運動處方與運動介入對智能障礙者健康體適能的影響

Effects of Exercise Prescriptions and Interventions on Health-Related Physical Fitness of People With Intellectual Disabilities

10.6162/SRR.202006_(153).0003

黃韻潔(Yun-Chieh Huang)；潘正宸(Cheng-Chen Pan)

心肺適能 ； 肌肉適能 ； 身體組成 ； 肥胖 ； 心血管疾病 ； cardiovascular fitness ； muscular fitness ； body composition ； obesity ； cardiovascular disease

大專體育

153期（2020 / 06 / 30）

24 - 36

繁體中文

相較於常人，智能障礙者在心肺適能、肌肉適能及身體組成的情況較差。隨著年紀增長，身體適能亦逐漸退化，造成久坐行為漸增，較無法達成運動指引中每日身體活動的建議量，使罹患肥胖及心血管疾病風險機率增高。透過運動處方的元素（frequency, intensity, time, type, volume, rate of progression, FITT-VP），即頻率、強度、時間、運動形式、運動量、漸進率規劃智能障礙者的運動介入計畫，改善其體適能狀況，顯得格外重要。本文目的為檢視介入研究的文獻中，對於滿足執行運動處方FITT-VP建議量的情況，及介入對體適能的影響，並瞭解運動介入時的實施策略可能為何。分析結果發現：相較肌肉適能與身體組成，有氧適能多能提及FITT-VP，但多有建議量不足的情形。然而肌肉適能的運動處方描述，則因不同運動形式，在運動處方元素的描述不易一致。對心肺及肌肉適能的影響，多有正面效益，然而對身體組成，仍有不一致的結論，其可能原因是，智能障礙者屬高異質性的族群，因此運動介入的初始階段，建議仍須在運動處方的各元素做個別化調整，以期確保參與訓練的正面成效能持續。本文闡述智能障礙者運動處方的建議方針，建議需留意其高異質的身心特質來擬定有效策略，如：運動前掌握其身體及用藥狀況、找尋支持人員共同參與、運動期間透過增強系統、示範演練、善用運動同儕等來降低運動阻礙、並記錄運動狀況、持續加強相關知識，應可達成改善智能障礙者健康體適能之目標。

People with intellectual disabilities (IDs) tend to have relatively poor cardiovascular fitness, muscular fitness, and body composition. As they age, their physical fitness deteriorates; they become more sedentary and less likely to meet physical activity and exercise guidelines. The risks of obesity and cardiovascular disease thus increase. An effective exercise intervention plan should include 6 components: frequency, intensity, time, type, volume, and rate of progression (FITT-VP). This study reviews the literature on achieving the recommended FITT-VP amounts and the effects of interventions on physical fitness. The goals are to understand implementable strategies for people with IDs and elaborate on suggested guidelines. The results show that the components of FITT-VP were mentioned more often with respect to aerobic fitness than muscular fitness or body composition, yet often did not meet the recommended guidelines. Given the differences in exercise modalities, the prescriptions of FITT-VP were less likely to be consistent with those targeting muscular fitness. FITT-VP has a positive effect on cardiovascular and muscular fitness, though there is less agreement regarding body composition. However, people with IDs are a highly heterogeneous group with different physical and mental traits. To ensure stable positive outcomes, individualized programming in FITT-VP is recommended in the initial phase of exercise intervention. Effective strategies include inquiring about their physical and medication conditions before exercise; seeking supporters for joint participation; establishing a reinforcement system, obtaining demonstration, and help from exercising peers to reduce exercise barriers; keeping an exercise log; and broadening related knowledge.

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