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研究生: 黃奕仁
Huang, Yi-Jen
論文名稱: 十六週團體運動介入計畫對老年人全人健康之影響
The Effects of 16-week Group-based Exercise Intervention on Wellness of Elderly
指導教授: 方進隆
Fang, Chin-Lung
學位類別: 博士
Doctor
系所名稱: 體育學系
Department of Physical Education
論文出版年: 2005
畢業學年度: 93
語文別: 中文
論文頁數: 195
中文關鍵詞: 全人健康老年人運動介入代謝適能運動階段健康生活型態生活品質
英文關鍵詞: wellness, elderly, exercise intervention, metabolic fitness, stage of change, wellness lifestyle, quality of life
論文種類: 學術論文
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  • 本研究目的為探討十六週團體運動介入計畫對老年人全人健康包括生理、心理、健康生活型態與生活品質之影響。94位65-100歲老年人分為運動組63人(平均年齡76.32±6.55歲),和僅參與健康檢測之對照組31人(平均年齡81.10±8.24歲)。運動組接受十六週每週一次二小時綜合運動課程(包括伸展、平衡、肌力與耐力訓練),搭配自我運動監控計畫,介入期間每週運動頻率3.56 ± 2.08次,每次運動時間20分鐘以上,訓練強度訂在自覺輕鬆-有點吃力(RPE11-15)之水準,達到ACSM所定老年人運動計畫之標準,同時對照組運動頻率維持在每週1.29 ± 2.50次之水準。全體並於計畫前、後及三個月追蹤期檢測生理狀態、運動能力、細胞代謝、心理健康、運動習慣、健康生活型態及生活品質。將檢測結果以獨立t檢定和重複量數單因子變異數分析處理後發現,運動介入後運動組生理部分在生理狀態(收縮血壓、安靜心跳)、身體組成(肌肉量、體脂肪率)、運動功能(反應能力、平衡、柔軟度、下肢動力與心肺耐力)、細胞代謝適能(葡萄糖耐受度、胰島素敏感性及血液中脂類)、抗老化指標(DHEA-S)、心理自覺健康、「健康體能促進」與「疾病預防」等生活型態均有顯著改善。同時心理情緒指數(老人憂鬱量表GDS正向平均分數)、運動階段、健康生活型態與生活品質部分明顯優於對照組。追蹤三個月發現,運動組生理健康、運動能力、細胞代謝適能、抗老化指標DHEA-S、自覺健康與自我效能仍顯著優於前測,此時運動階段明顯向前推進,健康生活型態中「健康體能促進」、「個人安全」及生活品質中「活力」、「工作能力」均明顯高於對照組。結論指出,本研究十六週運動介入計畫使運動組每週運動頻率明顯增加,進而改善了基本生理狀態、身體組成、身體運動功能、細胞代謝適能和抗老化指標等生理健康,同時也增強了心理自覺健康、和健康體能促進行為。相對於對照組的衰退,運動組維持較佳的健康生活型態及生活品質水準。運動計畫介入的效益使運動組在追蹤三個月後仍維持較佳的生理健康、健康體能促進行為、自我效能、活力與工作能力滿意度,顯示本研究十六週團體運動介入計畫有助於老年人身心健康的改善和生活品質的維持。

    The purpose of this study was to investigate the effects of 16-week exercise intervention on the wellness of the elderly, including the physical, metabolic, functional, psychological fitness, healthy lifestyle and quality of life. Ninety four elderly above 65 years old were recruited as the subjects for this study and divided into two groups. The exercise group (EG) consisting of 63 elderly (average age 76.32±6.55 yrs, 10 male, 53 female) joined the intervention program with group-based exercise course 2 hours per week and engaged in self-monitoring exercises for 16 weeks. The group-based exercise included comprehensive stretching, balance, strength and endurance