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研究生:余羅平
研究生(外文):Lo-Ping Yu
論文名稱:能力回復復健對高齡失能者的肌力和日常生活功能提昇之成效
論文名稱(外文):Outcome effects of Produce Outcome for Weakness Elderly Rehabilitation (Power) training on physical and ADL performance among older adults
指導教授:蔚順華蔚順華引用關係
指導教授(外文):Shun-Hwa Wei
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:英文
論文頁數:80
中文關鍵詞:能力回復老化加速規肌肉爆發力失能活化
外文關鍵詞:Produce Outcome Worthwhile for the Elderly Rehabilitationfrailtyaccelerometermuscle powerPOWERPower Rehabilitationre-activation
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研究背景與動機:老化會造成的生理機能改變,使功能性活動受限,最後影響到日常生活、休閒活動。老人的脆弱與行動不便(loss of mobility),最主要的原因為肌肉質量、力量與耐力降低。事實上日常活動經常需要有強度而短促的肌肉作用力量,因此肌肉爆發力(muscle power)在肌肉功能表現上扮演一個很重要的角色。「能力回復復健」(Power Rehabilitation)是一種針對老化的復健,由日本專業復健醫療群所開發的輔助復健運動方法,是阻力運動的一種,有6台機器針對6大肌群進行回復訓練,其目標在於回復因老化或器質性傷害造成的活動力低下,讓需要復健或虛弱的高齡者甚至其他疾病的患者經由訓練後,提升其生活品質、日常活動功能與自立性。現階段,國內、外對「能力回復復健」在高齡失能者的肌肉爆發力和日常生活功能提昇之成效和研究都很缺乏。
研究目的:探討能力回復訓練對老人肌肉爆發力之提昇效果,和探討能力回復訓練對老人日常生活功能之提昇效果。
受試者:46位 65歲以上高齡失能者。
研究方法: 實驗組接受能力回復復健,每週兩次,為期三個月。控制組則未做任何訓練。兩組每4週評量一次,用加速規放在6台能力回復訓練機器的砝碼上,計算出加速度和肌肉爆發力(power)。並記錄日常生活功能測試:雙手平行伸展(functional reach test)、坐姿體前彎、起走測試(timed-up and go test)和10公尺步。
結果:(1)經3個月的能力回復復健,訓練組的老人在加速度和肌肉爆發力,在6 台機器訓練的6大肌群都有136~524%的顯著的進步(p<0.01)。(2) 訓練組的老人在加速度和肌肉爆發力的進步,跟控制組比有顯著的差異(p<0.05)。(3)在日常生活功能上,訓練組的老人在,雙手平行伸展、坐姿體前彎、起走測試和10公尺步。都有9.6~28.4%的顯著的進步(p<0.05)。(4)其中起走測試和10公尺步跟控制組比有顯著的差異(p<0.01)。
結論: 「能力回復復健」的概念和方法可有效的增加失能老年人的肌肉爆發力,以及提升日常生活功能(例如行走、站立起走等),可對臨床上和社區中的推廣。加速規利用能力回復訓練機,能有效計算出加速度和肌肉爆發力(power)。可進一步發展為臨床上的評量工具。
Background: Aging leads to significant losses in moving and physical strength, thus causing physical weakness. Physical weakness also leads to frailty of falls, dependently perform activities of daily living (ADL), threatens of public care insurance. Power is a potentially major etiologic factor in age-related functional decline. Power Rehabilitation(PR), a new resistance training regime, can improve in power and independence level of the elderly people. The first word of PR was in brief of Produce Outcome Worthwhile for the Elderly Rehabilitation (POWER). Purpose: (1)To investigate the effectiveness of PR training on muscle contraction velocity and power of older adults, (2)to investigate the effectiveness of PR training into improvement in ADL performance (FR & TUG).
Design: single-blind, randomized controlled trial
Subjects: 46 subjects aged above 65 years older adults, with ADL limitations.
Methods: Participants were randomized into 2 groups. Experimental (n=23) group processed PR twice a week for 3 months whereas control group (n=23) did not. Both groups were measured in every 4 weeks. Accelerometer was used to stick on the weights of PR machines, to calculate the velocity, acceleration and power of subjects processed. The outcomes of physical performance were recorded by functional reach, sit-and-reach, timed up and go and 10-Meter Walk test.
