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研究生: 黃建榮
Huang, Chien-Jung
論文名稱: 中醫保健課程對於改善長者步態穩定成效之評估-以臺北市為例
The Effect of Traditional Chinese Medicine Prevention on Gait Stability for the Community Elderly in Taipei City.
指導教授: 劉潔心
Liu, Chieh-Hsing
口試委員: 劉潔心
Liu, Chieh-Hsing
董貞吟
Tung, Chen-Yin
郭鐘隆
Guo, Jong-Long
林昭庚
Lin, Jaung-Geng
廖建彰
Liao, Chien-Chang
口試日期: 2024/06/12
學位類別: 博士
Doctor
系所名稱: 健康促進與衛生教育學系
Department of Health Promotion and Health Education
論文出版年: 2024
畢業學年度: 112
語文別: 中文
論文頁數: 230
中文關鍵詞: 社區老人中醫運動中醫保健課程慣性傳感器恐懼跌倒
英文關鍵詞: community-dwelling elderly, Traditional Chinese Medicine exercise, TCM healthcare program, inertial sensor, fear of falling
研究方法: 準實驗設計法
DOI URL: http://doi.org/10.6345/NTNU202401034
論文種類: 學術論文
相關次數: 點閱:60下載:0
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  • 背景:臺北市老年人口比例全台最高,跌倒恐懼與行走步態被廣泛認為是導致老人跌倒的重要風險因子,但關於社區老年人步態參數的研究在臺灣相對有限。
    目的:本研究旨在瞭解臺北市社區老年人的跌倒恐懼與步態參數現況,並評估融入健康信念模式的中醫保健課程對其之影響。
    方法:本研究採準實驗設計,以方便抽樣在臺北市招募65歲至85歲社區老人,設計以健康信念模式融入之提升下肢功能中醫保健課程,介入為期一個月,課程包括數種中醫身體活動、穴位按摩、藥膳及茶飲。研究區分介入課程A組、介入課程B組及對照組,B組差異為減少特定的中醫身體活動。研究工具使用可攜式慣性傳感器進行15公尺折返步態量測,及跌倒自覺風險量表(FES-I)進行評估。
    結果:參與者對跌倒存在高程度恐懼,在步速、步頻、步幅長度、腳趾最小離地高度等步態參數有良好的表現,為活動力較為活躍族群。A組介入組內對步速、步幅長度、步距、雙支撐以及腳跟最大離地高度具顯著改善效果;課程B組介入於對腳跟最大離地高度具組間顯著改善效果,但該課程對跌倒恐懼及步距有負向的影響。
    結論:以提升下肢功能為目的之中醫保健課程,短期即能有效改善社區老年人步態表現,比一般身體活動更對老人行動推進能力有幫助。

    Background: In Taiwan, Taipei City has the highest proportion of elderly residents nationwide. Fear of falling and gait disturbances are widely acknowledged as significant risk factors for falls. However, research on gait parameters among community-dwelling elderly individuals in Taiwan remains relatively sparse.
    Objective: This study aims to assess the current state of fear of falling and gait parameters among elderly residents of Taipei City and to evaluate the effects of a Traditional Chinese Medicine (TCM) healthcare program that incorporates the Health Belief Model.
    Methods: A quasi-experimental design, this study recruited community-dwelling elderly individuals aged 65 and above from Taipei City through convenience sampling. The TCM healthcare program was designed to enhance lower limb functionality and included components such as TCM physical activities, acupressure, medical cuisine, and herbal teas. Participants were assigned to intervention group A, intervention group B, or a control group, with Group B receiving reduced TCM physical activities. The program spanned one month, with sessions lasting 120 minutes weekly. Measurements were conducted using a portable inertial sensor for a 15-meter return gait test, and assessments were carried out using the Fear of Falling Scale (FES-I).
    Results: The findings revealed a widespread prevalence of fear of falling among participants, alongside positive outcomes in gait parameters such as walking speed, cadence, stride length, and minimum toe clearance. Group A showed significant improvements in walking speed, cadence, stride length, step length, double support, and maximum heel height following the intervention. Although Group B demonstrated significant enhancements in maximum heel height exceeding those of the control group, it negatively impacted fear of falling and step length.
    Conclusion: The TCM healthcare program, integrated with the Health Belief Model, was effective in improving gait parameters among the elderly population in the community. These results offer valuable insights for the development of future health policies and program designs, aiming to enhance the quality of life and physical health of community-dwelling seniors.

    第一章 緒論 1 第一節 研究動機 1 第二節 研究重要性 4 第三節 研究目的 6 第四節 研究問題 7 第五節 研究假設 8 第六節 名詞定義 9 第二章 、文獻探討 12 第一節 預防長者跌倒重要性 12 第二節 跌倒風險因子及篩檢工具 15 第三節 恐懼跌倒與步態之關聯 21 第四節 步態平衡之介入與評估工具 23 第五節 中醫養生保健課程與預防跌倒、穩定步態之探討 45 第六節 健康信念模式 73 第三章、 研究方法與步驟 77 第一節 研究設計 77 第二節 研究架構 78 第三節 操作型定義 80 第四節 研究對象 83 第五節 研究工具 84 第六節 研究步驟 89 第七節 介入課程設計 90 第八節 資料處理及分析 120 第九節 研究倫理 121 第四章 結果與討論 122 第一節 基本人口學特質分佈 122 第二節 跌倒恐懼分數分析 125 第三節 步態參數分析 130 第四節 討論 153 第五章 結論與建議 172 第一節 結論 172 第二節 建議 174 第三節 研究限制 180 參考文獻 182 附錄一 研究問卷 226 附錄二 人體試驗委員會核准函 228

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