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研究生:余亮
研究生(外文):Liang Yu
論文名稱:姿勢矯正運動對無規律運動老人的姿勢
論文名稱(外文):Postural Correction Exercise on Posture and Physical Fitness in a Group of Community Sedentary Elderly –
指導教授:李雪楨李雪楨引用關係張谷州張谷州引用關係
指導教授(外文):Hsuei-Chen LeeKu-Chou Chang
學位類別:碩士
校院名稱:國立陽明大學
系所名稱:物理治療暨輔助科技學系
學門:醫藥衛生學門
學類:復健醫學學類
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:78
中文關鍵詞:姿勢體適能無規律運動老年人運動介入
外文關鍵詞:posturefitnesssedentaryelderlyexercise
相關次數:
  • 被引用被引用:5
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  • 下載下載:210
  • 收藏至我的研究室書目清單書目收藏:3
研究背景與目的:老化所伴隨之身體結構的改變與身體功能的衰退會導致身體維持姿勢能力降低。老化相關的姿勢改變通常包括頭前傾、肩膀前屈、胸椎駝背、腰椎前凸及髖膝關節屈曲;這些姿勢的變化會進而導致動作系統的失衡及日常生活功能表現困難。無規律運動的老人尤其會因為精瘦組織的減少、神經肌肉系統的衰退及生物力學相關障礙,更嚴重影響其體態與功能。本研究以一群無規律運動習慣的社區老年人為對象,探討姿勢矯正運動處方對老人姿勢及體適能的影響。
研究方法與步驟:本研究採前瞻式收案,自高雄市前鎮區某醫療院所門診患者篩檢出平常無規律運動的老年人六十位;以性別配對隨機分組模式,分為實驗組與對照組兩組。實驗組進行六週、每週三次之個別化姿勢矯正運動,其內容包括10分鐘的暖身關節運動,30分鐘的姿勢矯正運動及10分鐘的放鬆及拉筋運動;而對照組則只進行單張衛教,其衛教單張內容包括維持良好姿勢的重要性及簡易的姿勢矯正運動。本研究採用碼表、量尺、測力器、曲尺及測距輪分別用來測量老年人之放鬆及挺直之頭前傾及駝背程度、柔軟度、平衡能力、背肌力及心肺適能等八項變項;分別於運動介入前、六週運動介入後,以及運動介入結束半年後三個時間點進行測量。採用重複量數二因子變異數分析實驗組與對照組兩組之間前、後測及六個月後追蹤測量之變化趨勢是否達統計上顯著差異,來探討運動介入對於改善姿勢及體適能等各項指標的效果;同時並探討放鬆及挺直之頭前傾及駝背程度之姿勢變項與柔軟度、平衡能力、背肌力及心肺適能等體適能變項之間的相關性。
研究結果:前測資料之各變項相關性方面,放鬆時頭前傾程度與柔軟度(r=-.44, P <.01)、平衡能力(r=-.39, P<.01)、背肌力指數(r=-.30, P <.05)、六分鐘行走距離(r = -.42, P <.01)呈顯著負相關。挺直時頭前傾程度與柔軟度(r=-.45, P<.01)、平衡能力(r=-.38, P<.01)、背肌力指數(r=-.36, P<.01)、六分鐘行走距離(r=-.54, P<.01)呈顯著負相關。經過六週運動介入,實驗組(N=25)的背肌力平均值由134.2牛頓微幅下降為126.4牛頓(P=0.19);而對照組(N=17)的背肌力平均值則由148.3牛頓顯著下降為116.4牛頓(P<0.05)。經重複量數二因子變異數分析後,發現其時間與組別因子之交互作用達到顯著水準(P=0.02),顯示六週之運動介入確實有助於延緩實驗組之肌力退化程度。進一步分析性別之影響效應,發現年老男性族群之六分鐘行走距離表現,在實驗組(N=11)平均由357.0公尺明顯增加為391.6公尺,而對照組(N=8)平均值則由447.4公尺下降為418.9公尺;經重複量數二因子變異數分析發現其時間與組別因子之交互作用亦達顯著水準(P=0.02),顯示六週之運動介入確實有助於增加年老男性組之六分鐘行走距離。透過相關性分析,六分鐘行走距離除了與頭前傾程度及挺直時駝背指數(r=-.27, P<.05)呈顯著負相關以外,亦與身高(r=.35, P<.01)、柔軟度(r=.31, P<.05)、平衡能力(r=.38, P<.01)、背肌力指數(r=.41, P<.01)呈顯著正相關;顯示六分鐘行走距離是個能反映老年人體態與體適能的綜合指標。
結論與建議:本研究驗證老年人之屈曲姿勢程度愈明顯者,其各項體適能表現亦愈差。而六週的姿勢矯正運動介入能有效改善老年人的駝背指數、背肌力及六分鐘行走距離。本研究結果能提供老年人姿勢矯正運動介入效果的基礎數據,能作為未來老年人姿勢相關介入研究的研究設計基礎,並有助於未來物理治療師在規劃執行老人的主動運動治療策略的參考。建議未來研究可朝加大樣本數以增加統計檢力,及延長運動介入期間以彰顯運動介入之短期與長期持續效果。社區基層診所可以配合縣市政府衛生主管機關,於推動社區健康促進方案時,加強宣導正確的運動習慣、姿勢矯正及體適能促進等相關衛教,以嘉惠更多老年人之身心健康、行動功能以及生活品質。
Study Background and Purpose: Aging-related deteriorations of body structure and physical function could lead to decreased ability for maintenance of good posture. Flexed posture commonly seen in older people is characterized by a forward head, rounded shoulders, increased thoracic kyphosis, reduced lumbar lordosis, flexed hips and knees, and decline in height. Although the precise etiology of flexed posture is unknown, there are many underlying musculoskeletal, neuromuscular, and sensory impairments associated with flexed posture. General muscular weakness, neuromuscular deficiencies and biomechanical insufficiency make those sedentary older adults more prone to the flexed posture and its associated physical impairments. This study aimed to investigate the effects of individualized postural correction exercise on posture and physical fitness in a group of community sedentary elderly.
