以系統性文獻回顧檢視台灣地區運動介入於增進老人平衡能力之應用

研究背景：老人身體機能退化性改變直接影響平衡的穩定，進而提高跌倒的危險性。平衡能力為功能性表現與降低日常生活跌倒等危險因子的重要基礎，預防老人跌倒成為重要之健康議題。國內外學者以系統性文獻回顧法探討平衡能力訓練在預防老人跌倒的成效，但目前並無學者以系統性文獻回顧單獨針對國內預防老人跌倒運動之平衡能力訓練設計進行分析。研究目的：一、統整國內應用各種平衡訓練之實證研究，檢視各研究平衡能力訓練之研究品質；二、分析國內應用不同平衡訓練之現況訓練內容、頻率、時間、測量指標及成效。研究方法：採用Smyth（2009）提出系統性回顧執行步驟，蒐集期間為2016年3月前之收錄於八個資料庫之期刊文獻，包括：PubMed、EBSCO Medline with full Text、The Cochrane library、CINAHL-EBSCO host、Airiti Library華藝線上圖書館、臺灣碩博士論文知識加值系統、臺灣期刊論文索引系統及政府研究資訊系統。查閱過程使用關鍵字：老人（old or elder）、運動（exercise）或體感（somatosensory）及平衡能力（balance）、同時加入Taiwan搜尋發表於英文期刊之國內研究文獻，刪除非納入條件及重複出現的文獻，最後選取符合本研究設計之文獻納入評讀進行分析。研究結果：共納入40篇研究分析，近年來以運動訓練為主要介入性措施的實驗性文章（RCT）數量，有逐漸增加的趨勢；有11篇文章之研究樣本數小於30位，研究設計不夠嚴謹，使其研究結果之外推性受限，無法證實增進平衡能力之成效；國內學者以組合式運動（瑜珈＋平衡遊戲等)、太極、瑜珈、有氧阻力訓練、行走訓練等運動適合老人，訓練時間為60分鐘，每週次數以2-3次，訓練頻率以12週為最常見，以功能性評估測量平衡能力列為成效指標，皆實證老人平衡能力提升之成效，有效預防跌倒帶來的意外傷害。討論與結論：本研究透過系統性文獻回顧法，統整國內關於運動訓練於增進老年人平衡能力之研究，結果發現增進老人平衡能力訓練的方法以組合式運動對老年族群較為合適，訓練時間為60分鐘，每週2-3次，為期12週，運用功能性評估方式配合電腦化平衡能力評估系統為測量平衡能力之成效，使研究結果更具客觀及精確。此外，透過遊戲聲光刺激認知的「體感運動」，讓老人族群享受運動的樂趣，進而提高訓練平衡能力之動機與效果，故組合式運動及體感運動確實可做為臨床實務與研究的參考。

關鍵字

老人；運動；體感；平衡能力；系統性文獻回顧；臺灣

並列摘要

Background：Changes in the physical function of the elderly directly affect balance stability, and thus increase the risk of falling. Balance ability is the important risk factor for functional performance and reduction of daily life falls. To prevent the elderly from falling has become an important health issue. Domestic and foreign scholars have reviewed the effectiveness of balance training in the prevention of falling of the elderly through systematic literature review. However, up to now, there is no systematic review of the balanced ability training designed for the domestic prevention of the elderly's fall movement. Objective and Methods：The purpose of the study is to consolidate the domestic application of balanced training studies and to the study the research quality of the balance ability training. In addition, this research also aims to analyze the contents, frequency, time, measurement indicators and effectiveness of different balance trainings. Systematic review bought up by Smyth in 2009 was applied in this research and the periodicals before March, 2016 of the seven databases were collected. The databases include PubMed, EBSCO Medline with full Text, The Cochrane library, CINAHL-EBSCO host, Airiti Library, and National Digital Library of Theses and Dissertations in Taiwan. Results：The research results are as followed: 40 related research were being analyzed. In recent years, research regarding randomized controlled trial (RCT) in on the rise. There were 11 articles had samples less than 30, which indicates that the study design was not rigorous and limits research results. Exercises such as yoga, Tai-chi, aerobic resistance training, walking training are suitable for the elderly. Training time should be 60 minutes, and it is common to train for 2-3 times a week for 12 weeks. With the measurement of balance performance as result indicators, it is proven that the effectiveness of balance can help to prevent falls caused by accidental injury. Through the systematic review of this study, we can see that exercise helps improve the balance of the elderly. Discussion and Conclusion：The use of functional assessment methods in line with the computerized balance of capacity assessment can make the results more objective and accurate. In addition, through somatosensory movement, which indicates stimulation of sound and light, the elderly can enjoy the fun of sports and thus improve the effect of training. The combination of exercise and somatosensory movement can indeed be used as clinical practice and research reference.