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下肢運動改善中高齡者的功能性體適能、基本生理指標、
運動自我效能、睡眠品質及心理健康
張籃茵1 黃心樹2* 徐永年3 劉紋妙4
摘 要
接受刊載:108 年 11 月 26 日 https://doi.org/10.6224/JN.202004_67(2).06
1 林新醫院護理部護理師 2 中臺科技大學護理系副教授 3 衛生福利部桃園醫院院長 4 中臺科技大學老人照顧系副教授
表一
兩組中高齡者在人口學變項之分布情形(N = 100)
全體(N = 100) 實驗組(n = 50) 對照組(n = 50)
變項 n(%) n(%) n(%) t / χ2 值 p值
性別 19.25*** < .001
男性 25(25) 3( 6) 22(44)
女性 75(75) 47(94) 28(56)
教育程度 24.65*** < .001
未受教育 26(26) 21(42) 5(10)
國中小 43(43) 24(48) 19(38)
高中職以上 31(31) 5(10) 26(52)
婚姻狀況 11.82** .008
未婚 1( 1) 0( 0) 1( 2)
已婚 58(58) 24(48) 34(68)
離婚 6( 6) 1( 2) 5(10)
喪偶 35(35) 25(50) 10(20)
居住狀況 10.49* .015
獨居 8( 8) 2( 4) 6(12)
夫妻同住 39(39) 15(30) 24(48)
與子女同住 51(51) 33(66) 18(36)
其他 2( 2) 0( 0) 2( 4)
慢性病 4.60* .032
無 32(32) 11(22) 21(42)
有 68(68) 39(78) 29(58)
慢性病類別 a
高血壓 46(49) 28(54) 18(43) 4.03* .045
高血脂 3( 3) 1( 2) 2( 5) 0.34 .558
心臟病 16(17) 8(15) 8(19) 0.00 1.000
糖尿病 21(22) 13(25) 8(19) 1.51 .220
其他 8( 9) 2( 4) 6(14) 2.17 .140
每週運動次數 14.05* .015
0 6( 6) 2( 4) 4( 8)
1 7( 7) 3( 6) 4( 8)
2 15(15) 7(14) 8(16)
3 31(31) 17(34) 14(28)
4 13(13) 12(24) 1( 2)
5 28(28) 9(18) 19(38)
每週運動時間( 分) 19.95** .001
0–10 6( 6) 3( 6) 3 (6)
11–20 25(25) 18(36) 7(14)
21–30 36(36) 22(44) 14(28)
31–40 12(12) 4( 8) 8(16)
41–50 9( 9) 0( 0) 9(18)
51( 含)以上 12(12) 3 (6) 9(18)
運動時身體感覺 5.45 .245
非常輕鬆 3( 3) 0( 0) 3( 6)
很輕鬆 32(32) 19(38) 13(26)
輕鬆 50(50) 23(46) 27(54)
有點累 14(14) 7(14) 7(14)
很累 1( 1) 1( 2) 0( 0)
非常累 0( 0) 0( 0) 0( 0)
年齡( 歲) (M ± SD) 72.86 ± 9.01 75.80 ± 7.38 69.92 ± 9.60 3.44*** .001
身高(cm) (M ± SD) 158.03 ± 7.13 156.20 ± 5.67 159.86 ± 7.99 -2.64** .010
(M ± SD)
體重(kg) 61.59 ± 11.24 59.71 ± 8.96 63.47 ± 12.95 -1.69 .095
慢性病數
前測(M ± SD) 0.94 ± 0.81 1.04 ± 0.75 0.84 ± 0.87 1.23 .221
後測(M ± SD) 0.97 ± 0.86 1.10 ± 0.81 0.84 ± 0.89 1.52 .130
註 :a 複選題。
*p < .05. **p < .01. ***p < .001.
