12週漸增式肌力訓練對老年人不同體能表現之成效

Effect of a 12-week incremental muscle strength training regimen on different physical performance in elderly people

10.6288/TJPH.202008_39(4).109036

胡巧欣(Chiao-Hsin Hu)；吳一德(I-Te Wu)

老年人 ； 肌力 ； 運動訓練 ； 社區環境 ； elderly ； muscle strength ； exercise training ； community environment

台灣公共衛生雜誌

39卷4期（2020 / 08 / 24）

412 - 426

繁體中文

目標：12週漸增式肌力訓練對老年人不同體能表現之成效。方法：招募65歲以上無規律運動習慣60位老年人，依上、下肢肌力（muscle strength）與走路速度檢測結果，分成體能良好組18位、體能普通組16位、體能衰弱組（physical weakness）11位和控制組15位等4組。運動訓練組三組老年人均參與每週兩次、每次約90鐘運動訓練共12週；控制組則正常作息。分別於運動介入前、後評估上、下肢肌力（muscle strength）、單腳站（one leg stance）、10公尺走路速度（10-meter walk speed），與簡易身體功能量表（short physical performance battery, SPPB）。結果：共56位受試者完成本研究，除慢性病罹患率，各組基本資料並無統計差異。經12週漸增式肌力訓練介入後，體能良好組及體能普通組在上、下肢肌力、單腳站立、10m走路速度四項表現達顯著成效；體能衰弱組則在上、下肢肌力、10公尺走路速度三項表現達顯著成效。進一步分析發現在上肢肌力之改變量體能良好及體能普通組顯著高於對照組；在下肢肌力與單腳站立之改變量體能良好及體能普通組顯著高於體能衰弱組及對照組；其餘10公尺走路速度及簡易體能活動組間皆未達顯著差異（p＞.05）。結論：12週漸增式肌力訓練對不同體能程度的老年人在各項體能表現皆有促進效果，可提供國內各社區關懷據點，應用於不同體能程度的老年人介入及效益評估之參考。

Objectives: The effect of 12 weeks of muscle strength training on the physical performance of elderly people was investigated. Methods: This study recruited 60 people older than 65 years and without a regular exercise habit. On the basis of their upper and lower limb muscle strength and walking speed, they were divided into a control group (15 participants) and three training groups, namely high physical fitness (18 participants), general fitness (16 participants), and physical weakness (11 participants) groups. The training groups trained twice weekly for 90 min for 12 weeks, whereas the control group kept their normal routine. Upper and lower limb muscle strength, one-leg stance, 10-m walking speed, and short physical performance battery (SPPB) score were assessed before and after the exercise intervention. Results: A total of 56 subjects completed this research. Except for the prevalence of chronic diseases, no significant differences were discovered in the basic data of the groups. After 12 weeks of incremental muscle training, the high physical fitness and general fitness groups achieved significant improvements in upper and lower limb muscle strength, one-leg stance, and 10-m walking speed. By contrast, the poor physical fitness group significantly improved their upper and lower limb muscle strength and 10-m walking speed. Upon further analysis, we discovered that the improvements in upper limb muscle strength in the high physical fitness and general fitness groups were significantly greater than those in the control group. Moreover, the improvements in lower limb muscle strength and one-leg stance in the high physical fitness and general fitness groups were significantly greater than those in the poor physical weakness and control groups. No clear differences in 10-m walking speed and SPPB score were found (p ＞ .05). Conclusions: The 12-week incremental muscle training benefitted the elderly participants with different physical fitness levels in every aspect of physical performance. This research can be provided as a reference to every community care center in Taiwan to demonstrate an effective exercise intervention and the benefits for elderly people with varying levels of physical fitness.

