十六週團體運動介入計畫對老年人全人健康之影響

Abstract

本研究目的為探討十六週團體運動介入計畫對老年人全人健康包括生理、心理、健康生活型態與生活品質之影響。94位65-100歲老年人分為運動組63人（平均年齡76.32±6.55歲），和僅參與健康檢測之對照組31人（平均年齡81.10±8.24歲）。運動組接受十六週每週一次二小時綜合運動課程（包括伸展、平衡、肌力與耐力訓練），搭配自我運動監控計畫，介入期間每週運動頻率3.56 ± 2.08次，每次運動時間20分鐘以上，訓練強度訂在自覺輕鬆-有點吃力（RPE11-15）之水準，達到ACSM所定老年人運動計畫之標準，同時對照組運動頻率維持在每週1.29 ± 2.50次之水準。全體並於計畫前、後及三個月追蹤期檢測生理狀態、運動能力、細胞代謝、心理健康、運動習慣、健康生活型態及生活品質。將檢測結果以獨立t檢定和重複量數單因子變異數分析處理後發現，運動介入後運動組生理部分在生理狀態（收縮血壓、安靜心跳）、身體組成（肌肉量、體脂肪率）、運動功能（反應能力、平衡、柔軟度、下肢動力與心肺耐力）、細胞代謝適能（葡萄糖耐受度、胰島素敏感性及血液中脂類）、抗老化指標（DHEA-S）、心理自覺健康、「健康體能促進」與「疾病預防」等生活型態均有顯著改善。同時心理情緒指數（老人憂鬱量表GDS正向平均分數）、運動階段、健康生活型態與生活品質部分明顯優於對照組。追蹤三個月發現，運動組生理健康、運動能力、細胞代謝適能、抗老化指標DHEA-S、自覺健康與自我效能仍顯著優於前測，此時運動階段明顯向前推進，健康生活型態中「健康體能促進」、「個人安全」及生活品質中「活力」、「工作能力」均明顯高於對照組。結論指出，本研究十六週運動介入計畫使運動組每週運動頻率明顯增加，進而改善了基本生理狀態、身體組成、身體運動功能、細胞代謝適能和抗老化指標等生理健康，同時也增強了心理自覺健康、和健康體能促進行為。相對於對照組的衰退，運動組維持較佳的健康生活型態及生活品質水準。運動計畫介入的效益使運動組在追蹤三個月後仍維持較佳的生理健康、健康體能促進行為、自我效能、活力與工作能力滿意度，顯示本研究十六週團體運動介入計畫有助於老年人身心健康的改善和生活品質的維持。The purpose of this study was to investigate the effects of 16-week exercise intervention on the wellness of the elderly, including the physical, metabolic, functional, psychological fitness, healthy lifestyle and quality of life. Ninety four elderly above 65 years old were recruited as the subjects for this study and divided into two groups. The exercise group (EG) consisting of 63 elderly (average age 76.32±6.55 yrs, 10 male, 53 female) joined the intervention program with group-based exercise course 2 hours per week and engaged in self-monitoring exercises for 16 weeks. The group-based exercise included comprehensive stretching, balance, strength and endurance training with intensity of RPE 11-15, more than 20 minutes each session. Totally, the EG elderly performed about 3.5 times of exercise per week. The other 31 subjects (average age 81.10±8.24 yrs, 15 male, 16 female) received no special training and just measured their wellness before, after and 3 months followed the intervention program same as the EG served as the control group (CG). The collected data were analyzed by t-test and one way ANOVA and the results were as followed: After 16weeks intervention, the systolic blood pressure, rest heart rate, body composition (muscle mass increased and body fat decreased), functional exercise abilities (reaction, balance, flexibility, low extremity power and cardiorespiratory endurance), metabolic fitness (glucose tolerance, insulin sensitivity, serum triglyceride, total cholesterol), and anti-aging index (DHEA-sulfate), self-perceived health status, wellness lifestyle about health-related fitness and disease prevention of EG improved significantly. In the same time, the geriatric depression scale (GDS-SF) positive average score, quality of life, Stage of change (SOC) about regular exercise behavior were higher than CG. After 3- month follow up, the physiological health, functional abilities, metabolic fitness, and anti-aging index, exercise SOC, self-perceived health status, self-efficacy were significantly better than pretest. Wellness lifestyle score about health-related fitness and personal safety, and QOL score on vitality and working ability facets of the EG were significantly better than CG. The conclusion suggested that 16-week exercise intervention improved physiological, functional, metabolic fitness and body composition. At the same time, psychophysical benefits were significantly enhanced. After 3 months followed, physiological benefits maintained, besides the health-related behavior, SOC and self-efficacy about regular exercise also progressed. Perceived higher vitality and working ability showed that current exercise intervention could profit psychophysical health and maintain life quality of elderly.