驗證社區高齡者功能性體適能快速評估與多元性運動介入效益之研究

Verify the effect of rapid functional fitness test and the multi-component exercise training for community-dwelling older adults

何信弘(Ho Hsin-Hung)

指導教授 ： 張少熙

國立臺灣師範大學/運動與休閒學院/體育學系/博士(2016年)

https://doi.org/10.6345/NTNU202204617

摘要

社區高齡運動是經濟與有效的方案，廣為各國採行。隨著運動需求日增，運動介入朝向分眾化、專業化才能提升資源分配的效益。我國高齡者參與運動比例雖高、時間也足夠，但仍有社區部分高齡者受肌少症的侵襲增加失能、跌倒風險，其背後原因亦值得探究，過往研究指出運動方案辦理上缺乏評估策略，難以針對需求提供適當運動介入，混合式的編班方式，參與運動的效益也難以釐清，皆會造成健康促進資源的浪擲。為提出具體論證並解決此困境，本研究目的有二，首先欲瞭解快速評估系統與功能性體適能的相關性與預測效力，其次要驗證不同肌少症風險者參與多元運動介入方案的效益跟限制，為達研究目的，本研究分別採用調查研究法及準實驗法。調查研究法的部分，總計調查臺北市與臺南市共145位高齡者之功能性體適能、握力、單腳站立之表現，參與者平均年齡71.35歲；其次，以準實驗設計確認不同肌少症風險高齡者，在共同參與依ACSM建議編制的多元性運動訓練 (伸展、阻力、有氧及平衡運動) 介入後，藉由第0週、第13週實施功能性體適能測驗，了解其效益與差異，共有60位高齡者完成介入與測試，平均年齡74.62歲，於考驗水準α<.05下，分別進行獨立樣本t檢定、卡方檢定、相關分析、多元迴歸分析及二因子重複量數變異數分析等。調查研究部分，確認快速評估系統與功能性體適能在上肢肌力、下肢肌力、動態平衡等存有中等以上顯著相關性，並存在線性關係且有中等以上的預測效益；準實驗設計之結果發現多元性運動介入效益依據肌少症風險之不同存有差異，高風險者所得的運動效益顯著較低。建議未來高齡者運動介入應採取能力分組，可提高促進效益、降低風險並充分針對需求設計專業課程，同時降低主辦單位的評估成本。

關鍵字

肌少症 ； 握力 ； 單腳站立 ； 多元性運動 ； 高齡者

並列摘要

Exercise training, an economic and effective strategy to boost the health of community-dwelling older adults, has been adopted in many countries for the past decades. Research shows that a high percentage of the aged population in Taiwan do spend quite an amount of time on daily activities or health-related programs; however, there is widespread lack of intensity. This lack of intensity leads to them suffering from sarcopenia and increases their risk of falling down or becoming disabled. Unfortunately, the aged are not offered proper exercise training, based on their functional fitness or performance tests. They are mixed in the same programs despite their fitness differences, which has greatly reduced the effects of exercise training and has wasted lots of public resources. This study aims to verify the efficiency of rapid functional fitness tests to help health-promoting workers on the primary level to assess more accurately and conveniently the fitness of the older adults. In addition, this study focuses on the effectiveness of multi-component exercise training for people at different risk levels of sarcopenia. To this end, researcher used survey research and quasi-experiment method. The subjects of the first project were recruited from the health-promoting programs held in Taipei and Tainan, sponsored by the Ministry of Science and Technology in 2015 and Taipei city government. In it, 145 participants, averagely 71.35 years of age, completed Senior Functional Fitness Test (SFT), Handgrip Test, and One-leg Standing Test with their eyes open. Then in a quasi-experiment, another 60 older adult were recruited from the mentioned program, averagely 74.62 years of age and at different risk levels of sarcopenia, were selected and given multi-exercise training (aerobic exercise, resistance exercise, flexibility exercise, and balance training) for 12 weeks. By checking their performance differences at the beginning and at the end of the program, the efficiency of the tests and the effectiveness of the training are revealed. Based on the findings, it is strongly suggested that rapid multi-functional tests should be given to the aged before the intervention of exercise training, and that they should be put into different groups based on their fitness. By doing this, the program can be more effective, run lower
risk, cater to personal needs of the aged, and save the assessment cost.

並列關鍵字

sarcopenia ； hand grip strength ； one-leg standing test ； multi-component exercise ； older adult

參考文獻

Chodzko-Zajko, W. J., Proctor, D. N., Fiatarone Singh, M. A., Minson, C. T., Nigg, C. R., Salem, G. J., & Skinner, J. S. (2009). American College of Sports Medicine position stand. Exercise and physical activity for older adults. Medicine & Science in Sports & Exercise, 41(7), 1510-1530. doi:10.1249/MSS.0b013e3181a0c95c

一、中文

內政部 (2009)。社區照顧關懷據點服務效益指標評估-銀髮族體適能檢測實務操作手冊。南投縣：財團法人愚人之友社會福利慈善事業基金會。

內政部 (2015)。民國102年簡易生命表提要分析。取自http://sowf.moi.gov.tw/stat/Life/T04-analysis.html

內政部 (2015)。老人福利法。2015年12月9日，取自：http://law.moj.gov.tw/LawClass/LawAll.aspx?PCode=D0050037