1. Chan, SY,Kuo, CC,Chen, KM,Tseng, WS,Huang, HT,Li, CH(2016).Health promotion outcomes of a newly developed elastic band exercise program for older adults in the community: a pilot test.J Nurs Res,24,137-144.
   連結：
2. 李佳倫, CL,鄭景峰, CF(2010)。台灣老年人身體活動量與功能性體適能的關係。大專體育學刊，12，79-89。
   連結：
3. 馬振來, CL,郭俊巖, CY,呂季芳, CF(2017)。體適能導入社區關懷據點對高齡者身心健康影響之探討。社會發展研究學刊，20，1-38。
   連結：
4. American College of Sports Medicine,Franklin, BA,Whaley, MH,Howley, ET(2000).ACSM’s Guidelines for Exercise Testing and Prescription.Philadelphia:Lippincott Williams & Wilkins.
5. Amerivan College of Sport Medicine Position Stand(1998).The recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness, and flexibility in healthy adults.Med Sci Sports Exerc,30,975-991.
6. Amesberger, G,Finkenzeller, T,Worth, S,Müller, E(2011).Physical self-concept and physical fitness in elderly individuals.Scand J Med Sci Sports,21(Suppl 1),83-90.
7. Brown, M,Sinacore, DR,Ehsani, AA,Binder, EF,Holloszy, JO,Kohrt, WM(2000).Low-intensity exercise as a modifier of physical frailty in older adults.Arch Phys Med Rehabil,81,960-965.
8. Chan, DCD,Tsou, HH,Yang, RS(2012).A pilot randomized controlled trial to improve geriatric frailty.BMC Geriatric,12,58.
9. Chen, LK,Liu, LK,Woo, J(2014).Sarcopenia in Asia: consensus report of the Asian Working Group for Sarcopenia.J Am Med Dir Assoc,15,95-101.
10. Deschenes, MR,Kraemer, WJ(2002).Performance and physiologic adaptations to resistance training.Am J Phys Med Rehabil,81(11 Suppl),S3-S16.
11. Elder, BM(1999).Washington,Intercollegiate Center for Nursing Education, Whitworth College, Washington State University.
12. Guralnik, JM,Simonsick, EM,Ferrucci, L(1994).A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission.J Gerontol,49,M85-M94.
13. Hallage, T,Krause, MP,Haile, L(2010).The effects of 12 weeks of step aerobics training on functional fitness of elderly women.J Strength Cond Res,24,2261-2266.
14. Hand, BD,Cavanaugh, S,Forbes, W,Govern, J,Cress, ME(2012).Changes in health-related quality of life and functional fitness with exercise training in older adults who attend senior centers.Activit Adaptation Aging,36,29-54.
15. Lee, MC,Hsu, CC,Tsai, YF,Chen, CY,Lin, CC,Wang, CY(2018).Criterion-referenced values of grip strength and usual gait speed using instrumental activities of daily living disability as the criterion.J Geriatr Phys Ther,41,14-19.
16. Miotto, JM,Chodzko-Zajko, WJ,Reich, JL,Supler, MM(1999).Reliability and validity of the Fullerton functional fitness test: an independent replication study.J Aging Phys Activ,7,339-353.
17. Rikli, RE,Jones, CJ(2001).Senior Fitness Test Manual.Champaign, IL:Human Kinetics.
18. Sipilä, S,Multanen, J,Kallinen, M,Era, P,Suominen, H(1996).Effects of strength and endurance training on isometric muscle strength and walking speed in elderly women.Acta Physiol Scand,156,457-464.
19. Taaffe, DR,Duret, C,Wheeler, S,Marcus, R(1999).Once-weekly resistance exercise improves muscle strength and neuromuscular performance in older adults.J Am Geriatr Soc,47,1208-1214.
20. Vellas, BJ,Wayne, SJ,Romero, L,Baumgartner, RN,Rubenstein, LZ,Garry, PJ(1997).One-leg balance is an important predictor of injurious falls in older persons.J Am Geriatr Soc,45,735-738.
