某精神專科醫院住院病人兩種健康操介入效果比較之世代研究

A cohort study on the comparison of effectiveness between two exercise programs for inpatients of a psychiatric hospital

10.29827/YBYJZZ.202112_5(1).0002

陳秀甄(Hsiu-Chen Chen)；蔡佳瑜(Chia-Yu Tsai)；林宇宸(Yu-Chen Lin)

健康操 ； 職能治療 ； 慢性精神病人 ； 功能性體適能 ； lower extremity exercise ； occupational therapy ； chronic psychiatric patients ； functional fitness

醫保研究雜誌

5卷1期（2021 / 12 / 01）

13 - 23

繁體中文

目的：比較下肢健康操與五行健康操間對住院病人肌力／肌耐力、心肺耐力與下肢肌肉百分率之影響，以作為樣本醫院推動改善病人下肢肌力之參考。方法：採世代研究之兩組前後測設計；收案對象為樣本醫院慢性病房精神病人；收案條件為生理功能可獨立站立及認知功能可同時觀看健康操影片與依循內容之指引配合執行動作者；兩組樣本均採立意分派，其原則為選出可配合執行下肢健康操的病房為實驗組，另一維持執行五行健康操的病房為對照組，兩組間配對性別、診斷別，各獲得樣本35人；十二週介入前後均使用功能性體適能測量兩組樣本之肌力／肌耐力、心肺耐力並以InBody230測量肌肉百分率。兩組間效果比較採廣義性估計模式（GEE）分析。結果：兩組間控制發病年齡之混淆因素後，於30秒椅子坐立、2分鐘原地站立抬膝、左／右下肢肌肉百分率等四個效果變項均無顯著差異；其中30秒椅子坐立介入前後皆屬普通程度，左右腿肌肉百分率介入前後皆屬正常程度，2分鐘原地站立抬膝方面，對照組前測之2分鐘原地站立抬膝次數屬於待加強，實驗組前測較對照組顯著多（故屬於普通），介入後兩組前測至後測改變量未達顯著差異，故兩種健康操均無法有效提升肌力／肌耐力、心肺耐力及肌肉百分率。結論：由於兩種健康操活動均無介入效果，建議未來可從增加介入時間、提高運動強度、設計不同等級的運動套餐且須有專業人員在旁督導並請營養師針對研究對象調整五大營養素比例等方面加強並再次評價其效果。

Purpose. To compare the results of two exercise programs implemented for chronic psychiatric inpatients. Methods. This was a cohort study. Participants included had cognitive and physical capacities for completing the exercise program through video demonstration. Purposive sampling was used to select participants capable of carrying out the experimental lower-extremity exercise program aimed to improve lower extremity function and physical fitness. Participants in the control group performed the routine five-element calisthenics that emphasizes upper extremity movements. Each group included 35 gender- and diagnosis-matched participants. The intervention lasted for 12 weeks. Lower extremity muscle strength/endurance, cardiorespiratory fitness, and the lower extremity skeletal muscle mass ratio were measured pre-and-post with the 30-second chair stand test, 2-minute standing knee lift test, and InBody 230, respectively. Data were analyzed through a generalized estimating equation (GEE). Results. With the confounding factor (disease onset age) offset, no significant differences in the outcome variables were found between two groups. Both groups scored ＂average＂ on the pre- and post-tests of 30-second chair stand and right and left lower extremity skeletal muscle mass ratios. The control group scored ＂below average＂ on the standing knee lift test pre-and-post while the experimental group scored ＂average＂ on this test pre-and-post. Both the lower-extremity exercise program and the calisthenics did not significantly increase lower extremity functions and cardiorespiratory fitness for two groups. Conclusion. Future studies should increase the length and intensity of the lower-extremity exercise program, customize different programs matching individual patients' functional levels, include therapists' guidance/supervision during exercise, and emphasize patients' nutritional needs.

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