探討全身震動訓練對老年人之效益

Effects of whole body vibration on the elderly

曾炫諭(Shiuan-Yu Tseng)

指導教授 ： 李孟智 ； 王淳厚

中山醫學大學/醫學院/醫學研究所/博士(2016年)

摘要

中文摘要
目的:本研究探討全身震動訓練對於老年人身體平衡能力及柔軟度表現中針對不同震動頻率之效益，並根據不同頻率之結果添加震動過程中視覺遮蔽之訓練探究其肌肉力量表現。
實驗設計: 隨機分配試驗，單盲設計。
受試者: 於不同震動頻率研究中:四十五位平均年齡69.0 ± 4.1歲且無運動習慣之老年人參與本研究。在震動過程添加視覺遮蔽研究中:四十五位平均年齡69.22 ± 3.97歲且無運動習慣之老年人參與本研究。
介入: 於不同震動頻率研究中:參與者隨機納入震動訓練高頻組(40 Hz; n = 15)、低頻組(20 Hz; n = 15)、及控制組(Control; n = 15)，震動組接受每週3次，每次五分鐘，震幅(0-4 mm)為期3個月的全身震動訓練。在震動訓練頻率探究實驗後震動過程添加視覺遮蔽研究中:參與者隨機納入震動訓練組(20 Hz; n = 14)、震動訓練視覺控制組(20 Hz + closed eye; n = 17)、及控制組(Control; n = 14)，震動組接受每次五分鐘，每周三次，持續三個月的全身震動訓練。
量測參數: 於不同震動頻率研究中:所有受試者分別於訓練前、訓練中(1個月)、訓練後(3個月)、追蹤(6個月)時接受平衡系統(Balance system, Biodex, USA)之穩定度限制(limits of stability)參數測量受試者之平衡表現，及坐姿體前彎(sit and reach)測量受測者之柔軟度表現。在震動訓練頻率探究實驗後震動過程添加視覺遮蔽研究中: 所有受試者訓練前後藉由平衡系統(Balance system, Biodex, USA)之穩定度限制(limits of stability)參數量測受試者之平衡表現，並再藉由等速肌力測試儀(Isokinetic dynamometer System 4 Pro™, Biodex, USA)測試受測者接受訓練前後之下肢肌肉力量膝伸直肌群(Knee extensors)與膝彎曲肌之(knee flexors)力量變化。
結果: 於不同震動頻率研究中:在穩定度限制與坐姿體前彎表現中不同組別在4個不同測試時間點的表現均有顯著的交互作用(F = 25.218, p < 0.001，F = 12.235, p < 0.001；respectively)。Tukey事後分析比較發現在平衡能力表現中20 Hz組在1個月、3個月、6個月時與40 Hz及控制組比較均有明顯差異(p < 0.001)。而40 Hz組與控制組比較則在3個月震動訓練結束時有顯著差異(p = 0.033)，在其他時間點則未達統計上的顯著差異。在柔軟度表現上20 Hz組在1個月、3個月、6個月時40 Hz及控制組比較均有改善但未達統計上的顯著差異情形(p > 0.05)。但坐姿體前彎的改善在20 Hz震動訓練的組內效果最為顯著持續至六個月(F= 33.280, p < 0.001)。20 Hz組發生跌倒而就醫的次數相較於其他兩組為低，但未達統計上顯著差異(p = 0.302)。在震動過程添加視覺遮蔽研究中，於穩定度限制與肌肉力量表現中不同組別在前後測的表現均有顯著的交互作用(time × group, p < 0.001)，穩定度限制與肌肉力量表現在前後改變值三組中也都有顯著差異(F = 13.213, p < 0.001; F = 5.106)。事後分析比較發現，穩定度限制的改善在閉眼震動訓練20 Hz與單純震動訓練20 Hz組顯著優於與控制組(p < 0.001); 膝伸直肌(knee extensor)的肌肉力量進步百分比，震動訓練20 Hz閉眼組顯著優於單純20 Hz震動訓練組與控制組(p = 0.003, p = 0.000; respectively)。
結論: 綜合研究結果顯示無運動習慣之老年人接受3個月的不同頻率之全身震動訓練顯示出不同的效益。20 Hz的全身震動訓練對無運動習慣之老年人平衡能力及柔軟度有明顯助益。全身震動訓練在閉眼的控制底下顯示出不同的訓練效果。全身震動訓練於20 Hz時並關閉視覺對無運動習慣之老年人平衡感更有明顯助益。
關鍵字: 全身震動訓練; 平衡能力; 老年人; 柔軟度。

