運動介入對於老化造成步態改變的影響

Effect of exercise intervention to gait change by aging

10.3966/102473002018033201008

陳緯蓉(Wei-Rong Chen)；林惠婷(Hui-Ting Lin)；周台英(Tai-Ying Chou)

老化 ； 步態改變 ； aging ； gait change

中華體育季刊

32卷1期（2018 / 03 / 01）

75 - 83

繁體中文

臺灣逐年增加的高齡人口數意味著失能風險與照護成本不斷提高，其中跌倒是導致失能的重要危險因子，因此預防跌倒維持生理功能成了刻不容緩的議題；老化會造成人體生理的改變，過去研究表示肌力不足與步態的變化是最容易造成跌倒的原因，而肌力的下降與步態改變息息相關，也有若干研究發現運動的介入可以延緩老化造成的生理改變，增進肌肉力量的表現，但似乎較少將肌肉力量表現與下肢關節角度變化相連結；故本文將對此做出探討，並討論運動介入對於步態的影響。

In Taiwan, the increase of elderly population raises the possibility of disability and care cost. Falling, for older adults, is identified as a determinate factor of disability. Wherefore the prevention of falling for older adults has become an important issue. Previous studies suggest that muscle strength and gait stability are key risk factors of elderly falling, which both are related to age-related sarcopenia. It is found that exercise intervention could improve muscle strength and reduce the risk factor of falling. Nevertheless, few researches have investigated the relationship between muscle strength and gait variability. Therefore, this study reviews literature relating to the effect of exercise intervention to gait change of elderly adults.

