穿著負重鞋以提升高齡者下肢肌力之可能性

Feasibility of wearing weighted-shoes to improve the lower extremity muscle strength of the elderly

10.6406/JNCKUPER.202210_54(2).0006

陳育延(Yu-Yen Chen)；邱宏達(Hung-Ta Chiu)

高齡者 ； 跌倒風險 ； 步行運動 ； 負重鞋 ； The elderly ； risk of fall ； walking exercise ； weighted-shoe

成大體育學刊

54卷2期（2022 / 10 / 01）

84 - 98

繁體中文

臺灣正面臨高齡社會的衝擊，使得「預防跌倒」之健康議題日益受到重視，強化高齡族群下肢肌力已證實可有效降低跌倒之風險。現今已有許多維持肌力的訓練方法，然而對於高齡者介入的運動訓練，需特別考量到安全性及便利性之問題，其中「步行運動」是最受高齡者所喜愛的日常運動，若能在步行運動中，讓高齡者在安全使用的範疇下，穿戴可調整附加重量之健走鞋或慢跑鞋，以數個承載重量的負重套筒附加於足跟支撐架（heel counter），並可更換不同數量之圓柱體金屬法碼，依照自行能力進行不同負重的調整，以作為增強運動強度的運動輔具，並落實將訓練融入生活的理念。此必能增加高齡者日常步行之訓練效果，亦能維持及提升下肢骨骼肌系統能力，並預防跌倒的發生，使高齡族群能達到成功「活躍老化」的效應。

The aging impact had been a major considerable issue in Taiwan, aging has extended many health-related problems, so prevention of falls is an important issue for everyone. The importance of improving lower limb strength had been indicated as an important factor for preventing the risk of falls in the elderly. Nowadays, there are many different kinds of exercise training to maintain muscle strength. However, there is still safety and convenience issue need to be considered during the customized training program in the elderly. Thus, walking became the most acceptable and popular daily exercise among elder adult. Under the premise of application safety, adjustable weighted-shoes as a training device to enhance their lower limb strength and implemented the concept of integrating training into daily basis. By this training concept, improved lower extremity muscle activation, which may maintain muscle strength or even became stronger for decreasing the incidence of falls. In summary, the adjustable weighted-shoe as a training device could be a new acceptable training method and achieved the goal of successful aging for the elderly.

