不同活動型態高齡女性平衡能力之研究

The Study of the Ability of Balancing in Geriatric Females with Different Activity Lifestyles

10.29423/JSRR.200712_2(2).0008

沈竑毅(Hong-Yi Shen)；洪偉欽(Wei-Chin Hong)；成和正(Ho-Cheng Chen)

開眼單足站立測驗 ； 靜態平衡能力 ； one-leg stance test ； balance

運動與遊憩研究

2卷2期（2007 / 12 / 01）

129 - 142

繁體中文

The lifespan of our people has been greatly extended with the continuing improvement in health care and rapid development of biotechnology. This has resulted not only in a change in the infrastructure of our population but also our economy as well. The subsequent social problems evolved from an aging population have led to worldwide concern and extensive discussion. The ability to balance generally decreases as one progress into old age and often, this is accompanied by an increase in falls. Fall-related injuries have imposed a negative impact in economic and socials cost and also high costs in public health service. Studies have shown that the ability to balance can be improved with different exercise prototypes, physical training and regular exercise regimens. Thus, the objective of our study is to investigate the difference in the ability to balance between geriatric females who exercise regularly and those who lead a sedentary lifestyle. METHOD: By performing a one-leg stance test with eyes open, the ability of stationary balance is measured. Subjects involved are 80 females with an average age of 75.96±8.47 years old. They are first divided into two groups according to lifestyle, the group that perform regular exercise (41 females) and the other 39 who are inactive. The subjects are further divided into three groups according to age. They are the 65-74 years old group, the 75-84 years old group and the 85 years old and above age group where there are 36, 25 and 19 females respectively. The two-way ANOVA and descriptive statistics are employed with a significance level of α=.05. RESULTS: 1. No significant difference was found in the ability to balance with different lifestyles for geriatric females (p＞.05). 2. No significant difference was found in the ability to balance between the groups with different lifestyles (p＞.05). 3. Significant difference was found among the three different age groups in their ability to balance and after the Bonferroni correction, the 65-74 age group showed better abilities to the 85 and above age group. CONCLUSION: It is revealed in this study that regular exercise has limited effect on enhancing the ability to balance. We deduce this to be the result of the rapid degeneration of muscle strength and loss of bone density and insufficiency in the intensity of regular exercise, leaving old age to be the main factor that determines the ability of balance. Thus, we propose that additional tests in bone density and muscle strength of the lower extremities be done in order to clarify the possibilities of other factors.

The lifespan of our people has been greatly extended with the continuing improvement in health care and rapid development of biotechnology. This has resulted not only in a change in the infrastructure of our population but also our economy as well. The subsequent social problems evolved from an aging population have led to worldwide concern and extensive discussion. The ability to balance generally decreases as one progress into old age and often, this is accompanied by an increase in falls. Fall-related injuries have imposed a negative impact in economic and socials cost and also high costs in public health service. Studies have shown that the ability to balance can be improved with different exercise prototypes, physical training and regular exercise regimens. Thus, the objective of our study is to investigate the difference in the ability to balance between geriatric females who exercise regularly and those who lead a sedentary lifestyle. METHOD: By performing a one-leg stance test with eyes open, the ability of stationary balance is measured. Subjects involved are 80 females with an average age of 75.96±8.47 years old. They are first divided into two groups according to lifestyle, the group that perform regular exercise (41 females) and the other 39 who are inactive. The subjects are further divided into three groups according to age. They are the 65-74 years old group, the 75-84 years old group and the 85 years old and above age group where there are 36, 25 and 19 females respectively. The two-way ANOVA and descriptive statistics are employed with a significance level of α=.05. RESULTS: 1. No significant difference was found in the ability to balance with different lifestyles for geriatric females (p＞.05). 2. No significant difference was found in the ability to balance between the groups with different lifestyles (p＞.05). 3. Significant difference was found among the three different age groups in their ability to balance and after the Bonferroni correction, the 65-74 age group showed better abilities to the 85 and above age group. CONCLUSION: It is revealed in this study that regular exercise has limited effect on enhancing the ability to balance. We deduce this to be the result of the rapid degeneration of muscle strength and loss of bone density and insufficiency in the intensity of regular exercise, leaving old age to be the main factor that determines the ability of balance. Thus, we propose that additional tests in bone density and muscle strength of the lower extremities be done in order to clarify the possibilities of other factors.