表二
兩組在功能性體適能 、基本生理指標 、運動自我效能 、睡眠品質 、心理健康之共變數分析摘要表(N = 50)
前測(M ± SD) (M ± SE)
後測( 校正後)
項 目 實驗組 控制組 實驗組 控制組 F p
功能性體適能
30 秒坐站測驗( 秒) 14.26 ± 5.02 16.64 ± 6.83 17.26 ± 0.35 15.06 ± 0.35 19.86*** < .001
2.44公尺起身繞物測驗( 秒)
8.66 ± 2.92 7.70 ± 2.45 7.80 ± 0.17 8.56 ± 0.17 9.90** .002
2 分鐘抬腿測驗( 次) 79.90 ± 22.29 79.86 ± 29.34 90.86 ± 1.94 75.84 ± 1.94 30.13*** < .001
基本生理指標
舒張壓(mmHg) 71.08 ± 8.53 74.16 ± 7.53 75.82 ± 1.14 74.42 ± 1.14 0.74 .391
腰圍(cm) 87.16 ± 8.69 84.05 ± 12.17 82.03 ± 0.43 87.14 ± 0.43 69.21*** < .001
體脂肪比率(%) 32.38 ± 4.44 29.81 ± 5.77 30.82 ± 0.12 32.10 ± 0.12 59.11*** < .001
運動自我效能 0.55 ± 0.53 0.74 ± 0.70 1.31 ± 0.08 0.51 ± 0.08 51.66* < .050
睡眠品質
主觀睡眠品質 1.26 ± 0.88 1.48 ± 0.68 0.99 ± 0.10 1.61 ± 0.10 19.01*** < .001
睡眠時數( 時) 0.98 ± 0.94 0.92 ± 0.83 0.66 ± 0.09 1.00 ± 0.09 6.82* .010
睡眠效率 79.90 ± 22.29 79.86 ± 29.34 90.86 ± 1.94 75.84 ± 1.94 1.18 .280
睡眠困擾 1.52 ± 0.50 1.48 ± 0.50 1.27 ± 0.07 1.53 ± 0.07 7.44** .008
心理健康
生理慮病 3.89 ± 0.64 3.83 ± 0.72 4.01 ± 0.08 3.73 ± 0.08 6.64* .011
焦慮煩躁 3.96 ± 0.90 3.98 ± 0.75 4.09 ± 0.08 3.85 ± 0.08 4.41* .038
憂鬱低落 4.17 ± 0.65 4.19 ± 0.64 4.33 ± 0.06 4.05 ± 0.06 11.14** .001
社交困擾 4.55 ± 0.52 4.49 ± 0.58 4.58 ± 0.06 4.41 ± 0.06 3.93 .050
正向樂觀 3.59 ± 0.55 3.59 ± 0.74 3.98 ± 0.06 3.49 ± 0.06 33.81*** < .001
整體身心健康 4.02 ± 0.48 4.00 ± 0.49 4.19 ± 0.04 3.89 ± 0.04 25.88*** < .001
*p < .05. **p < .01. ***p < .001.
四 、中高齡者下肢運動介入對睡眠品質之影響 作者貢獻度
在睡眠品質量表中 ,依共變數分析顯示下肢運 研究設計:黃心樹 、徐永年
動對於中高齡者在個人主觀睡眠品質 、睡眠時數 、 資料蒐集:張籃茵 、劉紋妙
睡眠困擾 、白天功能障礙上有明顯的介入效果(p < 資料分析:黃心樹 、張籃茵
.05;表二),顯示實驗組中高齡者在睡眠品質獲得的 主要執筆:張籃茵
改善較多 ,此結果與林嘉玲等(2014)、Liu 等(2017) 總修潤:黃心樹
及蘇等(2017)研究相同 ,顯示有運動習慣的中高齡
者能改善睡眠品質 ,本研究經由下肢肌力運動及伸展 參考文獻
運動能有效改善睡眠品質。
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ABSTRACT
Background: Middle-aged and older individuals suffer from skeletal muscle loss due to aging, increasing the risk
of sarcopenia. Muscular dystrophy reduces lower-extremity muscle endurance. The annual incidence of falls in the
community is about 30–40%. Falls contribute to disability and fractures, affect quality of life, reduce mental health,
and, in severe cases, result in death. Therefore, preventing lower limb muscle weakness in middle-aged and older
individuals should be taken seriously.
Purpose: The purpose of this study was to promote community health with a focus on older, community-dwelling
individuals. The effects of a lower-extremity exercise intervention on middle-aged and older individuals in terms
of improving functional fitness, physiological indexes, exercise self-efficacy, sleep quality, and mental health were
explored.
Methods: This study used convenience sampling to recruit community residents over 55 years old as participants,
with 50 participants assigned to the control group and to the experimental group, respectively. The experimental
group participated in a 50-min lower extremity exercise intervention three times a week for 12 weeks. Differences in
functional fitness, basic physiological index, exercise self-efficacy, sleep quality, and mental health variables between
the two groups were assessed at the conclusion of the intervention.
Results: The lower-extremity muscle exercise program significantly improved functional fitness, physiological
indexes, exercise self-efficacy, sleep quality, and overall mental health status in the experimental group, as compared
to the control group (p < .05).
Conclusions/ Implications for Practice: It is recommended that the concept and application of lower extremity
movement intervention should be popularized among middle-aged and older individuals to promote physical and
mental health, prevent the decline and loss of lower extremity muscle strength, and help realize healthy aging goals.
Key Words: middle-aged and older individuals, lower extremity exercise, functional fitness, exercise self-effi-
cacy, sleep quality, mental health.