training with intensity of RPE 11-15, more than 20 minutes each session. Totally, the EG elderly performed about 3.5 times of exercise per week. The other 31 subjects (average age 81.10±8.24 yrs, 15 male, 16 female) received no special training and just measured their wellness before, after and 3 months followed the intervention program same as the EG served as the control group (CG). The collected data were analyzed by t-test and one way ANOVA and the results were as followed: After 16 weeks intervention, the systolic blood pressure, rest heart rate, body composition (muscle mass increased and body fat decreased), functional exercise abilities (reaction, balance, flexibility, low extremity power and cardiorespiratory endurance), metabolic fitness (glucose tolerance, insulin sensitivity, serum triglyceride, total cholesterol), and anti-aging index (DHEA-sulfate), self-perceived health status, wellness lifestyle about health-related fitness and disease prevention of EG improved significantly. In the same time, the geriatric depression scale (GDS-SF) positive average score, quality of life, Stage of change (SOC) about regular exercise behavior were higher than CG. After 3- month follow up, the physiological health, functional abilities, metabolic fitness, and anti-aging index, exercise SOC, self-perceived health status, self-efficacy were significantly better than pretest. Wellness lifestyle score about health-related fitness and personal safety, and QOL score on vitality and working ability facets of the EG were significantly better than CG. The conclusion suggested that 16-week exercise intervention improved physiological, functional, metabolic fitness and body composition. At the same time, psychophysical benefits were significantly enhanced. After 3 months followed, physiological benefits maintained, besides the health-related behavior, SOC and self-efficacy about regular exercise also progressed. Perceived higher vitality and working ability showed that current exercise intervention could profit psychophysical health and maintain life quality of elderly.