1. 張瑞泰、黃奕清、戴遠成、林琮智、李心白(2000)。規律慢跑和桌球運動對老年人生理特質及骨質密度的影響。體育學報，29，127-136。
   連結：
2. Alexander, B. H.,Rivara, F. P.,Wolf, M. E.(1992).The cost and frequency of hospitalization for fall-related injuries in older adults.Am. J. Public Health,82,1020-1023.
3. Bemben, M. G.,Massey, B. H.,Bemben, D. A.,Misner, J. E.,Boileau, R. A.(1991).Isometric muscle force production as a function of age in healthy 20- to 74-yr-old men.Journal of Medicine and Science in Sports and Exercise,23,1302-1310.
4. Berg, K. O.,Maki, B. E.,Williams, J. I.,Holliday, P. J.,Wood-Dauphinee, S. L.(1992).Clinical and laboratory measures of postural balance in an elderly population.Archives of Physical Medicine ＆ Rehabilitation,73(11),1073-1080.
5. Booth, F.,Weeden. S.,Buckwalter, J. (ed.),Goldberg, V. (ed.),Woo, S. (ed.)(1993).Musculoskeletal Soft-tissue Aging: Impact on Mobility.Rosemont, IL:American Academy of Orthopaedic Surgeons.
6. Briggs, R. C.,Gossman, M. R.,Birch, R.,Drews, J. E.,Shaddeau, S. A.(1989).Balance performance among noninstitutionalized elderly women.Physical Therapy,69,748-756.
7. Buchner, D. M.(1997).Physical activity and quality of life in older adults.Journal of the American Medical Association,277,64-66.
8. Clark, D. O.(1995).Racial and educational differences in physical activity among older adults.Gerontologist,35,472-480.
9. Day, L.,Filders, B.,Gordon, I.,Fitzharris, M.,Flamer, H.,Lord, S.(2002).Randomised factorial trial of falls prevention among older people living in their own homes.British Medical Journal,20,325, 128-131.
10. Downton, J. H.(1993).Falls in the elderly.Great Britain:British Library Cataloguing in Publication Data.
11. Era, P.,Schroll, M.,Hagerup, L.,Jurgensen, K. S.(1997).Physical fitness of Danish men and women aged 50 to 80 years.Ugeskift for laeger,159(43),6366-6370.
12. Gehlsen, G. M.,Whaley, M. H.(1990).Falls in the elderly: Part Π, blance, strength, and flexibility.Archives of Physical Medicine Rehabilitation,71,739-741.
13. Goggin, N. L.,Morrow, J. R.(2001).Physical activity behaviors of older adults.Journal of Aging Physical Activity,9,58-66.
14. Hoffman, M.,Schrader, J.,Applegate, T.,Koceja, D.(1998).Unilateral postural control of the functionally dominant and nondominant extremities of healthy subjects.Journal of Athletic Training,33(4),319-322.
15. Horak, F. B.,Lister MJ (ed).(1991).Contemporary management of motor control problems.Alexandria, VA:Foundation for Physical Therapy.
16. Kannus, P.,Parkkari, J.,Koskinen, S.,Niemi, S.,Palvanen, M.,Järvinen, M.,Vuori, I.(1999).Fall-induced injuries and deaths among older adults.Journal of the American Medical Association,281(20),1895-1899.
17. Kovar, P. A.,Allegrante, J. P.,MacKenize, R.,Petersen, M. G. E.,Gutin, B.,Charlson, M. E.(1992).Supervised fitness walking in patients with osteoarthritis of the knee.Ann. Int. Med.,116,529-534.
18. Kramer, J. F.,Balsor, B. E.(1990).Lower extremity preference and knee extensor torques in intercollegiate soccer players.Canadian Journal of Sports Science,15(3),180-184.
19. Ledin, T.,Kronhed, A. C.,Moller, C.,Moller, M.,Odkvist, L. M.,Olsson, B.(1990).Effects of balance training in elderly evaluated by clinical tests and dynamic petrography.Journal of Vestibular Research,1(2),129-138.
20. Lehmann, J.,de Lateur, B.,M. A. F. Singh (Eds.)(2000).Exercise, nutrition, and the older woman: Wellness for women over fifty.Folrida:CRC Press.
21. Liang, M. T.,Cameron, C. W. M.(1998).Balance and strength of elderly Chinese men and women.J. Nutr. Health Aging,2(1),21-27.
22. Mak, M. K.,Ng, P. L.(2003).Mediolateral sway in single-leg stance is the best discriminator of balance performance for Tai-Chi practitioners.Arch Physical Medicine Rehabilitation,84(5),683-686.
23. Meredith, C. N.,Frontera, W. R.,Fisher, E. C.,Hughes, V. A.,Herland, J. C.,Edwards, J.,Evans, W. J.(1989).Peripheral effects of endurance training in young and old subjects.Journal of Applied Physiology,66(6),2844-2849.
