以因材施教模式運動計畫介入對社區關懷據點老人在體能活動表現成效之初探

Effect of Performance-Based Tailored Exercise Program on Elderly Community Dwellers at Community Care Station: A Preliminary Report

陳家慶(Jia-Ching Chen) ； 張棋興(Qi-Xing Chang) ； 林春香(Chun-Hsiang Lin) ； 吳孟純(Meng-Chun Wu) ； 梁忠詔(Chung-Chao Liang) ； 江姿儀(Tzu-Yi Chiang)

《台灣老年醫學暨老年學雜誌》 13卷2期 (2018/05) Pp. 100-117

https://doi.org/10.29461/TGG.201805_13(2).0003

摘要

背景與目的：「預防及延緩失能照護計畫」是去年政府推行於社區老人健康照護的一項重要策略，而「社區照顧關懷據點」（簡稱社區據點）為政府落實在地老化與社區照顧的方式之一。本研究欲探討以因材施教模式之預防及延緩失能照護計畫對參與社區據點不同活動能力程度老人在體能活動表現的影響。方法：收案自花蓮縣鳳林鎮某社區據點老人26位，依握力與走路速度檢測區分不同身體活動能力程度為體健組9位，肌少症前期（pre-sarcopenia）組9位和體弱（weakness）組各8位。三組老人均參與每週兩次、每次約2小時運動方案訓練共12周。一位未參與運動介入治療師評估上、下肢肌力（muscle strength）、單腳站（one leg stance）、10公尺走路速度（10-meter walk speed），與簡易體功能量表（short physical performance battery, SPPB）。結果：共23位完成本研究。除慢性病罹患率，三組基本資料並無統計差異；所有老人於介入後除握力外，在各項體能活動表現均有顯著進步，各組表現以肌少症前期組與體弱組的下肢肌力、走路速度，與肌少症前期組的簡易體功能仍有顯著進步，而體健組僅在10公尺走路速度進步顯著(p＜0.05)。結論：12周之預防及延緩失能運動方案以因材施教模式介入對社區據點不同活動能力程度老人於活動能力表現可能有所助益，因無控制組，故結果解釋仍需謹慎。

關鍵字

社區關懷據點 ； 老人 ； 因材施教 ； 身體功能 ； 運動 ； 肌少症前期

並列摘要

Background and purpose: Care programs for preventing and delaying mobility disability have been initiated by Taiwanese government since 2017, and community care stations (CCS) are an integral part of the welfare policy for elderly community dwellers in Taiwan. The study aimed to investigate the effect of the mobility disability prevention program based on a performance-based tailored exercise plan on elderly community dwellers with various levels of physical mobility at a CCS. Method: 26 subjects were recruited from a CCS in Fonglin Township, Hualien and classified into the following three groups according to their performance in terms of grip strength and walking speed: the healthy group (n=9), the sub-weak group (n=9) and the weak group (n=8). Subject in all three groups participated in the performance-based tailored exercise program at the CCIS at the same time for two 2-hour sessions per week for 12 weeks. An experienced therapist uninvolved in the study assessed the performance of each subject before and after the intervention in terms of upper and lower limb muscle strength, bilateral one leg stance, 10-meter walk speed and short physical performance battery (SPPB). Results: 23 elderly community dwellers completed the pre and post assessments. No significant difference in baseline data was observed among the three groups except for ＂chronic disease.＂ For physical mobility, subjects in all three groups showed significant improvement except for grip strength. Subjects in the sub-weak and weak groups reported significant improvement in lower limb strength and walking speed, and significant improvement in SPPS was detected in the weak group. The healthy group demonstrated significant improvement only in walking speed (p＜0.05). Conclusion: a 12-week performance-based tailored exercise program administered at CCS for preventing and delaying mobility disability can benefit elderly community dwellers with different levels of physical mobility. However, the results should be interpreted with caution due to the absence of a control group in the study.

並列關鍵字

community care station ； older adult ； performance-based tailored program ； physical mobility ； exercise ； pre-sarcopenia