Methods: This prospective study recruited 60 community-dwelling sedentary elderly from an outpatient clinic in Kaohsiung city, and randomly allocated into experimental and control group stratified by sex. The experimental group received an individualized postural correction exercise program of 3 times per week for 6 weeks. Every exercise session lasted for 50 minutes, including 10-minute warming up and range of motion exercise, 30-minute postural correction exercise, and ended up with 10- minute cooling down and stretching exercises. The control group received a health education sheet regarding knowledge for posture maintenance and general postural correction instruction. We used timekeeper, ruler, handheld dynamometer and flexicurve to measure the elder’s body height, degree of forward head, kyphosis, flexibility, cardiovascular fitness, muscular strength, and balance performance. Two-way ANOVA with repeated measures were used to examine the effectiveness of the exercise program in improving the posture and physical fitness in the sedentary community elderly. Pearson product-moment correlation coefficient was used to investigate the relationships between postural indexes and fitness indexes.
Results: Fair to moderate negative relationships (r=-.30~-.54, P<.05) were shown between “usual / erect forward head posture” and flexibility, six minutes walking distance , muscular strength, as well as balance performance. After 6-week exercise intervention, the average muscular strength of the experimental group (N=25) showed only marginal decrease from 134.2 N to 126.4 N (P=0.19); while the control group (N=17) declined significantly from 148.3 N to 116.4 N (P<0.05). The time-by-group interaction effect analyzed by the two-way ANOVA with repeated measures was significant (P=0.02), and demonstrated the exercise intervention efficaciously delayed the deterioration of muscular strength in these sedentary elderly. We performed further analyses divided by sex, and found the average 6-min walk distance of the experimental male group (N=11) increased significantly from 357.0 m to 391.6 m; while the control male group (N=8) declined significantly from 447.4 m to 418.9 m. The time-by-group interaction effect was also significant (P=0.02), and demonstrated that the exercise intervention effectively improved the 6-min walk distance which appeared to be an overall index reflecting body posture and physical fitness according to our correlational findings.
Conclusions: An individually-prescribed postural correction exercise has been demonstrated to potentially improve the modifiable impairments of muscular strength in the back region, postural alignments and cardio-respiratory fitness associated with flexed posture. Although further studies which recruit larger samples to increase the statistical power and longer intervention period to better demonstrate the exercise effectiveness are warranted, this study provides a promising exercise intervention that my improve posture and physical performance in sedentary elderly. Health policies to encourage the sedentary elderly to exercise regularly and keep up good posture alignments were recommended to delay the deterioration of physical performance and promote the quality of life in the elderly.