    口試委員與系主任簽字證書 I 授權書 II 中文摘要 IV 英文摘要 V 謝誌 VI 目次 VIII 表次 XI 圖次 XIV 第壹章 緒論 1 第一節 問題背景 1 第二節 研究目的 3 第三節 研究假設 4 第四節 操作型定義 4 第五節 研究範圍 6 第貳章、文獻探討 7 第一節 全人健康與其相關檢測指標及工具 7 一、生理健康 8 二、心理狀態 8 三、體適能 9 四、全人健康生活型態 10 五、生活品質(quality of life)和生活滿意度(life satisfaction) 12 第二節 運動對全人健康之影響 14 一、生理部分 14 二、心理部分 16 三、生活型態 17 四、生活品質和生活滿意度 18 第三節 運動指導課程之內容 19 一、身體活動部分 19 二、社會支持之營造 20 三、運動認知、心理策略與健康生活行為課程 22 第四節 老年人健康生活行為之探討 23 第五節 影響老年人從事規律運動之理論與策略探討 26 第六節 本章結語 29 第參章 研究方法 30 第一節 研究對象 30 第二節 研究工具 30 一、全人健康指標:(實際整合式問卷見附錄) 30 (一) 生理健康 30 (二) 自覺健康與心理情緒狀態 33 (三) 運動行為與影響因素 34 (四) 健康生活型態 34 (五) 生活品質 35 (六) 運動量紀錄 35 二、課程主要內容 35 第三節 研究程序 39 第四節 研究設計 40 第五節 統計方法 41 附 圖 研究期間活動及檢測相關照片 42 第肆章 結果 48 第一節 運動介入計畫對老年人生理健康之影響 48 第二節 運動介入計畫對老年人心理自覺健康與運動行為之影響 73 第三節 運動介入計畫對老年人健康生活型態與生活品質之影響 88 附 圖 第四章生理各項檢測結果前後差異圖 102 第伍章 討論與結論 119 第一節 討論 119 一、運動介入計畫對老年人生理健康之影響 119 二、運動介入計畫對老年人心理自覺健康與運動行為之影響 128 三、運動介入計畫對老年人健康生活型態與生活品質之影響 133 第二節 結論與建議 140 一、結論 140 二、建議 142 引用文獻 143 中文部分 143 英文部分 144 附錄 151 附錄一:前測問卷 151 附錄二:社區老人運動班開課調查表 165 附錄三:課程時間調查信 167 附錄四:社區銀髮族團隊運動課程報名表 168 附錄五:安養中心運動班報名表 170 附錄六:安養中心團隊運動計劃課程說明 171 附錄七:自編簡易太極拳套路 172 附錄八:檢測注意事項說明書 173 附錄十一:受試者同意書 177 附錄十二:計畫邀請公文 178 附錄十三:問卷各項結果統計表 179 表次 第壹章表 表 1 - 1 生活品質問卷各範疇所包括之層面表 6 第貳章表 表 2 - 1 有氧運動的效果表 15 表 2 – 2阻力性運動的效果表 15 表 2 – 3健身運動心理效益表 16 表 2 - 4 規律運動改變階段定義表 20 表 2 - 5 不同階段行為改變策略表 20 第參章表 表 3 - 1 課程內容表 36 第肆章第一節表 表4 - 1 - 1 全體受測者基本生理資料表 48 表4 - 1 - 2 全體受測者身體運動能力基本資料表 49 表4 - 1 - 3 全體受測者代謝適能基本資料表 49 表4 - 1 - 4 男女性前測基本生理及運動能力差異表 50 表4 - 1 - 5 全體老年人前測體脂肪與生理表現相關表 52 表4 - 1 - 6 運動組與對照組前測生理基本資料表 53 表4 - 1 - 7 運動組與對照組前測身體運動能力基本資料表 54 表4 - 1 - 8 運動組與對照組前測代謝適能基本資料表 54 表4 - 1 - 9 運動組生理基本資料運動介入前後比較表 55 表4 - 1 - 10 對照組生理基本資料運動介入前後比較表 56 表4 - 1 – 11 運動組身體運動能力運動介入前後比較表 57 表4 - 1 - 12 對照組身體運動能力運動介入前後比較表 57 表4 - 1 - 13 運動組代謝適能運動介入前後比較表 58 表4 - 1 - 14 對照組代謝適能運動介入前後比較表 59 表4 - 1 - 15 全體老年人後測生理表現相關表 60 表4 - 1 - 16 運動組後測運動頻率與運動能力相關表 61 表4 - 1 - 17 運動組女性後測運動頻率與胰島素敏感性相關表 61 表4 - 1 - 18 運動組與對照組每週平均運動頻率表 62 表4 - 1 - 19 運動組與對照組前後測及追蹤期基本生理變化表 63 表4 - 1 - 20 運動組與對照組前後測及追蹤期身體運動能力變化表 64 表4 - 1 - 21 運動組與對照組前後測及追蹤期細胞代謝適能變化表 66 表4 - 1 - 22 全體老年人追蹤期生理表現相關表 70 表4 - 1 - 23 運動組追蹤期運動頻率及三酸甘油酯與生理指標之相關表 71 表4 - 1 - 24 運動組女性運動量與收縮壓、胰島素相關表 72 第肆章第二節表 表4 - 2 - 1 全體受測者自覺健康程度基本資料表 73 表4 - 2 - 2 全體老年人前測運動階段與影響因子之相關表 75 表4 - 2 - 3 全體老年人前測時運動階段影響因子逐步迴歸摘要表 75 表4 - 2 - 4 運動計畫介入後運動組與對照組自覺健康程度前後差異表 76 表4 - 2 - 5 運動組與對照組運動介入前後及組間差異表 77 表4 - 2 - 6 運動介入後和追蹤期二組在老人憂鬱評量之變化與差異表 78 表4 - 2 - 7 全體老年人後測時運動階段與其影響因子之相關表 80 表4 - 2 – 8 全體老年人後測時運動階段影響因子逐步迴歸摘要表 80 表4 - 2 – 9 全體老年人運動頻率後測時影響因子多元迴歸摘要表 81 表4 - 2 – 10 全體老年人後測時運動頻率影響因子逐步迴歸摘要表 81 表4 - 2 – 11 運動組與對照組前後及追蹤期自覺健康差異表 82 表4 - 2 - 12 運動介入前後與追蹤期二組運動階段及相關影響因子之變化與差異表 83 表4 - 2 - 13 全體老年人追蹤期運動階段及其影響因子之相關表 84 表4 - 2 –14 全體老年人追蹤期運動階段影響因子逐步迴歸摘要表 85 表4 - 2 - 15 全體老年人追蹤期運動頻率影響因子多元迴歸摘要表 85 表4 - 2 - 16 全體老年人追蹤運動頻率影響因子逐步迴歸摘要表 86 表4 - 2 - 17 運動組與對照組老年人運動計畫介入前後之運動階段變化表 86 第肆章第三節表 表4 - 3 - 1全體受測者健康生活型態各範疇基本資料表 88 表4 - 3 - 2運動組及對照組前測生活品質基本資料表 89 表4 - 3 - 3運動計畫介入前後運動組與對照組健康生活型態各範疇變化表 91 表4 - 3 - 4運動組與對照組生活品質運動介入前後及組間差異表 92 表4 - 3 - 5運動介入前後與追蹤期二組健康生活型態各範疇之變化與差異表 97 表4 - 3 - 6運動介入前後與追蹤期二組生活品質之變化與差異表 98 附錄表 表 一、運動組自覺健康程度基本資料表 179 表 二、對照組自覺健康程度基本資料表 180 表 三、全體受測者運動階段基本特性表 181 表 四、運動組運動階段基本資料表 182 表 五、對照組運動階段基本資料表 183 表 六、全體受測者健康生活型態各層面基本資料表 184 表 七、運動組健康生活型態各層面基本資料表 185 表 八、運動組健康生活型態各範疇基本資料表 187 表 九、對照組健康生活型態各層面疇基本資料表 187 表 十、對照組健康生活型態各範疇基本資料表 189 表 十一、運動計畫介入前後運動組與對照組健康生活型態各層面變化表 189 表 十二、全體受測者生活品質基本特性表 193 圖次 第三章圖 圖 3 - 1 研究設計流程圖 39 圖 3 - 2研究設計示意圖 40 第四章圖 圖4 - 1 運動組與對照組體重之變化。 102 圖4 - 2 運動組和對照組老年人在肌肉重變化之差異。 102 圖4 - 3 運動組與對照組脂肪重之變化。 103 圖4 - 4 運動組與對照組體脂肪率變化之差異。 103 圖4 - 5 運動組與對照組身體質量指數之變化。 104 圖4 - 6 運動組與對照組腰圍及臀圍之變化。 104 圖4 - 7 運動組與對照組腰臀圍比之變化。 105 圖4 - 8 運動組與對照組血壓之變化。 105 圖4 - 9 運動組與對照組氧飽和度之變化。 106 圖4 - 10 運動組與對照組安靜心跳之變化。 106 圖4 - 11 運動組與對照組肺功能之變化。 107 圖4 - 12 運動組與對照組第一秒呼氣比之變化。 107 圖4 - 13 運動組與對照組握力之變化。二組前、後測與追蹤期均無明顯改變。 108 圖4 - 14 運動組與對照組落棒測試之變化。 108 圖4 - 15 運動組與對照組全身聲光反應時間之變化。 109 圖4 - 16 運動組與對照組坐姿體前彎伸展距離之變化。 109 圖4 - 17 運動組與對照組睜眼單足站時間之變化。 110 圖4 - 18 運動組與對照組閉眼單足站時間之變化。 110 圖4 - 19 運動組與對照組功能性伸展測試之變化。 111 圖4 - 20 運動組與對照組八英呎站走時間之變化。 111 圖4 - 21 運動組與對照組六分鐘走距離之變化。 112 圖4 - 22 運動組與對照組葡萄糖耐受度測試之變化。 113 圖4 - 23 運動組與對照組胰島素值之變化。 114 圖4 - 24 運動組與對照組血糖曲線下面積之變化。 115 圖4 - 25 運動組與對照組胰島素曲線下面積之變化。 116 圖4 - 26 運動組與對照組血液中脂肪之變化。 117 圖4 - 27 運動組與對照組cortisol之變化。 118 圖4 - 28 運動組與對照組DHEA-S 之變化。 118

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