1. 曾偉晉、黃冠菱、黃啟煌、陳信良(2015)。長期漸進式離心運動訓練對高齡者下肢肌力與功能性體識之影響能。體育學報，48(2)，159-169。
   連結：
2. 黃泰諭、張哲榕、林曼蕙、方進隆(2005)。十週水中有氧訓練對女性老年人功能性體適能之影響。運動生理暨體育學報，3，121-129。
   連結：
3. 詹文祥、邱文信(2011)。老化現象對步態之影響。中華體育季刊，25(4)，677-685。
   連結：
4. 劉雅甄(2016)。高齡者動體視力與步態速度隨老化之變異情形。體育學報，49(4)，431-442。
   連結：
5. 羅明葵、徐昌俊(2010)。以身體活動發展老人健康促進服務。大專體育，111，69-74。
   連結：
6. Abbasi, A.,Sadeghi, H.,Tabrizi, H. B.,Bagheri, K.,Ghasemizad, A.,Asl, A. K.(2011).Effect of whole body vibration, aquatic balance and combined training on neuromuscular performance, balance and walking ability in male elderly able-bodied individual.World Applied Sciences Journal,15(1),84-91.
7. Adams, S. C.,Segal, R. J.,McKenzie, D. C.,Vallerand, J. R.,Morielli, A. R.,Mackey, J. R.,Courneya, K. S.(2016).Impact of resistance and aerobic exercise on sarcopenia and dynapenia in breast cancer patients receiving adjuvant chemotherapy: A multicenter randomized controlled trial.Breast Cancer Research and Treatment,158(3),497-507.
8. American College of Sports Medicine,Chodzko-Zajko, W. J.,Proctor, D. N.,Fiatarone Singh, M. A.,Minson, C. T.,Nigg, C. R.,Skinner, J. S.(2009).American College of Sports Medicine position stand. Exercise and physical activity for older adults.Medicine Science Sports Exercise,41(7),1510-1530.
9. Begg, R. K.,Sparrow, W. A.(2000).Gait Characteristics of young and older individuals negotiating a raised surface implications for the prevention of falls.The Gerontological Society of America,559(3),147-141.
10. Bhangu, J.,King-Kallimanis, B. L.,Donoghue, O. A.,Carroll, L.,Kenny, R. A.(2017).Falls, non-accidental falls and syncope in community-dwelling adults aged 50 years and older: Implications for cardiovascular assessment.PLoS One,12(7),e0180997.
11. Boyer, K. A.,Andriacchi, T. P.,Beaupre, G. S.(2012).The role of physical activity in changes in walking mechanics with age.Gait Posture,36(1),149-153.
12. Colado, J. C.,Triplett, N. T.,Tella, V.,Saucedo, P.,Abellan, J.(2009).Effects of aquatic resistance training on health and fitness in postmenopausal women.European Journal of Applied Physiology,106(1),113-122.
13. Evans, W. J.,Capmpbell, W. W.(1993).Sarcopenia and age-related changes in body composition and functional capacity.American Institute of Nutrition,123,465-468.
14. Fletcher, P. C.,Hirdes, J. P.(2002).Risk factors for falling among community-based seniors using home care services.The Gerontological Society of America,57(8),504-510.
15. Franz, J. R.,Kram, R.(2013).How does age affect leg muscle activity/coactivity during uphill and downhill walking?.Gait Posture,37(3),378-384.
16. Grabiner, P. C.,Biswas, S. T.,Grabiner, M. D.(2001).Age-related changes in spatial and temporal gait variables.Archivesof Physical Medicine Rehabilitation,82(1),31-35.
17. Hausdorff, J. M.,Rios, D. A.,Edelberg, H. K.(2001).Gait variability and fall risk in community-living older adults: A 1-year prospective study.Archives Physcial Medicine Rehabilitation,82(8),1050-1056.
18. Hortobagyi, T.,Solnik, S.,Gruber, A.,Rider, P.,Steinweg, K.,Helseth, J.,DeVita, P.(2009).Interaction between age and gait velocity in the amplitude and timing of antagonist muscle coactivation.Gait Posture,29(4),558-564.
19. Hosseini, S. S.,Mirzaei, B.,Panahi, M.,Rostamkhany, H.(2011).Effect of Aquatic Balance Training and Detraining on Neuromuscular Performance, Balance and Walking Ability in Healthy Older Men.Middle-East Journal,13(3),345-354.
20. Hsu, H. C.,Jhan, L. J.(2008).Risk Factors of Falling among the Elderly in Taiwan.Taiwan Geriatrics & Gerontology,3(2),141-154.
21. Kang, H. G.,Dingwell, J. B.(2008).Separating the effects of age and walking speed on gait variability.Gait Posture,27(4),572-577.
22. Katsura, Y.,Yoshikawa, T.,Ueda, S. Y.,Usui, T.,Sotobayashi, D.,Nakao, H.,Fujimoto, S.(2010).Effects of aquatic exercise training using water-resistance equipment in elderly.Europe Journal Applied Physiology,108(5),957-964.
23. Kim, S. G.,Lee, C. W.(2013).The effects of hippotherapy on elderly persons static balance and gait.Journal of Physical Therapy Science,26(1),25-27.
24. Lamoureux, E.,Sparrow, W. A.,Murphy, A.,Newton, R. U.(2003).The effects of improved strength on obstacle negotiation in community-living older adults.Gait & Posture,17(3),273-283.
25. Lee, D. Y.,Seo, S. G.,Kim, E. J.,Lee, D. J.,Bae, K. J.,Lee, K. M.,Choi, I. H.(2017).Inter-segmental motions of the foot: Differences between younger and older healthy adult females.Journal of Foot and Ankle Research,10,29.
26. Lim, H. S.,Roh, S. Y.,Yoon, S.(2013).An 8-week aquatic exercise program is effective at improving gait stability of the elderly.Journal of Physical Therapy Science,25(11),1467-1470.
27. Mills, P. M.,Barrett, R. S.,Morrison, S.(2008).Toe clearance variability during walking in young and elderly men.Gait Posture,28(1),101-107.
28. Owings, T. M.,Grabiner, M. D.(2004).Variability of step kinematics in young and older adults.Gait and Posture,20(1),26-29.
29. Pahor, M.,Balir, S. N.,Espeland, M.,Fielding, R.,Gill, T. M.,Guralnik, J. M.,Studenski, S.(2006).Effects of a physical activity intervention on measures of physical performance: Results of the lifestyle interventions and independence for elders pilot (LIFE-P) Study.The Journals of Gerontology,61(11),1157-1165.
30. Peterson, D. S.,Martin, P. E.(2010).Effects of age and walking speed on coactivation and cost of walking in healthy adults.Gait and Posture,31(3),355-359.
31. Rubenstein, L. Z.,Josephson, K. R.(2002).The epidemiology of falls and syncope.Clinics Geriatr Medicine,18,141-158.
32. Sanders, M. E.,Takeshima, N.,Rogers, M. E.,Colado, J. C.,Borreani, S.(2013).Impact of the S.W.E.A.T. water-exercise method on activities of daily living for older women.Journal of Sports Science and Medicine,12(4),707-715.
33. Schmitz, A.,Silder, A.,Heiderscheit, B.,Mahoney, J.,Thelen, D. G.(2009).Differences in lower-extremity muscular activation during walking between healthy older and young adults.Journal of Electromyogr and Kinesiol,19(6),1085-1091.
34. Takeshima, N.,Rogers, M. E.,Watanabe, E.,Brechue, W. F.,Okada, A.,Yamada, T.,Hayano, J.(2002).Water-based exercise improves health-related aspects of fitness in older women.Medicine and Science in Sports and Exercise,34(3),544-51.
35. Tirosh, O.,Sparrow, W. A.(2005).Age and walking speed effects on muscle recruitment in gait termination.Gait and Posture,21(3),279-288.
36. Vestergaard, S.,Nayfield, S. G.,Patel, K. V.,Eldadah, B.,Cesari, M.,Ferrucci, L.,Guralnik, J. M.(2009).Fatigue in a representative population of older persons and its association with functional impairment, functional limitation, and disability.The Journals of Gerontolgy.Series A, Biological Science and Medical Science,64(1),76-82.
37. Visser, M, Pluijm, S. M.,Stel, V. S.,Bosscher, R. J.,Deeg, D. J.(2002).Physical activity as a determinant of change in mobility performance: The longitudinal aging study amsterdam.American Geriatrics Society,50(11),1774-1781.
38. Wu, R.,Delahunt, E.,Ditroilo, M.,Lowery, M.,De Vito, G.(2016).Effects of age and sex on neuromuscular-mechanical determinants of muscle strength.Age,38(3),57.
39. Zhang, C.,Mao, D.,Riskowski, J. L.,Song, Q.(2011).Strategies of stepping over obstacles: The effects of long-term exercise in older adults.Gait and Posture,34(2),191-196.
40. 洪瑞敏、林昭宏、陳健智、林卷立、陳丙何、許妙如(2014)。踩車運動訓練對於健康老年人以及年輕人之行走能力以及腦部動作皮質活化之影響。物理治療，39(1)，32-41。

1. 蘇宥蓁,胡巧欣,吳一德(2020)。漸進式運動模組對老年人功能性體適能的影響。運動與遊憩研究，14(3)，17-31。
2. (2023)。連結社群復返健康：排灣族文化照顧的省思。思與言：人文與社會科學期刊，61(3)，161-208。