運動訓練對老年精神障礙者的平衡與行走成效－採專業合作模式

The Effects of Exercise Training on Balance and Walking Performance in Older Adults with Mental Illness-A Cross-Disciplinary Collaboration Approach

禚昌麟(Chang-Lin Cho) ； 陳其嶸(Chyi-Rong Chen) ； 張雁晴(Yen-Ching Chang) ； 楊沛穎(Pei-Yen Yang) ； 徐玉英(Yu-Ying Hsu) ； 陳明德(Ming-De Chen)

《職能治療學會雜誌》 33卷2期 (2015/12) Pp. 149-167

https://doi.org/10.6594/JTOTA.2015.33(2).02

摘要

背景及目的：老年精神障礙者（簡稱精障者）身體健康狀況不佳，是跌倒與多種慢性疾病的高危險群。運動訓練已被認定為有效的跌倒預防介入之一。在長期精神障礙照護機構中，老年精障者的復健成效受到多層面的影響，僅由單一專業所提供的治療服務模式已無法滿足其需求。因而，本研究之目為藉由專業合作模式，提供老年精障者運動訓練，以改善其平衡與行走能力。方法：研究採用單組前後測量加上3 個月的追蹤評量研究設計。透過立意取樣，選取某精神科專科教學醫院內目前因平衡問題而接受身體約束處置之個案。參與者接受每週三次，每次60 分鐘，持續進行13 週的專業合作所發展之平衡行走運動團體訓練。評量包括柏格氏平衡量表、2 分鐘行走距離與10 公尺行走時間，並比較訓練前、後和追蹤期的差異程度。結果：共有29 位個案參與，其中25 位完成後測，19 位完成追蹤評量。參與者在柏格氏平衡量表 (p ＜ .001) 和2 分鐘行走距離 (p = .028) 在三次不同測驗階段的分數達統計顯著差異。結論: 本研究以專業合作模式並採用多面向的功能性訓練介入，參與者之平衡和行走能力獲得顯著改善。此研究成效可供臨床參考，未來可有更多嚴謹的研究來驗證此研究成效。

關鍵字

精神障礙 ； 專業合作 ； 平衡 ； 行走 ； 運動訓練

並列摘要

Background: Older adults with mental illness (MI) have poor physical health, high risks of falls and various chronic diseases. Exercise training has been regarded as one of the effective fall prevention interventions. In long-term care institutions for older adults with MI, many factors impact on their rehabilitation effects. Services provided by single professional cannot meet all needs of this population. Using a cross-disciplinary collaboration approach, the aim of this study was to provide an exercise training program for older adults with MI to improve their balance and walking ability. Method: This was one-group pretest-posttest design with a three-month post-intervention follow-up. We purposely selected 29 participants who had physical restraints due to balance disorder from one psychiatric hospital. Participants attended a 13-week exercise training program (3 times per week, 60 minutes each). Instruments included Berg Balance Scale (BBS), 2-Minute Walk Test (2MWT), and 10 Meter Walk Test. Changes in measurements were compared among the three time points (baseline, post-intervention, and 3-month post-intervention follow-up). Results: Twenty-nine participants were recruited. Of them, 25 completed the post-intervention assessments and 19 completed the follow-up evaluations. There were significant differences in BBS (p ＜ .001) and 2MWT (p =.028) among the three time points. Conclusion: These findings suggest that a multi-component exercise training program using a cross-disciplinary collaboration approach can improve balance and walking ability for older adults with mental illness. However, further rigorous studies are needed to confirm these findings.

並列關鍵字

Mental illness ； Collaboration ； Balance ； Walking ； Exercise training