Result: (1)Peak muscle power significantly improved in the experimental group for all 6 machines (p<0.01).Within-group analysis revealed significant improvement, 136~524%, for all 6 machines of PR in the E-group. (2)The analysis revealed significant differences between the two groups for all 6 machines of PR. (3) Within-group analysis revealed significant improvement, 9.6~28.4%, for functional reach, sit-and-reach and TUG test in the E-group(p<0.05). (4)The analysis revealed significant differences between the two groups for TUG and timed 10m walk(p<0.01).
Conclusion: After Power Rehabilitation training, the elderly would increase in power of physical, by mean of velocity, and ADL performances, e.g. FR and TUG. PR training might be a useful tool for rehabilitation and prevention of age-related declines in function. Although minor acquisition errors were present, accelerometers can provide a reliable and comparable means to assess muscle power.
Contents
SIGNATURE PAGE I
THESIS APPROVAL FORM II
致 謝 III
中 文 摘 要 IV
ABSTRACT V
CONTENTS VI
LIST OF FIGURES X
LIST OF TABLES XI
CHAPTER 1 INTRODUCTION 1
1.1 BACKGROUND 1
1.2 STUDY NEEDS 3
1.3 STUDY QUESTION 3
1.4 STUDY PURPOSES 3
1.5 HYPOTHESIS 4
CHAPTER 2 LITERATURE REVIEW 5
2.1 AGING 5
2.1.1 Aging society 5
2.1.2 Sarcopenia 5
2.2 IMPORTANCE OF POWER IN AGING 6
2.2.1 Definition of power 6
2.2.2 Power decline with aging 7
2.3 VELOCITY DECLINE WITH AGING 8
2.4 RESISTANCE TRAINING AND POWER REHABILITATION 9
2.4.1 Benefits of resistance training 9
2.4.2 Power Rehabilitation 10
2.5 MEASUREMENT OF POWER 13
2.5.1 Physical definition of power 13
2.5.2 Methods of measurement 13
2.5.2 Comparison of traditional measurements 19
2.5.3 Accelerometer 19
2.6 DATA ANALYSIS 26
2.6.1 Data acquisition: Inertial 26
2.6.2 Techniques for Improving Resolution in Tilt and Inertial 28
2.6.3 Resolution limited by accelerometer "noise" 28
2.6.4 A/D Converter Resolution 29
2.6.5 Digital trickery 29
2.7 CONCLUSIONS OF REVIEW 30
CHAPTER 3 METHODS 31
3.1 STUDY FRAMEWORK 31
3.2 SUBJECTS 31
3.3 EQUIPMENT AND DEVICES 32
3.3.1 6-machines of Power Rehabilitation 32
3.3.2 Accelerometer 33
3.3.2 Data acquisition devices 35
3.4 PROCEDUCE 38
3.5 TRAINING INTERVENTION 40
3.6 MEASUREMENT 42
3.6.1 ADL performance assessments 42
3.6.2 Acceleration and power of subjects 43
3.7 DATA ANALYSIS 43
3.7.1 Acceleration data 43
3.7.2 acceleration data collected in Labview 45
3.7.3 Data processing in Labview 46
3.8 STATISTICAL ANALYSIS 50
CHAPTER 4 RESULTS 51
4.1 DESCRIPTIVE CHARACTERISTICS AND INTERVENTION COMPLIANCE 51
4.2 MUSCLE POWER 53
4.3 FUNCTIONAL PERFORMANCE 57
CHAPTER 5 DISCUSSION 59
5.1 MUSCLE POWER 59
5.2 SEQUENCE OF POWER GAINS 60
5.3 MOVEMENT VELOCITY 61
5.4 FUNCTIONAL PERFORMANCE 62
5.5 MINIMAL LOADS 62
5.6 FREQUENCY 63
5.7 SENSITIVE OF POWER AND FUNCTIONAL PERFORMANCE MEASUREMENTS 64
5.8 SAFETY OF POWER REHABILITATION 65
5.9 LIMITATIONS AND BIAS 65
CHAPTER 6 CONCLUSION 67
REFERENCES 68
APPENDIX 74
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