24. Peters, K. D.,Kochanek, K. D.,Murphy, S. L.(1998).Deaths: final data for 1996.Natl Vital Stat Rep.,47(9),1-100.
25. Powers, S. K.,Howley, E. T.(2002).Exercise Physiology: theory and application to fitness and performance.McGraw-Hill, Inc.
26. Province, M. A.,Hadley, E. C.,Hornbrook, M. C.,Lipsitz, L. A.,Miller, J. P.,Mulrow, C. D.(1995).The effects of exercise on falls in elderly patients. Apreplanned meta-analysis of the FICSIT Trails. Frailty and Injuries: Cooperative Studies of Intervention Techniques.JAMA,273,1341-1347.
27. Resnick, B.,Spellbring, A. M.(2000).Understanding what motivates older adults to exercise.J. Gerontol Nurs,26(3),34-42.
28. Shephard, R. J.(1997).Aging, physical activity, and health.Human Kinetics.
29. Stephen, J. A.,Olson, S.(2000).Reducing falls and resulting hip fractures among older women.Morb Mortal Wkly Rep,49,3-12.
30. Tinetti, M. E.,Doucette, J.,Claus, E.(1995).The contribution of predisposing and situational risk factors to serious fall injuries.Journal of the American Geriatrics Society,43(11),1207-1213.
31. Tinetti, M. E.,Doucette, J.,Claus, E.,Marottoli, R.(1995).Risks factors for serious injury during falls by older persons in the community.J. Am. Geriatr. Soc.,43(11),1214-1221.
32. Tinetti, M. E.,Williams, C. S.(1998).The effect of falls and fall injuries on functioning in community-dwelling older persons.Journal of Gerontology Series A-Biological Sciences & Medical Sciences,53(2),112-119.
33. U. S. Department of Health and Human Services(1996).Physical Activity and Health: A Report of the Surgeon General.Atlanta, GA:U. S. Department of Health and Human Services.
34. Van Heuvelen, M. J.,Kempen, G. I.,Ormel, J.,Rispens, P.(1998).Physical fitness related to age and physical activity in older persons.Medicine & Science in Sports & Exercise,30(3),434-441.
35. Williams, M. A.(Eds.),J. L. Roitman(Eds.),E. J. Haver(Eds.),M. Herridge(Eds.),M. Kelsey(Eds.),T. P. LaFontaine(Eds.),L. Miller(Eds.),M. Wegner(Eds.),T. York (Eds.)(2001).ACSM's resource manual for Guideline for exercise testing and prescription.Baltimore:Williams & Wilkins.
36. Woollacott, M. H.,Shumway-Cook, A.,Nashner, L. M.(1986).Aging and posture control: changes in sensory organization and muscular coordination.International Journal of Aging & Human Developmen,23(2),97-114.
37. Woolley, S. M.,Czaja, S. J.,Drury, C. G.(1997).An assessment of falls in elderly men and women.Journals of Gerontoogy. Series A, Biological Sciences & Medical Sciences,52(2),80-87.
38. Yokokawa, Y.,Kai, I.,Usui, Y.,Kosoda, F.,Furuta, T.,Konaka, K.(2003).Intervention study using a fall prevention program to prevent functional decline of old-old elderly in a rural community.Nippon Ronen Igakkai Zasshi,40(1),47-52.
39. 內政部統計資訊服務網
40. 方進隆(1992)。規律運動與健康促進和疾病預防。中華體育季刊，5(4)，1-7。
41. 世界衛生組織=World Health Organization, WHO
42. 中華民國臺灣地區八十二年老人狀況調查報告
43. 行政院經濟建設委員會
44. 行政院衛生統計資訊網
45. 行政院衛生署(2001)。中華民國八十二年衛生統計。臺北:行政院衛生署。
46. 行政院衛生署(1993)。中華民國八十二年衛生統計。臺北:行政院衛生署。
47. 李亞芸、吳英、蔡亦爲、李雪楨、王瑞瑤、楊雅如(2006)。運動訓練對預防老年女性跌倒之效益：統合分析。物理治療，31(5)，273-284。
48. 林茂榮、蔡素蘭、陳淑雅、曾信嘉(2000)。臺灣中部某鄉村社區老人跌倒之危險因子。臺灣衛誌，21，73-82。
49. 林碧珠(2001)。髖骨骨折跌倒相關特性及其對老人影響之研究。公共衛生，28，49-60。
50. 林銀秋(2001)。健康老年人的跌倒危機－骨骼肌肉系統及步態分析之討論。中華體育，17(3)，70-73。
51. 林麗娟(1993)。運動與老化。中華體育，7(3)，120-125。
52. 高宓憶、莊立民、胡名霞、謝松蒼、吳英黛(2004)。糖連病周邊神經病變患者的運動能力及平衡表現。台灣醫學，8，323-331。
53. 張梅蘭、王子娟、劉作仁、李淑美、梁家豐、徐道昌(1998)。老人跌倒者與非跌倒者平衡能力之定量評估。中華民國物理治療學會雜誌，23(4)，255-268。
54. 張燕明(2002)。臺中，國立臺灣體育學院體育研究所。
55. 梁偉成、紀煥庭、胡名霞、林茂榮(2005)。社區老人跌倒機轉與傷害嚴重度。物理治療，30(3)，105-115。
56. 梁繼權、湯麗玉、呂碧鴻(1997)。安養機構老人跌倒的前瞻性研究。中華民國家庭醫學雜誌，7(2)，59-68。
57. 許淑芬(2005)。臺北，國立臺灣師範大學衛生教育學系。
58. 黃永任(2001)。老年人的運動處方。國民體育季刊，30(2)，13-19。
59. 黃春長(1994)。老人教育－銀髮飛揚系列叢書（一）：高齡化社會。嘉義:紅豆出版社。
60. 趙峻郁、賴正全、葉秀煌(2002)。適度規律運動對老年人身體機能增進之助益。高雄餐旅學報，5，165-174。
61. 鄭名涵(2003)。臺北，國立臺灣師範大學體育學系。
62. 藍青(1996)。高齡者運動醫學。國民體育季刊，25(1)，84-90。