社區高齡者複合式防跌運動方案規劃與評估

Abstract

在高齡化社會，防跌訓練可以積極延緩老化預防失能，也是提升老年獨立生活能力的重要策略。本研究目的旨在以世界衛生組織之高齡者跌倒預防架構，發展社區高齡者複合式防跌運動方案課程，並評估課程對提升社區高齡者身體功能與平衡能力的成效，以評價課程之合適性，並探究參與者之防跌知識、運動習慣改變的影響等。本研究自台北、高雄及屏東等社區徵召符合條件之參與對象共118位，平均年齡為74.15（±5.87），參與10週複合式防跌運動方案。訓練課程包括防跌知識衛教與測驗及五大主題的複合式防跌運動課程介入，運動課程分別為伸展運動、心肺適能、肌力與耐力、平衡與協調及敏捷力，採用巡迴訓練方式進行。以身體功能與動、靜態平衡檢測，評估參與者課程介入前後之成效。身體功能包含雙手背後相扣、坐姿體前彎、30秒坐站、兩分鐘踏步、2.44公尺繞物。動態平衡包含富田踏步、2.44公尺繞物，靜態平衡包含張眼及閉眼單腳站立。統計方法包含t檢定、單因子共變數分析及詹森-內曼法，顯著差異p值小於.05。結果顯示，複合式防跌運動方案介入後，社區長者於柔軟度、心肺適能、下肢肌力、敏捷力及動靜態平衡均可見顯著進步（p< .05），防跌知識與運動頻率亦可見提升（p< .05）。本研究社區高齡者複合式防跌運動方案為結構式的團體訓練課程，可有效提升社區高齡者身體功能及平衡能力，同時其操作簡易且訓練器材易取得，兼具目的性與可近性，可作為社區跌倒防制的有效介入模式，及提供治療師運動課程設計參考之用。Introduction: Fall prevention training is an important strategy for declining disability and enhancing the ability of the elderly to live independently. Objectives: The purpose of this study was to develop a multicomponent exercise program for fall prevention, and to evaluate the effect of a fall prevention education, physical function, balancing ability and exercise habit in community-dwelling elderly, under the concept of fall prevention for the elderly recommended by WHO global report. Methods: Totally 118 participants from Taipei, Kaohsiung and Pingtung community-dwelling elderly were recruited to take 10 weeks multicomponent exercise program for fall prevention. The mean age of the participants was 74.15±5.87 years old (range from 65 to 90). The training programs included a session of fall-prevention education and multicomponent exercise with five themes, namely stretching exercises, cardiorespiratory fitness, muscular strength, balance and agility. Multicomponent exercise was a structured training program and conducted by way of circuit training model. Each participant was assessed in his/her physical functions, static and dynamic balance abilities before and after intervention. Physical functions included back scratch test, chair sit and reach test, 30 second chair stand test, and 2-minute step test. Balancing ability included one leg stance test with eye open/close, 8-foot up and go test, and Fukuda step test. The data were analyzed with paired t-test, one way ANCOVA, and Johnson-Neyman method. Results: The physical function and balancing ability of the participants were significantly improved in flexibility, lower extremity muscle strength, cardiorespiratory fitness, agility, and static and dynamic balance ability (p< .05). The participants’ fall-prevention knowledge was improved and their exercise frequency became more after the training program (p< .05). Conclusions: The multicomponent exercise program for fall prevention in the study was suggested to be beneficial for the community-dwelling elderly in their physical function and balancing ability. Multicomponent exercise program for fall prevention can be promoted for its simple and safe training equipment and operational procedure in community- dwellingelderly.