目 錄
目錄 III
表目錄 V
圖目錄 VI
中文摘要 VIII
英文摘要 XI
一、緒論 1
二、文獻探討 5
第一節 老年人生理老化及體適能之文獻探討 5
第二節 老年人生理老化及姿勢變化之文獻探討 9
第三節 老年人姿勢檢測之文獻探討 10
第四節 老年人體適能檢測之文獻探討 13
第五節 對無規律運動或駝背老人之運動介入文獻探討 17
第六節 研究問題與假說 20
三、研究方法 21
第一節 個案來源 21
第二節 測量變項 21
一、姿勢測量:放鬆姿勢及挺直姿勢的頭前傾程度、駝背指數 22
二、體適能檢測:背肌力、柔軟度、平衡能力、心肺功能檢測 22
第三節 個別化姿勢矯正運動處方介入 24
第四節 研究工具的信效度 25
第五節 研究步驟 26
第六節 資料分析 27
四、結果 28
第一節 研究對象的基本資料分析 30
第二節 前測資料姿勢及體適能各個連續性變項之相關性 31
第三節 實驗組受試者之運動介入執行度 32
第四節 運動介入前後對於姿勢及體適能等各變項之結果 32
第五節 性別分開處理之統計分析結果及六個月追蹤後測結果 38
五、討論 41
第一節 研究對象的基本屬性及各項研究變項之討論 41
第二節 前測資料各個連續性變項之相關性之探討 43
第三節 實驗組研究對象之運動介入執行度之討論 43
第四節 運動介入前後對於姿勢及體適能等變項之影響之討論 44
六、結論及建議 47
第一節 結論 47
第二節 研究限制與建議 49
一、研究設計與取樣 49
二、研究工具 49
三、研究結果 49
七、參考文獻 51


表 目 錄
表1: 受試者人口學基本資料 56
表2: 前測資料各變項之間皮爾森積差相關矩陣(N=60) 57
表3: 實驗組和對照組組內之各項變項於運動介入前後之比較 遺漏值用前測的資料取代後測 58
表4: 實驗組與對照組組內之各項變項於運動介入前後之比較 捨棄遺漏值 59
表5: 實驗組和對照組組間之各項變項於運動介入前後之比較 遺漏值用前測的資料取代後測 60
表6: 實驗組與對照組組間之各項變項於運動介入前後之比較 捨棄遺漏值 61
表7: 實驗組與對照組組間之各項變項於運動介入前後之比較 捨棄遺漏值後性別之差異 62
表8: 實驗組與對照組組間之各項變項於運動介入前後及六個月後追蹤測量之比較 63


圖 目 錄
圖1: 測量頭前傾程度 64
圖2: 曲尺與方格紙 64
圖3: 利用曲尺測量脊椎的曲度 65
圖4: 將脊椎的曲度描繪在方格紙上 65
圖5: 駝背指數 = 寬度(B) / 長度(E) X 100 66
圖6: 測力計(microFET, Hoggan Health Industries, Draper, UT) 66
圖7: 利用測力計測量背部伸直肌群 67
圖8: 立姿體前彎測驗。如果無法碰觸到地板,則紀錄下手指到地板之距離 67
圖9: 立姿體前彎測驗。如果可以碰觸到地板,則記錄下超出木箱的距離 68
圖10: 60公分長具滑軌的直尺 68
圖11: 平衡能力檢測 69
圖12: 測距輪及可歸零的距離計數器 69
圖13: 測距輪 70
圖14: 六分鐘行走測試 70
圖15: 運動處方軟體 71
圖16: 手腳運動腳踏車熱身運動 71
圖17: 利用牆壁進行姿勢矯正及肌力訓練 72
圖18: 使用懸吊運動訓練設施進行姿勢矯正及肌力訓練 72
圖19: 進行呼吸擴胸運動配合上肢的向上伸展 73
圖20: 站三角板:後小腿肌肉群的拉筋運動 73
圖21: 實驗組與對照組於前測、後測、半年追蹤後測之變化趨勢圖 放鬆時駝背指數 74
圖22: 實驗組與對照組於前測、後測、半年追蹤後測之變化趨勢圖 挺直時駝背指數 74
圖23: 實驗組與對照組於前測、後測、半年追蹤後測之變化趨勢圖 放鬆時頭前傾 75
圖24: 實驗組與對照組於前測、後測、半年追蹤後測之變化趨勢圖 挺直時頭前傾 75
圖25: 實驗組與對照組於前測、後測、半年追蹤後測之變化趨勢圖 柔軟度 76
圖26: 實驗組與對照組於前測、後測、半年追蹤後測之變化趨勢圖 平衡能力 76
圖27: 實驗組與對照組於前測、後測、半年追蹤後測之變化趨勢圖 背肌力 77
圖28: 實驗組與對照組於前測、後測、半年追蹤後測之變化趨勢圖 肌力指數 77
圖29: 實驗組與對照組於前測、後測、半年追蹤後測之變化趨勢圖 六分鐘行走距離 78
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