宜蘭縣社區長者體適能表現及其與運動量、跌倒經歷相關性研究

背景：跌倒是老年人發生創傷相關疾病和死亡最常見的原因。在臺灣，老年人跌倒的發生率為15.5%，其中約一半需要醫療照護，而宜蘭縣人口老化指數更高於全國，因此建立系統性的預防跌倒與健康促進體系是必須的。研究方法：本研究為橫斷性研究，回溯分析國立陽明大學附設醫院民國106年7月10日至108年12月25日社區長者體適能檢測資料，以百分位數呈現體適能狀況，並探討體適能與運動量、跌倒次數、是否因跌倒住院的相關性。結果：收集2,130位宜蘭縣65歲以上社區長者體適能檢測結果，建立宜蘭縣社區活躍長者體適能常模。本研究顯示運動量與30秒連續坐椅站立（r=0.088,p<0.001）、30秒屈伸臂（r=0.112,p<0.001）、握力（r=0.095,p<0.001）及骨質密度（r=0.085,p=0.006）呈低度正相關，與2.44公尺坐站行走（r=-0.095,p<0.001）及6公尺步行速度（r=-0.082,p<0.001）呈低度負相關。不同跌倒次數之間在30秒連續坐椅站立（F=9.770,p<0.001）、30秒屈伸臂（F=5.136,p=0.002）、抓背伸展（F=7.679,p<0.001）、2.44公尺坐站行走（F=8.375,p<0.001）、開眼單足立（F=9.172,p<0.001）、握力（F=10.165,p<0.001）及6公尺步行速度（F=8.555,p<0.001）方面存在顯著差異。一年內曾因跌倒住院者其30秒連續坐椅站立（t=3.453,p=0.001）、抓背伸展（t=2.492,p=0.013）、2.44公尺坐站行走（t=-2.618,p=0.009）、6公尺步行速度（t=-3.840,p<0.001）皆較不曾因跌倒住院者差。結論：本研究建立宜蘭縣65歲以上社區活躍長者體適能常模。運動量與下肢肌力、上肢肌力、動態平衡與敏捷度、握力、步行速度，及骨質密度呈低度相關。一年內不曾跌倒者，其靜態平衡及握力表現皆優於曾跌倒者。一年內跌倒三次以上者與一年內曾因跌倒住院者，其下肢肌力、上肢柔軟度、動態平衡與敏捷度，及步行速度皆較差。本研究可做為擬定社區長者健康促進及預防跌倒策略的參考依據。

關鍵字

社區長者；體適能；跌倒

並列摘要

Background and Purpose: Falling is the most common cause of trauma-related morbidity and mortality in older adults. In Taiwan, the incidence of falls among the elderly is 15.5 percent, of which about half require medical care. Yilan County has a higher aging index than the whole country, so the establishment of a system of prevention of falls and health promotion is necessary. Methods: This study is a cross-sectional study. It retrospectively analyzes the physical fitness test data of the community-dwelling elderly from July 10, 2017 to December 25, 2019. The physical fitness status is presented in percentiles. This study analyzed the Physical fitness performance, the correlation between the amount of exercise and physical fitness, and the correlation between the number of falls, hospitalization due to falls and physical fitness. Results: A total of 2,130 community elder's data were collected, and a physical fitness norm for the active elderly over 65 in Yilan County was established. The amount of exercise showed a positive and low significant correlation with 30-second chair stand (r = 0.088, p < 0.001), 30-second arm curl (r = 0.112, p < 0.001), grip strength (r = 0.095, p < 0.001), and bone density (r = 0.085, p = 0.006). The amount of exercise also showed a negative and low significant correlation with 8-feet up-and-go (r = -0.095, p < 0.001), and 6-meter walk test (r = -0.082, p < 0.001). About the number of falls, there were significant between-group difference in 30-second chair stand (F = 9.770, p < 0.001), 30-second arm curl (F = 5.136, p = 0.002), backstretch tests (F = 7.679, p < 0.001), 8-feet up-and-go (F = 8.375, p < 0.001), single-leg standing (F = 9.172, p < 0.001), grip strength (F = 10.165, p < 0.001), and 6-meter walk test (F = 8.555, p < 0.001). Those who had been hospitalized due to a fall within a year had poor 30-second chair stand (t = 3.453, p = 0.001), backstretch tests (t = 2.492, p = 0.013), 8-feet up-and-go (t = -2.618, p = 0.009), and 6-meter walk (t = -3.840, p < 0.001). Conclusion: This study established a physical fitness norm for the active elderly over 65 in Yilan County. The amount of exercise showed a low significant correlation with strength, agility and dynamic balance, walk velocity, and bone density. Those who had not fallen within one year had better static balance and grip strength than those who had fallen. Those who had fallen more than 3 times within a year and those who had been hospitalized due to a fall within a year had poor lower limb strength, upper limb flexibility, agility and dynamic balance, and walk velocity. The results of this study can be used as a reference for developing health promotion and falls prevention strategies for the community elderly.

並列關鍵字

Community-dwelling elderly ； Physical fitness ； Fall

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