坐式八段錦對於護理之家失能住民每日血壓波動之前驅性研究

A Pilot Study of the Effects of Seated-Version Baduanjin on Day-to-Day Blood Pressure Fluctuation among Nursing Home Residents

10.6516/TJTCM.202109_24(3).0002

陳冠佐(Kuan-Tso Chen)；洪春金(Chun-Chin Hung)；林淑芬(Shu-Fen Lin)；林佩靜(Pei-Ching Lin)；唐睿誼(Rui-Yi Tang)；蔡金川(Chin-Chuan Tsai)

八段錦 ； 血壓波動 ； 高齡 ； 失能 ； 預防及延緩失能照護服務 ； Badunjin ； Blood Pressure Fluctuation ； Aging ； Disability ； The Programs to Prevent or Delay Disability

中醫藥研究論叢

24卷3期（2021 / 09 / 30）

29 - 41

繁體中文

目的：近期研究顯示罹患失智症、阿茲海默症、腦血管疾病之高齡者與血壓波動（Blood pressure variability, BPV）有相關性；血壓波動越高，罹患失智症、阿茲海默症、腦血管疾病之風險越高。系統性回顧顯示八段錦對於間隔時間訪視的血壓值（Visit-to-visit blood pressure）具有調控的效益。然而目前坐式八段錦對於高齡輪椅依賴長者的每日血壓波動則無相關研究。因此，本研究將探討坐式八段錦介入護理之家住民對於長期血壓波動的調控效益。方法：本研究在護理之家連續執行4個月的坐式八段錦氣功活動，每週施作2次，每次33分鐘。依據參與八段錦氣功的程度，被分配為積極參與組（n=12）與消極參與組（n=11）。每日早上常規定時測量個案的收縮壓（Systolic blood pressure, SBP）、舒張壓（Diastolic blood pressure, DBP）及環境溫度，並且計算分析每月的收縮壓變異係數（Coefficient of variation of SBP, SBP-CoV）與舒張壓變異係數（Coefficient of variation of DBP, DBP-CoV），藉由廣義估計方程式（Generalized estimating equation model）分析血壓波動。結果：結果顯示積極參與組在連續施作3個月後，收縮壓波動顯著降低2.748%（B=-2.748, 95% CI: [-0.406 to -5.09], p=0.021），連續施作4個月後效果維持，血壓波動降低2.872%（B=-2.872, 95% CI: [-0.498 to -5.247], p=0.018），然而舒張壓波動則無明顯改變。而在氣溫較低且溫度波動大的時期，消極參與組的長輩們血壓波動提高約1.858%（B=1.858, 95% CI: [0.166 to 3.550], p=0.031），積極參與組則不受影響。結論：本研究顯示坐式八段錦對於失能長者血壓波動具有正面調控效益。

Objectives: Recent research have demonstrated that the development of dementia, Alzheimer's disease and cerebrovascular disease in the elderly is associated with blood pressure variability (BPV). It is proposed that higher BPV is risk factor for above disease. Previous meta-analysis study proposed that Baduanjin exercise is beneficial for visit-to-visit blood pressure regulation. However, the research for the effect of seated-version Baduanjin for the wheelchair dependence older people on day-to-day BPV was deficient. The aim of this study is to investigate the efficacy of modified seated version Baduanjin on day-to-day BPV. Methods: Baduanjin practice was implemented as a 33-minute regular physical exercise held twice weekly within 4 months. Disabled residents lived in the nursing home were divided into active participants group (n=12) and inactive participants group (n=11) according to the attendance in this study. Systolic blood pressure (SBP), diastolic blood pressure (DBP) and daily room temperature were measured every morning and monthly coefficient of variation of SBP (SBP-CoV) and DBP (DBP-CoV) were calculated for each resident from November 2017 to March 2018. Results: The generalized estimating equation model revealed a significant reduction of SBP-CoV in the third month among active participants group (regression coefficient of group by time interaction B=-2.748, 95% CI: [-0.406 to -5.09], p=0.021) and sustained to the forth month (regression coefficient of group by time interaction B=-2.872, 95% CI: [-0.498 to -5.247], p=0.018). There is no significant change in diastolic blood pressure fluctuations. The significant increase of SBP-CoV in inactive participants in the third month was observed, which was thought due to cold weather. (regression coefficient B=1.858, 95% CI: [0.166 to 3.550], p=0.031). Conclusions: The preliminary result of our study was that regular seated-version Baduanjin exercise could significantly reduce the systolic blood pressure fluctuation in the elders.

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