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Effects of Multi-component Exercise Training on Functional Fitness in Community-dwelling Older Adults
|Abstract:||緒論：規律運動可提升高齡者體適能、改善慢性疾病狀況及降低死亡率。多數臺灣高齡者運動時間充足，卻缺乏足夠的運動強度與多樣的運動種類（Type）。美國運動醫學會建議高齡者每週至少累計達到中等強度以上的身體活動量150分鐘，在運動種類上建議為多元性運動項目，包括：有氧訓練（aerobic training）；阻力運動訓練（resistance exercise training）；3.柔軟度運動（flexibility exercise）及；4.平衡訓練（balance training）。然而，以此原則發展之運動訓練課程相關研究並不多見，而該主張是否適用於社區高齡者運動推廣計畫、其體適能促進效益，及運動訓練後之保留效果，均尚待進一步的研究驗證。基於此，本研究目的旨在探討12週多元性運動訓練對社區高齡者功能性體適能之影響與保留效果。方法：以準實驗設計進行研究，招募90位65歲以上社區高齡者（年齡72.81±6.47歲），實驗組54人與控制組36人。實驗組接受12週多元性運動訓練課程，每週2次、每次120分鐘，並達到自覺量表5-6中等強度等級以上，之後中止訓練12週；控制組則無訓練。並以功能性體適能檢測進行測驗，項目包括：手臂彎舉、坐姿起立、抓背測驗、椅子坐姿前彎、8英尺立走及2分鐘原地踏步。於第0週進行前測、第12週進行後測、第24週進行保留測。結果：12週多元性運動訓練後，經功能性體適能測驗發現，實驗組在上肢肌力、下肢肌力、敏捷性、心肺耐力顯著進步；控制組在上肢肌力、下肢肌力、上肢柔軟度顯著退步。12至24週間無運動訓練介入，實驗組在肌力、柔軟度比有氧運動、敏捷性等有更佳的保留效果；控制組在12週後肌力、柔軟度將顯著退步、且24週後敏捷性、心肺耐力亦顯著退步。結論：多元性運動訓練，可顯著提升社區高齡者功能性體適能，無多元性運動訓練介入會導致社區高齡者功能性體適能顯著退步。依此結論，本研究具體建議：1、設計及執行社區高齡者運動方案時宜參照ACSM提出之多元性運動訓練原則；2、運動方案規劃期程與頻率上，宜每週至少辦理2次，每次120分鐘並連續辦理12週或以上；3、運動方案宜採長期、持續性辦理，有助參與者功能性體適能提升及維持。|
Introduction: This study analyzed the contributions of multi-component exercise training (MET) programs in improving the physical fitness of older adults or alleviating the effects of chronic diseases on them. Most of Taiwan's older adults devote considerable time to exercise for improving their health; however, the lack of adequate exercise intensity and monotonous exercise routines result in no change in fitness. The American College of Sports Medicine (ACSM) proposed guidelines and position stands to enable older adults to perform exercise routines adequately and efficiently. The ACSM recommended diverse exercise routines, which are: (a) aerobic exercise, (b) resistance exercise, (c) flexibility exercise, and (d) balance training. However, exercise training courses related to the research and development of the guidelines was rare. We investigate the effects of a 12 week MET program on the performance of the functional fitness and retention of fitness in community-dwelling older adults. In addition, we confirmed the duration for which the effects of the MET program can be maintained or diminished. Methods: A total of 90 community-dwelling older adults (age: 72.81� 6.47 years) were recruited and assigned to an MET group or a control group (CG). The participants in the MET group trained for 12 weeks with 2 sessions per week, 120 min per session, and an intensity of 5-6 on the Ratings of Perceived Exertion scale; by contrast, the participants in the CG did not engage in any training activity. The functional fitness tests for all participants were assessed before the training program and 12 and 24 weeks after the training program. The data were analyzed using paired and independent samples t tests. Results: Compared to pretest and posttest assessments, performance levels of MET group in the chair stand, arm curl, 8-foot up-and-go, and 2-min step tests increased significantly after the 12-week MET program; by contrast, the performance levels of CG group in the chair stand, arm curl, and back scratch tests decreased significantly after 12 weeks. We also compared the posttest and retention test assessments, and the results indicated that the performance levels of the participants in the MET group in the chair stand, arm curl, back scratch, chair sit-and-reach, 8-foot up-and-go, and 2-min step tests decreased significantly after 12 weeks of detraining; similarly, the performance of the participants in the CG group decreased significantly after the next 12 weeks of detraining. Therefore, we concluded that MET can effectively alleviate the decline in strength and cardiorespiratory endurance of community-dwelling older adults; however, it cannot maintain the alleviating effects over 12 weeks. Conclusion: MET can significantly improve multiple dimensions of the functional fitness of older adults and maintain the muscle strength and flexibility that they originally had before join the MET program. After the 12-week follow-up, the performance levels of the participants regressed significantly. Furthermore, the positive effects of MET can be maintained for 12 weeks. From the beginning to the end of the experiment, the performance levels of the participants who did not engage in the MET program declined over time. We thus present the following recommendations: (a) community exercise programs based on various sports training principles should be implemented according to ACSM's guidelines; (b) the training program must be performed at least 2 times per week for 12 consecutive weeks or more, and each training session must last 120 min; and (c) a long-term and persistent approach must be adopted in the exercise program to help participants improve and maintain functional fitness.
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