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研究生:張兆韡
論文名稱:身體活動課程對輕中度智障者職業生理功能的成效
論文名稱(外文):The Effects of a Physical Activity Program on the Occupational Physiological Functions of Persons with Mild and Moderate Mental Retardation
指導教授:吳明宜吳明宜引用關係
學位類別:碩士
校院名稱:國立高雄師範大學
系所名稱:復建諮商研究所
學門:社會服務學門
學類:身心障礙服務學類
論文種類:學術論文
論文出版年:2009
畢業學年度:97
語文別:中文
論文頁數:185
中文關鍵詞:身體活動智障職業生理功能
外文關鍵詞:Physical ActivityMental RetardationOccupational Physiological Functions
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目的:
本研究目的在探討為期八週、每週三次的身體活動課程對於輕中度智障者的職業生理功能的影響,分別探討其對於(1)體適能及(2)工作體能方面的改變。
方法:
研究對象為高雄市某福利基金會庇護工場之輕度及中度智障生產員,完成八週活動介入以及前後測者共計8名(男6名,女2名),平均年齡28.75歲(標準差7.59)。實驗介入之「身體活動課程」乃參閱Jewett, Bain與Ennis(1995)「終身體適能發展課程」的原理來設計,內容包括:動態伸展操為主的暖身操、以有氧活動提昇心肺功能的主運動,和以徒手肌力訓練及伸展運動作為恢復運動,並結合體適能概念及飲食營養與健康生活的認知課程。研究所指之體適能則包括身體質量、心肺適能、肌肉適能和柔軟度;工作體能包括移動與平衡能力、負重能力、手功能、姿勢變換能力等功能性能力。分別使用行政院體育委員會(2001)公佈的「國民體能檢測實施辦法」和張彧等人(2005)所發展之「台大醫院功能性能力評估-身體能力測試」來量測。以無母數分析之魏克森符號等級測驗法(Wilcoxon rank-signed test)與效益量(effect size)來檢定體適能及工作體能的訓練成果,並輔以個案研究法(case study)方式,來探討實驗介入個別性成效。
結果:
在體適能部分,對輕中度智障者之心肺適能可達接近中等效益量的成效;對身體組成和柔軟度方面能力雖可提升,但未達顯著性;對腹肌耐力則未有任何成效。在工作體能成效上,對輕中度智障者之移動與平衡能力、負重能力、手功能、和姿勢變換能力等多數分項測驗都有達到顯著性改善,效益量輕度到高度不等;但在移動與平衡之左右單腳站立及左右閉眼單腳站立、負重能力之胸部至眼高雙手抬舉、手功能之左右手握力、姿勢變換能力之連續彎腰取物再站起等分項能力,未能達到顯著性改善成效。
結論:
身體活動介入對智障工作者在體適能及工作體能上有改善成效。建議學校能針對智障者生理特質規劃相關體能活動,職場也能重視智障工作者生理負荷及職業健康的相關議題。職業重建應將體能活動訓練納入提升工作能力措施之ㄧ。此外,在智障者職業生理功能的促進上,需提供飲食控制及相關心理衛教諮商以達到相輔相成之成效。
Aims:
This study aimed to explore the effects of a physical activity program, undertaken three times a week for eight weeks, on the vocational physiological functions of persons with mild and moderate mental retardation. Focuses were on the changes of physical fitness and physical capacity, respectively.

Method:
The participants of this study were ten manufacturing workers with mild and moderate mental retardation in a social welfare shelter workshop in Kaohsiung City. Eight among the ten workers (six men, two woman, and mean age 28.75, standard deviation 7.59) accomplished the 8-week activity, pre-test and pro-test.
The design of this physical activity program was based on the principles of “Lifelong Body Fitness Developing Program” by Jewett, Bain and Ennis (1995). The contents included warm-up stretching exercises, aerobic main activities for enhancing cardiopulmonary functions, and recovering exercises consisting of manual muscle strength training and stretching, as well as education sessions regarding the importance of physical fitness, healthy living and nutrition.
The measures of physical fitness in this study included body mass, cardiopulmonary fitness, muscle strength and flexibility, based on the “Civilian Body Fitness Measurement” published by the Physical Educational Committee of the Executive Yen (2001). The measures of physical capacity in this study included movement and balance, work strength, hand function, and posture change capacity, based on the “Functional Capability Evaluation of the National Taiwan University Hospital” by Chang-Yu and others (2005).
The Wilcoxon rank-signed test and effect size analysis were utilized to inspect the global training effects on physical fitness and physical capacity. Additional case study analyses were added to investigate the individualized effects of the experimental intervention.

