不老健身房對社區高齡長者體適能之影響

Effectiveness of the Ageless Gym Program on Functional Fitness Among the Community Elder Population

盧盈良(Ying-Liang Lu)

指導教授 ： 陳秀熙

共同指導教授 ： 許辰陽 ； 葉彥伯(Yen-Po Yeh)

國立臺灣大學/公共衛生學院/公共衛生碩士學位學程/碩士(2021年)

https://doi.org/10.6342/NTU202102969

摘要

研究背景
台灣人口結構漸趨老年化，過往研究顯示社區長者在體適能表現以及運動習慣上普遍缺乏。近年與老年相關之疾病如老年衰弱症與肌少症對於社區年長族群亦漸成重要之疾病負擔。然目前未有具實證效益之整合式社區年者者體適能介入計畫。面對這些老化問題，彰化縣衛生所不老健身房因此而設立，其特色是結合公衛、醫療、護理、運動和營養等專業讓民眾接受個別化的運動指導介入。
目的
本研究旨在
1.評估彰化社區長者整合介入模式對於身體組成以及體適能表現之效益。
2.介紹彰化不老健身中心社區長者體適能整合介入模式的建立
方法
本研究採類實驗研究設計(quasi-experimental design)，前後重複測量實驗設計(Pretest-posttest repeated measurement design)。以彰化縣衛生所不老健身房模式進行8週的自主訓練為介入方式。針對有按計畫回來複測之個案進行前後測比較，回溯性分析在彰化縣3家衛生所不老健身房的社區老人的功能性體適能檢測之差異。此外也針對所有個案的體適能測驗初測資料進行分析，討論於社區長者的功能性體適能狀況分佈以及其相關影響因子。蒐集資料包括自2017年6月至2020年12月間，共計三間衛生所不老健身房(社頭、二水及埔心)。紀錄參加民眾之年齡、性別、身高、體重、血壓、腰臀圍、運動狀況、日常工作量以及體適能檢測等數據，再使用混合線性模式進行多變項迴歸分析其效益。
結果
使用混合線性模式進行多變向迴歸分析，其介入效益顯示，除了在身體組成的項目中的「腰臀比」(0.04 , 95%CI: 0.00-0.09)及「骨骼肌率」(0.16 , 95%CI: 0.01-0.31)達統計學上顯著差異外，在「雙手抓背」(1.79 , 95%CI: 1.01-2.57)、「坐椅體前彎」( 2.52 , 95%CI: 1.66-3.38)、「30秒屈舉啞鈴」( 2.62 , 95%CI:2.20-3.03)、「30秒坐站」(2.80 , 95%CI: 2.36-3.23)、「2分鐘踏步抬膝」(10.58 , 95%CI: 8.31-12.84)、「2.44起身繞行」(-0.29 , 95%CI: -0.43-0.14)以及「開眼單腳站立」(1.86 , 95%CI: 0.87-2.85)等總計9個項目中均呈現統計學上顯著差異之進步趨勢。而在「手握力」(0.95, 95% CI:-0.03-1.93)及「6公尺直線」(-0.19, 95% CI:-0.41-0.04)項目上雖然未達統計學上顯著差異，但都呈現進步的趨勢。藉由比較運用所有服務研究中收集的資料以及僅保留具完整前後側之結果顯示，本研究所運用的會混合線性模式評估方法可有效在服務性計畫中進行效益評估，有效偵測介入之效益與運用收集之資料。
結論與建議
本研究顯示不老健身房模式的介入模式可以幫助社區中的長者在功能性體適能的表現獲得進步。其在地化融入社區的開放管理模式，也能讓民眾可獲得良好的運動環境，藉以達到推廣運動、活躍老化和預防肌少症之目的。

關鍵字

功能性體適能 ； 社區老人 ； 不老健身房 ； 運動處方 ； 運動即良藥

並列摘要

Background
The issues of aging population associated with the increased disease burden on degenerative diseases such as frailty and sarcopenia have became a new threat to communities. As one of the country with soaring proportion of the elderly subjects, Taiwan have allocated resourced aimed at increasing body fitness and preventing the occurrence of degenerative diseases mentioned above. However, the is a lack of evidence-based intervention model targeting at the elder community dwellers.
For the aging issue, the ageless gyms in Changhua were set up, which combine the professions of public health, medical care, nursing, exercise and nutrition to provide the integrated fitness service to the elder population in community.
Study Aim
This study is aimed to
1.evaluate the effectiveness of the community-based integrated intervention model on body compositions and fitness measurements to provide the empirical evidence on the implementation of the Changhua ageless gym;
2.introduce the establishment of a community-based integrated intervention model on the basis of the ageless gym platform in Changhua.
Method
This study applied a quasi-experimental design and Pretest-posttest repeated measurement design. A 8-weeks training course tailored by the initial evaluation of each attendant was adapted in the platform of ageless gym in Changhua. The exercise intervention was provided by a multi-disciplinary team in the platform of Changhua ageless gym. The outcome measurements including a series of body compositions and fitness measurements derived from three health centers (Shetou, Ershui and Puxin) between June 2017 and December 2020 in Changhua were used to evaluated the efficacy of the proposed integrated intervention model. Factors associated with the outcomes including age, gender, height, weight, blood pressure, waist and hip circumference, habit of exercise and daily workload were collected. We use mixed linear model for multivariate regression analysis as the method to analysis the efficacy of the intervention on fitness measurement.
Results
We use mixed linear model for multivariate regression analysis as the method to analysis the efficacy of the intervention on fitness measurement. The result showed, except for the body composite proportion of "waist-hip ratio" (0.04,95%CI: 0.00-0.09) and "skeletal muscle" (0.16,95%CI: 0.01-0.31) reached statistical significance, the items of "hands grasping back"(1.79, 95% CI: 1.01-2.57), "chair forward bending"(2.52, 95% CI:1.66-3.38), "30 seconds bending dumbbell"(2.62, 95% CI: 2.20-3.03), "30 seconds sitting and standing" (2.80, 95% CI: 2.36-3.23), "two minutes stepping and raising knees" (10.58, 95% CI:8.31-12.84), "2.44 meters to get up and go around"(-0.29, 95%CI:-0.43--0.14), and "open eyes to stand on one foot"(1.86, 95% CI:0.87-2.85) all resulted in statistically significant improvement among the attendants. Although the items of "hand grip"(0.95, 95% CI:-0.03-1.93) and "6 meters straight line" (-0.19, 95% CI:-0.41-0.04) did not reach the statistically significant improvement after intervention, a trend toward positive results was observed.
Conclusion
The results proved the positive effectiveness of the proposed community-based integrated intervention model in terms of physical fitness and exercise performance. Besides, such models of community-based integrated intervention and open management provided the public with an ideal environment for fitness training, so as to achieve the purpose of improving fitness, activating healthy aging, and preventing degenerative disease such as sarcopenia.

並列關鍵字

functional fitness ； geriatric population ； ageless gym ； exercise prescription ； exercise is medicine

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