1. 林銀秋(2003)。健康老年人的跌倒危機─ 骨骼肌肉系統及步態分析之討論。中華體育季刊，17(3)，70-74。
   連結：
2. 蔡宗晏,王進華(2007)。淺談肌電圖在運動科學中的應用。大專體育，90，155-159。
   連結：
3. Amazeen, E. L.(1997).The effects of volume on perceived heaviness by dynamic touch: With and without vision.Ecological Psychology,9(4),245-263.
4. Barrett, R.,Mills, P.,Begg, R.(2010).A systematic review of the effect of ageing and falls history on minimum foot clearance characteristics during level walking.Gait & Posture,32(4),429-435.
5. Cao, Z.-B.,Maeda, A.,Shima, N.,Kurata, H.,Nishizono, H.(2007).The effect of a 12-week combined exercise intervention program on physical performance and gait kinematics in community-dwelling elderly women.Journal of Physiological Anthropology,26(3),325-332.
6. Chen, H.-C.,Ashton-Miller, J. A.,Alexander, N. B.,Schultz, A. B.(1991).Stepping over obstacles: gait patterns of healthy young and old adults.Journal of Gerontology,46(6),M196-M203.
7. Chiou, S. S.,Turner, N.,Zwiener, J.,Weaver, D. L.,Haskell, W. E.(2012).Effect of boot weight and sole flexibility on gait and physiological responses of firefighters in stepping over obstacles.Human Factors,54(3),373-386.
8. Chiu, H.-T.,Lin, H.-H.(2019).A preference test on shoes with varied distributions of masses.Footwear Science
9. Di Fabio, R. P.,Kurszewski, W. M.,Jorgenson, E. E.,Kunz, R. C.(2004).Footlift Asymmetry During Obstacle Avoidance in High‐Risk Elderly.Journal of The American Geriatrics Society,52(12),2088-2093.
10. Fiatarone, M. A.,Evans, W. J.(1993).The Etiology and Reversibility of Muscle Dysfunction in the Aged.Journal of Gerontology,48(Special_Issue),77-83.
11. Galna, B.,Peters, A.,Murphy, A. T.,Morris, M. E.(2009).Obstacle crossing deficits in older adults: a systematic review.Gait & Posture,30(3),270-275.
12. Gottschall, J. S.,Kram, R.(2005).Energy cost and muscular activity required for leg swing during walking.Journal of Applied Physiology,99(1),23-30.
13. Grisso, J. A.,Schwarz, D. F.,Wishner, A. R.,Weene, B.,Holmes, J. H.,Sutton, R. L.(1990).Injuries in an elderly inner‐city population.Journal of the American Geriatrics Society,38(12),1326-1331.
14. Hahn, M. E.,Chou, L.-S.(2004).Age-related reduction in sagittal plane center of mass motion during obstacle crossing.Journal of Biomechanics,37(6),837-844.
15. Horlings, C. G.,Van Engelen, B. G.,Allum, J. H.,Bloem, B. R.(2008).A weak balance: the contribution of muscle weakness to postural instability and falls.Nature Reviews Neurology,4(9),504.
16. Huang, Y.Z.,Deng, P.P.,Chiu, H.T.(2014).Different preference of the weighted shoes between the female and male subjects.7th World Congress of Biomechanics,Boston, USA:
17. Ikenaga, M.,Yamada, Y.,Mihara, R.,Yoshida, T.,Fujii, K.,Morimura, K.,Kiyonaga, A.(2012).Effects of slightly-weighted shoe intervention on lower limb muscle mass and gait patterns in the elderly.Japanese Journal of Physical Fitness Sports Medicine,61(5),469-477.
18. Jones, CJ,Rose, DJ(2005).Physical activity instruction of older adults.Champaign, IL:Human Kinetics.
19. King, A. C.,Pruitt, L. A.,Phillips, W.,Oka, R.,Rodenburg, A.,Haskell, W. L.(2000).Comparative effects of two physical activity programs on measured and perceived physical functioning and other health-related quality of life outcomes in older adults.The Journals of Gerontology: Series A: Biological Sciences Medical Sciences
20. kubo, Y.,Osuka, Y.,Jung, S.,Rafael, F.,Tsujimoto, T.,Aiba, T.,Tanaka, K.(2016).Walking can be more effective than balance training in fall prevention among community‐dwelling older adults.Geriatrics Gerontology International,16(1),118-125.
21. Kulinski, K.,DiCocco, C.,Skowronski, S.,Sprowls, P.(2017).Advancing community-based falls prevention programs for older adults—the work of the Administration for Community Living/Administration on Aging.Frontiers in Public Health,5,4.
22. 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.
23. Lowrey, C. R.,Watson, A.,Vallis, L. A.(2007).Age-related changes in avoidance strategies when negotiating single and multiple obstacles.Experimental Brain Research,182(3),289-299.
24. Massaad, F.,Lejeune, T. M.,Detrembleur, C.(2007).The up and down bobbing of human walking: a compromise between muscle work and efficiency.The Journal of Physiology,582(2),789-799.
25. Nene, A.,Byrne, C.,Hermens, H.(2004).Is rectus femoris really a part of quadriceps?: Assessment of rectus femoris function during gait in able-bodied adults.Gait & Posture,20(1),1-13.
26. Palvanen, M.,Kannus, P.,Parkkari, J.,Pitkäja, T.,Pasanen, M.,Vuori, I.,Järvinen, M.(2000).The injury mechanisms of osteoporotic upper extremity fractures among older adults: a controlled study of 287 consecutive patients and their 108 controls.Osteoporosis International,11(10),822-831.
27. Pan, H.-F.,Hsu, H.-C.,Chang, W.-N.,Renn, J.-H.,Wu, H.-W.(2016).Strategies for obstacle crossing in older adults with high and low risk of falling.Journal of Physical Therapy Science,28(5),1614-1620.
28. Persch, L. N.,Ugrinowitsch, C.,Pereira, G.,Rodacki, A. L.(2009).Strength training improves fall-related gait kinematics in the elderly: a randomized controlled trial.Clinical Biomechanics,24(10),819-825.
29. Robinovitch, S. N.,Feldman, F.,Yang, Y.,Schonnop, R.,Leung, P. M.,Sarraf, T.,Loughin, M.(2013).Video capture of the circumstances of falls in elderly people residing in long-term care: an observational study.The Lancet,381(9860),47-54.
30. Tinetti, M. E.,Speechley, M.,Ginter, S. F.(1988).Risk factors for falls among elderly persons living in the community.New England Journal of Medicine,319(26),1701-1707.
31. Yoo, E. J.,Jun, T. W.,Hawkins, S. A.(2010).The effects of a walking exercise program on fallrelated fitness, bone metabolism, and fall-related psychological factors in elderly women.Research in Sports Medicine,18(4),236-250.
32. 呂軒瑜(2015)。國立成功大學。
33. 洪鈴雅,張家豪,蔡虔祿(2013)。運動訓練對老年人跌倒風險之探討。健康生活與成功老化學刊，5(1)，28-36。
34. 教育部體育署(2018)。 運動現況調查報告書。臺北市。
35. 陳偉瑀(2007)。運動的好處。學校體育，98，29-35。
36. 蔡佳良,吳昇光(2003)。認知對老人姿勢控制和跌倒的影響。大專體育，68，172-177。
37. 鄧蓓蓓(2013)。國立成功大學。