Result:
On physical fitness, the results indicated that the effect size of cardiopulmonary fitness for people with mild and moderate mental retardation was close to moderate. The body mass and flexibility were enhanced, though not reaching significant differences. As to the abdominal muscle strength, it showed no effects. On physical capacity, the results indicated that the 8-week activity program was able to enhance the movement and balance, work strength, hand function, and posture change capacity, with effect size ranged from small to large. However, the followings did not show significant effects: (1) the single foot standing with eyes opened or closed; (2) lifting from chest to eyes level; (3) grasp power; and (4) dynamic posture change: bending to pick up objects.

Conclusion:
This study suggests positive effects of the physical activity program on several dimensions of physical fitness and physical capacity. It is recommended that physical fitness curriculum needs to be designed based on the characteristics of persons with mental retardation while they are in schools, and issues about the physical demands and vocational health ought to be emphasized while they are on the job. Physical activity intervention should be taken into consideration as a method to enhance one’s work capacity in vocational rehabilitation. In addition, diet control and health consulting need to be employed when enhancing the occupational physiological functions of persons with mental retardation.
第一章 緒論
第一節 研究背景與動機--------------------------------- 1
第二節 研究目的--------------------------------------- 4
第三節 研究假設--------------------------------------- 4
第四節 名詞解釋--------------------------------------- 5

第二章 文獻探討
第一節 生理功能與職業適應----------------------------- 8
第二節 身體活動與職場生理功能改善--------------------- 10
第三節 智障者生理健康、身體活動參與及生理功能表現----- 12
第四節 智障者職業適應與生理功能相關研究--------------- 15
第五節 身體活動與智障者職業生理功能相關研究----------- 18
第六節 飲食控制對生理功能改善的輔助成效--------------- 20
第七節 本章結語--------------------------------------- 21

第三章 研究方法
第一節 研究參與者------------------------------------- 23
第二節 研究設計--------------------------------------- 28
第三節 研究工具--------------------------------------- 33
第四節 資料分析--------------------------------------- 38

第四章 結果
第一節 體適能前後測變化情形--------------------------- 39
第二節 工作體能前後測變化情形------------------------- 40
第三節 8位研究參與者之個案報告------------------------ 45

第五章 討論
第一節 八週身體活動介入對智障工作者身體組成之成效----- 114
第二節 八週身體活動介入對肌耐力之成效----------------- 117
第三節 八週身體活動介入對柔軟度之成效----------------- 118
第四節 八週身體活動介入對移動與平衡能力之成效--------- 119
第五節 八週身體活動介入對負重能力之成效--------------- 121
第六節 八週身體活動介入對手部功能之成效--------------- 122
第七節 八週身體活動介入對姿勢變換能力之成效----------- 123

第六章 結論與建議
第一節 結論------------------------------------------- 124
第二節 研究限制--------------------------------------- 124
第三節 對未來研究之建議------------------------------- 125
第四節 對實務應用之建議------------------------------- 125

參考文獻 ----------------------------------------------- 127

附錄一 研究參與者同意書--------------------------------- 143
附錄二 研究參與者須知----------------------------------- 144
附錄三 健康飲食原則------------------------------------- 145
附錄四 每日飲食記錄表----------------------------------- 147
附錄五 八週身體活動教學設計表--------------------------- 148
附錄六 健康安全調查表----------------------------------- 167
附錄七 運動紀錄及自覺量表------------------------------- 168
附錄八 體適能評估紀錄表--------------------------------- 169
附錄九 體能常模(男)(女)------------------------------- 170
附錄十 工作體能評估紀錄表------------------------------- 175
附錄十一 工作體能評分等級說明----------------------------- 177
附錄十二 活動教學成效自覺量表----------------------------- 185
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