臺灣博碩士論文加值系統

背景：高齡者肌力下降為造成失能主要原因之一，因肌力不足、平衡能力下降造成意外跌倒，導致骨折與影響生活功能，增加非預期性住院率與長期照護經濟成本。
目的：探討藥球運動作為高齡者上肢阻力訓練之可行性及活動介入後增加肌肉力量及平衡能力之成效。
方法：研究採前後測實驗型(pretest-posttest)研究設計，以立意選樣方式，對象為彰化縣某長期照護機構65歲以上長者，可獨立站立5分鐘以上，並排除雙上肢或某一上肢癱瘓失能、重度失智、無法聽從指令及高血壓(≧160/100mmHg)，共23名。訓練工具：藥球(Medicine Ball)，重量：30%前測握力為1RM(repetition maximum，一次反覆最大重量)。運動實驗介入前四週為對照期；運動實驗介入六週為實驗期。實驗期第1-2週以30% RM肌力執行8項動作並重複6次，第3-6週則重複12次，每週2次。藥球運動介入前、後分別進行握力測試、起身行走測試(Get-up and Go Test)、功能性前伸測試(Functional Reach Test)及柏格氏平衡量表測試(Berg Balance Scale)，以評估肌力與平衡能力。
結果：以無母數Wilcoxon分析檢定結果，右手握力測試Z=-3.94、P<0.01，左手握力Z=-3.86、 P<0.01，起身行走測試Z=-3.28、 P<0.01，功能性前伸測試Z=-1.10、 P=0.01，伯格氏平衡量表之平衡能力實驗期Z=-1.34、P=0.18。結果顯示，藥球運動介入對高齡者雙手握力與平衡表現有相關性提升。
結論：藥球運動介入可能增進高齡者上肢肌力與平衡表現，期望未來能將藥球運動模組推廣以增進高齡者健康促進達到延緩失能的目標。

Background: The decline in muscle strength in elderly people is one of the main causes of disability. Accidental fall due to lack of muscle strength and decreased balance. Lead to fractures and affect ADL function. Increase unintended hospitalization rates and long-term care for economic costs.
Objective: To explore the feasibility of medicine ball exercise as an upper limb resistance training and effects of medicine ball exercise on muscle strength and body balance in the elderly.
Method: Study the pretest-posttest research design and purpose sampling. The object is an elderly person aged 65 or older, the long-term care institution in Changhua County. Can stand alone for more than 5 min, and exclude double upper limbs or some upper limbs disability, severe dementia, inability to follow instructions, Hypertension (≧160/100mmHg). A total of 23 cases were received. Training tool: Medicine Ball, weight: 30% pre-measured grip strength is 1RM (repetition maximum, one time over maximum weight). The first four weeks of the intervention of the exercise experiment is the control period; The exercise experiment involved six weeks as the experimental period. During the first 1-2 weeks of the experiment, 8 actions were performed with 30% RM muscle strength and repeated 6 times, repeated 12 times in the 3rd-6th week, twice a week. The grip strength test, Get-up and Go Test, Functional Reach Test and Berg Balance Scale were performed to assess muscle strength and body balance before and after the ball movement.
Results: The results of Wilcoxon analysis without parental number were used. The right hand grip test was Z=-3.94, P<0.01, the left hand grip strength was Z=-3.86, P<0.01, and the Time Up and Go test was Z=-3.28, P<0.01, the Functional Reach test Z=-1.10, P=0.01, the Berg's balance scale experimental period Z= -1.34, P=0.18. The balance-related performances of the two-hand grip, the Time Up and Go test and the Functional Reach test have significant progress differences.
Conclusion: The Medicine Ball exercise increased the upper limb muscle strength and body balance performance in the elderly. In the future, Medicine Ball exercise might enhance the health promotion and delaying disability in the elderly.

目 錄
目錄 …......……………………….…………………………… i
表目錄 …......……………………….………………………… iii
圖目錄 …......……………………….………………………… iv
第壹章 緒論
第一節 研究背景與動機 …......………………………. 1
第二節 研究目的 …......……………………….……… 3
第貳章 文獻探討
第一節 老化對生理結構改變影響 …......…………… 5
第二節 肌力與平衡能力之關係 …......…………… 7
第三節 運動對生理與健康影響 ......…………......….. 10
第四節 運動介入對於肌力與平衡能力的影響 ….. 12
第五節 高齡者的訓練強度探討......…………......…… 15
第六節 小結 ......…………......……………………… 16
第參章 研究設計與研究方法
第一節 招募受試者 ......…………......……………… 17
第二節 介入方式與流程 ......…………......………… 19
第三節 運動訓練設計 ......…………......…………… 20
第四節 測試方法與步驟 ......…………......………… 21
第五節 資料統計與分析方法 ......…………......…….. 23
第肆章 研究結果
第一節 參與者資料分析 ......…………......………… 24
第二節 藥球運動對上肢握力表現的效果 ......……… 26
第三節 藥球運動對平衡功能性表現的效果 ......…… 28
第四節 分組比較訓練成果 ......…………......……… 30
第伍章 討論
第一節 研究發現 .....…………......…………………. 32
第二節 藥球運動介入改善高齡者肌肉能力及平衡
表現成效 ......…………......………………… 33
第三節 高齡者參與藥球運動可行性探討 …......…… 34
第陸章 結論與建議
第一節 結論 ....…………......………………………… 35
第二節 研究限制與建議 …......……………………… 37
參考文獻-中文文獻 .....…………......…………………… 38
參考文獻-英文文獻 ..…………......……………………… 40
附錄
附錄一、伯格氏平衡量表 (Berg Balance Scale) ...… 45

表 目 錄
表一 基本資料 ......…………......………………………… 24
表二 生理參數 ......…………......………………………… 25
表三 活動介入對握力表現的效果 ......…………......…….. 27
表四 活動介入對平衡功能表現的效果 ..…………......….. 27
表五 以性別分組比較實驗期訓練成效 ......…………........ 30
表六 以握力分組比較實驗期訓練成效 ......…………........ 31
表七 以年齡分組比較實驗期訓練成效 ......…………........ 31

圖 目 錄
圖一 重量1-5磅藥球 ......…………......………………… 20
圖二 握力器 ......…......…......…......…......…………......… 21
圖三 受試者十週血壓變化 ..………......………………… 25
圖四 受試者十週心跳變化 ......…………..……………… 25
圖五 受試者十週左、右手握力變化 .....………………… 26
圖六 受試者起立行走變化 .....…………...... …………… 29
圖七 受試者功能性前伸變化 .....…………. …….....…… 29
圖八 受試者伯格氏平衡量(BBS)變化 ......……………… 29

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