch strength can be seen as critical indicators of national health development. These statistics are still not available in domestic clinical reports, since living standards and dietary habits have changed dramatically in Taiwan in the last decades. It is necessary, therefore, to survey the current state of national health development at regular intervals. Materials and Methods:This project aimed to establish comparative figures of national health development by measuring hand grip and key pinch strength for 6 to 22-year-old students in Taiwan. At the initial stage, we investigated young students after considering the homogeneity of their living background including lifestyle and work environment, compared to that of adults. The Jamar dynamometer was used to measure grip strength and the Jamar pinch gauge to measure the key pinch strength. All subjects, from different school districts in Taiwan, were free of disease or injury that could affect hand strength. All complementary factors such as age, sex, height, weight, dominant hand for writing and exercise were recorded. Results: In our first four-year survey, we examined a total of 4,884 students (3,347 males and 1,497 females). The peak of the curve for grip strength for males occurred around age 20, while for females it occurred around age 17. The peak of the curve for key pinch strength occurred at 22 years old for both males and females. In some cases the pinch curve increased after age 22. There were variant coefficients among grip and pinch strength according to age, height, weight and other factors when samples were clustered into two age groups, 6 to 14 years and 15 to 22 years. The grip strength of Taiwanese studens is similar to American students’ but pinch strength is different, according to studies done in 1985 in the United States. Conclusions: Follow-up research is needed with a larger sample size of various ages which takes living background, work environment and other variables into consideration. The sample database created by this project is the biggest currently and has an important contribution to the healthcare of young students. A computeraided data processing system and a PDA(Personal Digital Assistant) query system was set up to assist in research and consulting during the initial stage. Furthermore, a proposed prototype of the medical diagnosis expert system will be presented at the next stage to provide clinical information to improve the quality of health service.

並列關鍵字

Hand grip and key pinch strength ； norms ； medical informatics ； medical diagnosis expert system ； Personal Digital Assistant