國小肥胖學童PACER運動表現及心血管反應之比較研究

Abstract

本研究以17名10~12歲正常組學童（%fat≤25%）、18名肥胖組（%fat＞25%）為研究對象，比較其身體組成及進行PACER 20公尺漸進式折返跑運動過程、運動後恢復期心血管反應之差異。身體組成包含身高、體重、身體質量指數、腰圍、全身脂肪比率、全身肌肉比率、軀幹脂肪比率、軀幹肌肉比率、手部脂肪比率、手部肌肉比率、腿部脂肪比率、腿部肌肉比率等基本生理測量值，PACER運動至累計二次無法到達折返點停止，其運動所收集之心跳率、收縮壓、舒張壓作為比較心血管反應之指標。

所得資料經獨立樣本t考驗之統計分析後，結果發現：（1）在身體組成方面，肥胖學童在體重、身體質量指數、腰圍、全身脂肪比率、軀幹脂肪比率、上肢脂肪比率、下肢脂肪比率高於正常組學童，達顯著差異水準（p＜.05）。腰圍與全身脂肪比率、軀幹脂肪比率相關較身體質量指數為高。在國內三種不同身體質量指數肥胖兒童在進行篩選上都會有少部份因被歸類於正常或稍重而可能被忽略；（2）在PACER運動方面，經由統計迴歸發現，受試學童之PACER運動趟數表現總變異有84.0%與腿部肌肉比率和年齡有關；受試學童在PACER趟數表現與美、日體適能測驗標準相較，學童表現不如美、日學童。（3）在心血管反應方面，無論收縮壓、舒張壓，肥胖組學童增加的幅度均高於正常組學童，此外肥胖組學童PACER運動後第一分鐘心跳恢復能力較正常組學童為慢。

因此本研究得到以下結論：（1）目前國內以身高體重換算之身體質量指數無法全然反映出學童身體肥胖程度，建議腰圍可作為未來兒童肥胖程度之判定方法要素之ㄧ；（2）影響PACER運動主要因素在於下肢肌力，因此，我國學童平日應加強肌力訓練，因為有肌耐力運動才能持久，方能進一步提升心肺適能表現；（3）肥胖組學童在從事PACER運動時心血管機能適應較正常組學童為差，可能導致肥胖學童日後容易引發心血管疾病，應及早注意並介入治療改善。若從運動可達之最大心跳而言，PACER是適合測試國小學童心肺適能之運動項目。

The purpose of this study was to compare the different cardiovascular response between male obese and normal primary school students during PACER exercise. Seventeen normal and eighteen obese primary school students participated in body composition analyzing and exercising PACER fitness test. During PACER exercise, heart rate and blood pressure were measured as indexes for cardiovascular respond.

Independent t-tests were utilized to determine significant differences between male obese and normal students on all variables. The level of significance was set at .05. The result showed that（1）body composition： male obese primary school students have significant higher total body fat percentage, trunk fat percentage, upper extremities fat percentage, and lower extremities fat percentage than normal primary school students （p＜.05）. In all participants, waist circumference has higher relation to body fat percentage and trunk fat percentage than body mass index. Few male obese students were regarded as normal or overweight while facilitating three body mass index standards in Taiwan.（2）PACER exercise：After data was analyzed with step regression, lower extremities muscle percentage and age can explain 84% of PACER laps performance. Compared with the fitness test standards in USA and Japan, all participants have lower PACER laps performance.（3）cardiovascular response：The increases of systolic and diastolic blood pressure in male obese students are higher than male normal students. Heart rate recovery to the baseline in male obese students is slower than male normal students.

In this study, we concluded that：（1）Body mass index can not totally reflect the obese degree of school-aged males. Waist circumference is a good index to evaluate the degree of obesity. （2）The main factor affects schoolchildren’s PACER performance is the percentage of lower extremities. Teachers should train the students’ muscular strength to improve their cardiovascular fitness ；（3）Male normal school students’s have better cardiovascular adaptation than male obese school students. It is possible that male obese school students suffer from cardiovascular disease in the future. If we consider the maximal heart rate that all participants achieved, PACER seems to be a good fitness test for schoolchildren.