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題名：團體運動處方介入對鄉村老人功能性體適能與健康生活品質之影響
作者：王秀華 引用關係
作者(外文)：Hsiu-Hua Wang
校院名稱：國立體育大學
系所名稱：體育研究所
指導教授：蔡櫻蘭
方進隆
學位類別：博士
出版日期：2013
主題關鍵詞：老化；SF-36；運動階段；身體活動；預防醫學；Aging；SF-36；Stage of Change；Physical Activity；Preventive Medicine
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目的：本研究欲建立適合鄉村老人「全面性團體功能性體適能運動處方」策略模式，並探討12週的「全面團體功能性體適能運動處方」課程介入對鄉村老人在功能性體適能及健康生活品質的改變成效。方法：本研究第一階段以嘉義縣地區266位65歲以上鄉村健康老人爲研究對象(77.2±5.6歲、154.6±7.1公分、58.6±9.4公斤)，以身體活動程度及運動階段調查表，瞭解鄉村老人之運動行為，進而以SF-36問卷調查訪談瞭解健康生活品質狀況，並同時進行功能性體適能之檢測，繼而以描述性統計、卡方考驗、單因子變異數分析、與複迴歸分析各變項之資料，以及探討鄉村老人基本生理參數與六項功能性體適能是否可作為健康生活品質之預測用變項。第二階段以立意取樣方式，並從中選取符合身體活動量未達建議量之久坐者為團體運動處方介入對象，分爲實驗組53位(77.3±5.3歲、154.2±7.3公分、59.1±7.9公斤)與對照組74位(77.8±5.8歲、154.5±7.1公分、57.7±11.3公斤)兩組的驗證性實驗設計。實驗組之受試者需從事為期12週，每次約90分鐘，每週2次全面性團體運動處方介入和1次的居家自主運動。所有受試者於12週後再次實施健康生活品質問卷訪談施測，以及功能性體適能評估之後測，所得資料先以獨立樣本t考驗檢定兩組受試者之基本生理參數是否具有同質性，進而以單因子共變數分析進行檢定，考驗本研究團體運動處方課程介入前後各依變項之改變，本研究統計顯著差異水準訂為α=.05。結果：一、健康生活品質不會因運動階段與身體活動程度的不同而有顯著差異(p>.05)，但在功能性體適能之上半身柔軟度(p<.05) 與敏捷/動態平衡(p<.05)會因運動階段的不同有顯著差異，而有氧耐力(p<.05)與敏捷/動態平衡(p<.05)會因身體活動程度的不同有顯著差異。二、六項功能性體適能之有氧耐力(p<.05)與敏捷/動態平衡(p<.05) 為健康生活品質之顯著預測用變項。三、實驗組在介入12週之團體運動課程訓練後，其身體質量指數、下肢肌力、有氧耐力達顯著差異水準(p<.05)；而在健康生活品質之各向度，除了身體疼痛、一般健康知覺與心理健康外(p>.05)，其餘在身體功能、身體功能角色限制、活力狀態、情緒功能角色限制、社交功能、生理總分、心理總分和整體健康總分面向皆達顯著差異水準(p<.05)。結論：團體運動處方訓練藉由全面性團體功能性體適能運動處方及有效的推廣策略介入能有效改善久坐式鄉村老人功能性體適能中的下半身肌力與有氧耐力，並且增進其健康生活品質。期許未來將安全有效的全面性運動處方策略推廣至更多的鄉村社區，讓更多久坐的老年族群生活型態變得更活躍，進而能獲得身心健康的提升。本研究之成果可作爲未來老年人預防醫學的參考。
Introduction：The health benefits of regular physical activity for elderly are well documented. Little is known about whether an integrated physical activity intervention would have health-related physical fitness and health-related quality of life benefits in rural community elderly. Purposes：1.To develop a strategic implementation model for promoting functional physical activity towards rural elderly; 2.To examine changes in functional fitness, and health-related quality of life as a result of a 12-week integrated functional fitness program in rural community elderly. Methods：266 elderly community residents (aged 65 or above)(77.2±5.6yrs, 154.6±7.1cm, 58.6±9.4kg) were recruited during the first stage of this experiment, functional fitness measures and self-response questionnaires including SF-36 and a self-report containing sections on demographic characteristics, and physical activity categories were assessed. Data analysis utilized were Descriptive analysis, Chi-square, One-way analysis of variance (ANOVA), and Multiple Regression to examine the predictability of physiological variables, and six functional fitness variables towards Health-related Quality of life in rural elderly. In the second stage, 127 sedentary elderly, including 53 experimental subjects (77.3±5.3yrs, 154.2±7.3cm, 59.1±7.9kg), and 74 control subjects (77.8±5.8yrs, 154.5±7.1cm, 57.7±11.3kg), were screened through purposive sampling method, and recruited for the 12-week of integrated functional fitness exercise intervention (90 min, 3 times per week, including 1 class home-based, and 2 group classes). Data were collected before and after the intervention. Independent Group T-test was used for the homogeneity test for the experimental and control group. One-way ANCOVA was utilized for the data analysis to explore the effects on health-related quality-of-life, and functional fitness. The significant level was α=.05. Results：1.No significant(p>.05) differences were found in the Health-related quality of life among elderly from different Stage of change, and different levels of physical activity; however, significant differences(p<.05) were found in Upper Body Flexibility, and Dynamic Balance among elderly of different Stage of Change; Moreover, Aerobic Endurance, Dynamic Balance were found significant different(p<.05) among elderly of different exercise levels;2.Aerobic Endurance, Dynamic Balance were significant predictors(p<.05) of Health-related Quality of life;3.Older adults experiencing 12-week integrated functional exercise intervention was significantly(p<.05) higher in BMI, Lower Body Muscular Strength, and Aerobic Endurance of functional fitness, and higher in most of the variables of health-related quality of life (including physical function role limitation, vitality, emotional function role limitation, social function, physical health, mental health, and total health), except Bodily Pain, General Health, and Mental Health. Conclusions：Through effective impementatioanl strategies, integrated group exercise program training could enhance lower body strength, and aerobic capacities, in turn, increase the health-related quality of life of rural community elderly. These results suggest that integrated implementation strategies are needed to promote increased in physical activity participation for more elderly communities, thus enhanced their physical and emotional health for a biggerpopulation of rural older adults. This study provides evidence for the future study of preventive medicine in rural community elderly.
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