關鍵字

全身震動訓練 ； 平衡能力 ； 柔軟度 ； 老年人。

並列摘要

Purpose: The aim this study was to investigate the effects of whole-body vibration training with different frequencies on the balance and flexibility of the healthy elderly. And according to the result of vibration frequencies parameters that add to a visual feedback-deprived plus WBV (VFDWBV) on balance and lower-extremity muscle strength in the elderly.
Study design: A single-blind randomized trial.
Subject: In different vibration frequency group: A total of 45 subjects, with a mean age of 69.6 ± 3.9 years, were randomly divided into three groups. The subjects were randomly divided into three groups: a high-frequency vibration group (40 Hz, n=15), a low frequency vibration group (20 Hz, n=15), and a no vibration control group (0Hz, n=15). In vibration training without visual feedback A total of 45 elderly subjects with an average age of 69.22±3.97 years, divided into a WBV group (n=14), a VFDWBV group (n=17), and a control group (n=14), completed the trial. The WBV training last for 3 months, and the subjects received WBV training 3 times per week for 5 min each time.
Parameter: In different vibration frequency training: The participants in the experiment all received assessments at Pre-training, Mid-training (Month 1), Post-training (Month 3), and Follow-up (Month 6). The assessment included the limits of stability test and the sit and reach test. In VFDWBV: The evaluation items included the limits of stability (LOS) test and evaluation of the strength of the knee extensor/flexor muscles.
Result: There was a significant inter action in the limits of stability test and the sit and reach test of the different groups at the four time points (F = 25.218, p < 0.001, F = 12.235, p < 0.001, respectively), showing that the 20 Hz group experienced a more positive effect on balance and flexibility than those in the 40 Hz and control groups at the four different measured time points. Post hoc analysis and comparison indicated significant differences in balance performance among the 20 Hz group, the 40 Hz group, and the control group at Month 1, Month 3, and Month 6 (p < 0.001). There was a significant difference between the 40 Hz group and the control group upon termination of the 3-months vibration training (p = 0.033); however, the differences at other time points did not reach statistical significant. The flexibility performances of the 20 Hz group improved more than those of the 40 Hz group and the control group at Month 1, Month 3, and Month 6. However, the difference did not reach statistical significant (p > 0.05). The within group effect of the improvement on the sit and reach test of the 20 Hz vibration training group was the most significant, and lasted to Month 6 (F = 33.280, p < 0.001). The within-group effect of the 40 Hz vibration training group lasted to Month 6 (F = 7.623, p = 0.005). Within the study period, it was found that the probability of medical appointments due to falls in the 20 Hz group was 0% (0/15), that in the 40 Hz group was 6.7% (1/15), and that in the control group was 20% (3/15). The number of medical appointments due to falls in the 20 Hz group was lower than that in the other two groups. However, the difference did not reach statistical significance (p = 0.302).
There were statistically significant differences in balance performance among the 3 groups at different time points (time X group interaction: F = 13.213,p < 0.001). In addition, the post hoc comparison showed that balance performance was better in the VFDWBV group and the WBV group than in the control group at Month 3 and Month 6 (p < 0.001). The strength of the knee extensor and knee flexor muscles had time x group interactions: F = 29.604, p < 0.001 and F = 4.684, p = 0.015, respectively. Relative to the pre-training performance, the post-training knee extensor strength of the VFDWBV group improved by 37.89% (p < 0.001), and the post-training knee flexor strength improved by 19.40% (p = 0.002). However, only the knee extensor strength of the WBV group showed improvement, with an increase of 15.40% (p < 0.001). There was no significant improvement in the control group. At the 6-month follow-up, 0 subject from the WBV group (0%, 0/14), 0 subject from the VFDWBV group (0%, 0/17), and 4 subjects from the control group (28.57%, 4/14) reported hospital visits due to falls. Fisher exact test found that the incidence of falls was higher in the control group than in the other groups (p = 0.013).
Conclusion: Whole-body vibration training at 20 Hz has significant benefit to the balance and flexibility of the elderly who do not engage in habitual exercise. WBV training at 20 Hz without visual feedback can significantly improve the balance performance and lower-extremity muscle strength of the elderly.
Key words: whole-body vibration; balance; flexibility; elderly

並列關鍵字

whole-body vibration ； balance ； flexibility ； elderly

參考文獻

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