生態學模式與多元性運動訓練介入對社區高齡者功能性體適能與休閒時間身體活動量之影響

Abstract

臺灣人口老化嚴重，65歲以上人口快速成長且比例急速攀升。為此，以運動促進高齡者健康的公共衛生方案顯得極其需要。雖然臺灣老年人口參與運動比例高、時間足夠，但運動強度不足、運動種類單調。其次，臺灣高齡者運動方案逐漸普及，但課程內容缺乏持續性及專業性。本研究目的旨在探究透過生態學模式 (個人、人際及社區層次) 促進多元性運動訓練 (柔軟度、阻力、有氧及平衡運動) 對社區高齡者在功能性體適能與休閒時間身體活動量之影響。本研究以臺北市衛生局103年社區悠活站-健康促進與輔導方案之參與者為研究對象，以準實驗設計法將參與者分為三組。實驗組1 (24人) 接受生態學模式為主的多元性運動訓練介入；實驗組2 (25人) 接受多元性運動訓練；控制組 (25人) 維持低強度身體活動。為了探究方案效益，所有受試者在第0週、第13週及第25週參與功能性體適能測驗，並填答休閒時間身體活動量表。資料分析在考驗水準α＜.05下進行描述性統計、獨立樣本t檢定、卡方檢定及二因子重覆量數變異數檢定。研究結果發現： (一) 低強度的休閒時間身體活動量無法改善社區高齡者的功能性體適能； (二) 從事多元性運動訓練，不論是否透過生態學模式介入，皆可有效提升功能性體適能與休閒時間身體活動量； (三) 透過生態學模式促進多元性運動訓練，對功能性體適能及休閒時間身體活動量的提升及維持效益優於僅從事多元性運動訓練。結論：多元性運動訓練，尤其是透過生態學模式進行，可有效提升並維持社區高齡者的功能性體適能及休閒時間身體活動量，是值得推行的公共衛生政策。Taiwan is an aging society, with the amount and proportion of older citizens aged 65 and over increasing rapidly in recent years. Because of such population trend, a public health intervention that focuses on using exercise to promote health among older adults has become imperative. Although studies have shown that many Taiwanese older adults do spend quite amount of time participating in physical activities, the intensity and variety of such participation is often limited. Furthermore, although there are increasing numbers of exercise programs available to seniors, oftentimes programs are not designed by professionals or for sustained participation among the older generation. The purpose of this study is to examine the impacts of multi-component exercise training (MET) programs (i.e., flexibility exercise, resistance exercise, aerobic training, and balance training, etc.) among older adults, with a focus on whether adapting an ecological approach that delivers interventions at different levels (i.e., individuals, organizations, and communities) can affect seniors' functional fitness and leisure-time physical activity participation. The subjects were recruited from the “Recreation Hubs—Health promotion and consultation project” initiated by the Department of Health in Taipei, Taiwan in 2014. Using a quasi-experimental design, participants were selected into three study groups. The Experimental Group 1 (24 participants) received the ecological-based MET intervention, while the Experimental Group 2 (25 participants) received the MET and the Control Group (25 participants) received no interventions and continued participating in low-intensity physical activities. To evaluate the impacts, data were collected from all participants using the Senior Functional Fitness Test (SFT) and Leisure Time Physical Activity (LTPA) scale one week before the project started (0 week), one week after the project ended (13th week), and at the 25th week. Results from the independent t-tests, chi-square tests and two-way ANOVA repeated measures (α＜.05) suggested that: (1) Participation in low-intensity physical activities alone cannot lead to enhanced functional fitness among older adults; (2) Participation in MET, despite it's an ecological-based model or not, can effectively promote seniors' functional fitness and leisure time physical activity participation; (3) The ecological-based MET can maintain and promote seniors' functional fitness and their participation in leisure time physical activities more effectively than the general MET. Conclusion: MET programs, especially those based on the ecological model, can effectively maintain and promote seniors' functional fitness and leisure time physical activity participation. Because of the benefits, policy makers are encouraged to promote MET programs as an effective public health intervention for older adults.