21. Wang, CY,Chen, TR,Lin, YH,Liu, MH,Chen, YC(2012).Gait speed measure: the effect of different measuring distances and the inclusion and exclusion of acceleration and deceleration.Percept Mot Skills,114,469-478.
22. Young, A,Dinan, S(1994).ABC of sports medicine: fitness for older people.BMJ,309,331-334.
23. 內政部：建立社區照顧關懷據點實施計畫。https://www.moi.gov.tw/。引用2018/03/13。Ministry of the Interior, R.O.C. (Taiwan). Community Care Sites Program Implementation. Available at: https://www.moi.gov.tw/. Accessed March 13, 2018. [In Chinese]
24. 內政部統計處：106年底人口結構分析，2018。https://www.moi.gov.tw/stat/index.aspx。引用2018/03/13。Department of Statistics, Ministry of the Interior, R.O.C. (Taiwan). Analysis of population structure at the end of 2017. Available at: https://www.moi.gov.tw/stat/index.aspx. Accessed March 13, 2018. [In Chinese]
25. 王靜玉, CY,陳柏宏, PH,蔡惠婷, HT(2018)。對護理之家失能失智住民執行複合式運動計畫介入成果。物理治療，43，153。
26. 行政院經濟建設委員會, Executive Yuan, R.O.C. (Taiwan).中華民國2012年至2060年人口推計.
27. 吳雅汝, YJ,周怡君, YC,詹鼎正, DC(2014)。文獻回顧—肌少症與衰弱症。內科學誌，25，131-136。
28. 李幸穎, HY,孫嘉宏, CH,林陳涌, CY(2015)。多面向巡迴訓練對城鄉社區老人身體功能與平衡能力之影響。物理治療，40，53-65。
29. 張珈瑛, CY,陳建廷, JT(2009)。銀髮族休閒運動態度與健康體適能認知之調查研究。嘉大體育健康休閒期刊，8，78-83。
30. 張棋興, QX,梁忠詔, CC,林春香, CH,魏于鈞, YC,陳司恩, SE,陳家慶, JC(2015)。原住民社區跌倒與非跌倒女性老人在下肢肌力、體能活動、平衡與走路能力之差異與相關性—以花蓮某偏鄉部落為例。物理治療，40，188-199。
31. 張靜怡, CY,黎家銘, JM,陳晶瑩, JY(2013)。台北市老人衰弱症篩檢試辦計畫。台北市醫師公會會刊，57，14-17。
32. 陳家慶, JC,林春香, CH,陳俐君, LC(2010)。復健運動對於改善社區骨關節炎及中風老人身體功能之成效：前驅研究。台灣復健醫學雜誌，38，97-105。
33. 陳家慶, JC,林春香, CH,魏于鈞, YC(2008)。長期規律性健康促進運動對花蓮社區老人身體功能之成效。台灣老年醫學雜誌，3，286-292。
34. 陳家慶, JC,張棋興, QX,林春香, CH,吳孟純, MC,梁忠詔, CC,江姿儀, TY(2018)。以因材施教模式運動計畫介入對社區關懷據點老人在體能活動表現成效之初探。台灣老年醫學雜誌，13，100-117。
35. 陳銘樹, MS,江行全, BC(2014)。規律運動對於不同型態慢性病中老年人步態功能的改善差異之初探研究。健康管理學刊，12，1-13。
36. 楊雅如, YR,羅鴻基, HJ,黃維貞, WC,吳泓熠, HY,王瑞瑤, RY(2017)。不同運動模式介入對於高齡者身體功能和活動之影響。物理治療，42，257-267。
37. 趙安娜, AN,高美玲, ML,林壽惠, SH(2004)。鄉村社區老人健康狀況與生活品質相關性之探討。長期照護雜誌，8，41-55。
38. 衛生福利部：長照專區。https://1966.gov.tw/LTC/lp-3638- 201.html。引用2018/03/13。Ministry of Health and Welfare, R.O.C. (Taiwan). The platform of long-term care policy. Available at: https://1966.gov.tw/LTC/lp-3638- 201.html. Accessed March 13, 2018. [In Chinese]
39. 衛生福利部國民健康署：民國100年台灣地區中老年身心社會生活狀況長期追蹤（第七次）成果報告。https://www.hpa.gov.tw/Pages/Detail.aspx?nodeid=242&pid=1282。引用2018/03/13。Health Promotion Administration, Ministry of Health and Welfare, R.O.C. (Taiwan). A long-term follow-up (seventh) results report of the middle-aged and elderly people’s physical, mental and social life in Taiwan, 2011. Available at: https://www.hpa.gov.tw/Pages/Detail.aspx?nodeid=242&pid=1282. Accessed March 13, 2018. [In Chinese]
40. 衛生福利部護理及健康照護司：衛生福利部106年度「預防及延緩失能照護計畫」申請作業須知。https://dep.mohw.gov.tw/DONAHC/lp-3242-10 4.html。引用2018/03/13。Department of Nursing and Health Care, Ministry of Health and Welfare, R.O.C. (Taiwan). The application instructions of “Prevention and Delay of Disability Care Project” for the Ministry of Health and Welfare, R.O.C. (Taiwan) in 2017. Available at: https://dep.mohw.gov.tw/DONAHC/lp-3242-10 4.html. Accessed March 13, 2018. [In Chinese]

1. 陳家羚,莊淑娸,張歆妤,江勁政(2022)。從WHO 2020身體活動指引觀點探討肌力與平衡能力對高齡者之重要性。運動表現期刊，9(2)，79-91。
2. (2022)。音律活化健康操對銀髮族功能性體適能之效益，以音活間照顧中心為例。休閒運動管理學刊，7(2)，1-19。
3. (2024)。停經後婦女從事多元運動後停止運動與再訓練對肌肉表現之影響。台灣公共衛生雜誌，43(3)，300-312。