無規律運動習慣高齡者日常間歇性身體活動與功能性體適能表現之研究

Abstract

高齡化成為我國重要議題，促進健康老化更顯關鍵，規律運動雖對高齡者生理功能具有效益，但規律運動習慣養成不易，且若能在運動前透過功能性體適能評估及了解其活動能力，可更精準設計運動處方。而「日常高強度間歇性身體活動 (Vigorous Intermittent Lifestyle Physical Activity, VILPA)」，則是將身體活動融入於日常生活中，像是短距離的快走、提重物與爬樓梯等，大幅減少身體活動參與阻礙。不過過往較少研究探討兩者間的關聯，據此，本研究將探討無規律運動習慣之高齡者日常間歇性身體活動與功能性體適能表現之關聯性，並依強度分為日常高強度間歇性身體活動及日常中強度間歇性身體活動 (Moderate Intermittent Lifestyle Physical Activity, MILPA)。本研究屬次級資料分析，其資料採便利取樣於臺大醫院進行收案，招募300位65歲以上高齡者，研究對象須連續配戴7日三軸加速規以及完成功能性體適能之檢測。本研究以SPSS 23進行多元線性迴歸分析以及邏輯斯迴歸分析。扣除資料不完整、有規律運動習慣以及三軸加速規配戴不符者，橫斷研究共納入132名高齡者，其結果顯示在控制所有共變數後，相較於未達成1-2分鐘VILPA者，達成者與其四項功能性體適能表現雖呈正向關聯，但未達統計顯著差異；中強度方面，相較於未達3分鐘MILPA者，達成5-10分鐘MILPA與其功能性體適能表現中的握力測驗公斤數呈正相關 (B=2.445；95% CI=0.076, 4.814)、計時起身三公尺行走測試的秒數呈負相關 (B=-4.509；95% CI=-6.700, -2.319)、六公尺步行測驗的速率呈正相關 (B=0.348；95% CI=0.234, 0.462) 及五次坐站測驗的秒數呈負相關 (B=-3.551；95% CI=-6.268, -0.834)，綜整上述發現MILPA與功能性體適能表現皆呈顯著正向關聯。縱貫研究共納入81名高齡者，其結果顯示在控制所有共變數後，基線量測時達1-2分鐘VILPA者，其握力測驗表現於一年後維持或進步之機率顯著較未達成者高 (OR=5.674；95% CI=1.431, 22.490)；中強度方面，相較於基線量測時未達3分鐘MILPA者，達3-5分鐘MILPA者，其計時起身三公尺行走測試 (OR=8.747；95% CI=1.045, 73.229)、六公尺步行測驗 (OR=27.534；95% CI=1.530, 495.424) 於一年後維持或進步之機率顯著較高；而達成5-10分鐘MILPA者，其六公尺步行測驗 (OR=8.841；95% CI=1.474, 53.037)、五次坐站測驗 (OR=8.228；95% CI=1.217, 55.613) 於一年後維持或進步之機率顯著較高。本研究為國內此議題之初探，其結果顯示無規律運動習慣之高齡者，於生活中達1-2分鐘日常高強度間歇性身體活動或5-10分鐘日常中強度間歇性身體活動，與其較佳的功能性體適能表現呈現顯著相關，建議高齡者可於日常生活中達成VILPA、MILPA，來維持及增進其功能性體適能之表現，亦建議未來研究者，更深入探討其與其他健康面向之關聯。With the increasing population of older adults, population aging has become an important issue in our country, making the promotion of healthy aging even more critical. Regular exercise has positive effects on the physiological functions of older adults, and assessing and understanding their physical activity capacity through functional fitness evaluation before before starting an exercise program may help design more precise exercise prescriptions. However, developing a consistent exercise habit remains a challenge. The term “Vigorous Intermittent Lifestyle Physical Activity (VILPA)” refers to incorporating physical activity into daily life, such as brisk walking over short distances, carrying heavy objects, and stair climbing, which significantly reduces barriers to physical activity participation. Nevertheless, limited research has investigated the association between VILPA and functional fitness performance. Therefore, this study aimed to investigate the association between daily intermittent physical activity and functional fitness performance in older adults without regular exercise habits, and further classifies the activities by intensity into VILPA and Moderate Intermittent Lifestyle Physical Activity (MILPA).This study was a secondary data analysis, and the data were collected using a convenience sampling method at National Taiwan University Hospital. A total of 300 older adults aged 65 years and above without regular exercise habits were recruited. Participants were required to wear a triaxial accelerometer device (GT3X+, ActiGraph) constantly for 7 days and complete functional fitness testing. Multiple linear regression analysis and logistic regression analysis were conducted using SPSS version 23.0. After excluding participantswith incomplete data, regular exercise habits, or invalid accelerometer wear time, 132 older adults were included in the cross-sectional study. Results showed that after control for all covariates, although participants who engaged in 1-2 minutes of VILPA were positively associated with four functional fitness performance outcomes, these associations did not reach statistical significance. Regarding moderate intermittent lifestyle physical activity (MILPA), compared to those who did not reach 3 minutes of MILPA, participants who engaged in continuous 5-10 minutes of MILPA demonstrated significant positive associations with handgrip strength (B=2.445；95% CI=0.076, 4.814), timed up and go test (B=-4.509；95% CI=-6.700, -2.319), 6-meter walk test (B=0.348；95% CI=0.234, 0.462), and five times sit-to-stand test (B=-3.551；95% CI=-6.268, -0.834). These results suggest that MILPA was significantly positively associated with overall functional fitness performance. A total of 81 older adults were included in the longitudinal study. Results showed that after control for all covariates, those who engaged in 1-2 minutes of VILPA at baseline had significantly higher odds of maintaining or improving handgrip strength after one year (OR=5.674；95% CI=1.431, 22.490). As for MILPA, compared to participants who did not reach 3 minutes of MILPA, those who engaged in continuous 3-5 minutes at baseline showed significantly higher odds of maintaining or improving performance in the timed up and go test (OR=8.747；95% CI=1.045, 73.229) and 6-meter walk test (OR=27.534；95% CI=1.530, 495.424). Furthermore, participants who engaged in continuous 5-10 minutes at baseline also showed significantly higher odds of maintaining or improving performance in the 6-meter walk test (OR=8.841；95% CI=1.474, 53.037) and five times sit-to-stand test (OR=8.228；95% CI=1.217, 55.613). This study is a preliminary exploration of this topic in Taiwan. The findings revealed that, among older adults without regular exercise habits, accumulating 1-2 minutes VILPA or 5-10 MILPA in daily life was significantly associated with better functional fitness performance. It is suggested that older adults integrate VILPA and MILPA into their daily routines to maintain and improve their functional fitness performance. Future research is also suggested to explore the associations between these activities and other health outcomes more deeply.