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研究生:王秀華
研究生(外文):Hsiu-Hua Wang
論文名稱:團體運動處方介入對鄉村老人功能性體適能與健康生活品質之影響
論文名稱(外文):effect of an Integrated group exercise program on functional fitness, and health-related quality of life in rural community elderly
指導教授:蔡櫻蘭蔡櫻蘭引用關係方進隆方進隆引用關係
指導教授(外文):Ying-Lan TsaiChin-Lung Fang
學位類別:博士
校院名稱:國立體育大學
系所名稱:體育研究所
學門:教育學門
學類:專業科目教育學類
論文種類:學術論文
論文出版年:2013
畢業學年度:101
語文別:中文
論文頁數:206
中文關鍵詞:老化SF-36運動階段身體活動預防醫學
外文關鍵詞:AgingSF-36Stage of ChangePhysical ActivityPreventive Medicine
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目的:本研究欲建立適合鄉村老人「全面性團體功能性體適能運動處方」策略模式,並探討12週的「全面團體功能性體適能運動處方」課程介入對鄉村老人在功能性體適能及健康生活品質的改變成效。方法:本研究第一階段以嘉義縣地區266位65歲以上鄉村健康老人爲研究對象(77.2±5.6歲、154.6±7.1公分、58.6±9.4公斤),以身體活動程度及運動階段調查表,瞭解鄉村老人之運動行為,進而以SF-36問卷調查訪談瞭解健康生活品質狀況,並同時進行功能性體適能之檢測,繼而以描述性統計、卡方考驗、單因子變異數分析、與複迴歸分析各變項之資料,以及探討鄉村老人基本生理參數與六項功能性體適能是否可作為健康生活品質之預測用變項。第二階段以立意取樣方式,並從中選取符合身體活動量未達建議量之久坐者為團體運動處方介入對象,分爲實驗組53位(77.3±5.3歲、154.2±7.3公分、59.1±7.9公斤)與對照組74位(77.8±5.8歲、154.5±7.1公分、57.7±11.3公斤)兩組的驗證性實驗設計。實驗組之受試者需從事為期12週,每次約90分鐘,每週2次全面性團體運動處方介入和1次的居家自主運動。所有受試者於12週後再次實施健康生活品質問卷訪談施測,以及功能性體適能評估之後測,所得資料先以獨立樣本t考驗檢定兩組受試者之基本生理參數是否具有同質性,進而以單因子共變數分析進行檢定,考驗本研究團體運動處方課程介入前後各依變項之改變,本研究統計顯著差異水準訂為α=.05。結果:一、健康生活品質不會因運動階段與身體活動程度的不同而有顯著差異(p>.05),但在功能性體適能之上半身柔軟度(p<.05) 與敏捷/動態平衡(p<.05)會因運動階段的不同有顯著差異,而有氧耐力(p<.05)與敏捷/動態平衡(p<.05)會因身體活動程度的不同有顯著差異。二、六項功能性體適能之有氧耐力(p<.05)與敏捷/動態平衡(p<.05) 為健康生活品質之顯著預測用變項。三、實驗組在介入12週之團體運動課程訓練後,其身體質量指數、下肢肌力、有氧耐力達顯著差異水準(p<.05);而在健康生活品質之各向度,除了身體疼痛、一般健康知覺與心理健康外(p>.05),其餘在身體功能、身體功能角色限制、活力狀態、情緒功能角色限制、社交功能、生理總分、心理總分和整體健康總分面向皆達顯著差異水準(p<.05)。結論:團體運動處方訓練藉由全面性團體功能性體適能運動處方及有效的推廣策略介入能有效改善久坐式鄉村老人功能性體適能中的下半身肌力與有氧耐力,並且增進其健康生活品質。期許未來將安全有效的全面性運動處方策略推廣至更多的鄉村社區,讓更多久坐的老年族群生活型態變得更活躍,進而能獲得身心健康的提升。本研究之成果可作爲未來老年人預防醫學的參考。
Introduction:The health benefits of regular physical activity for elderly are well documented. Little is known about whether an integrated physical activity intervention would have health-related physical fitness and health-related quality of life benefits in rural community elderly. Purposes:1.To develop a strategic implementation model for promoting functional physical activity towards rural elderly; 2.To examine changes in functional fitness, and health-related quality of life as a result of a 12-week integrated functional fitness program in rural community elderly. Methods:266 elderly community residents (aged 65 or above)(77.2±5.6yrs, 154.6±7.1cm, 58.6±9.4kg) were recruited during the first stage of this experiment, functional fitness measures and self-response questionnaires including SF-36 and a self-report containing sections on demographic characteristics, and physical activity categories were assessed. Data analysis utilized were Descriptive analysis, Chi-square, One-way analysis of variance (ANOVA), and Multiple Regression to examine the predictability of physiological variables, and six functional fitness variables towards Health-related Quality of life in rural elderly. In the second stage, 127 sedentary elderly, including 53 experimental subjects (77.3±5.3yrs, 154.2±7.3cm, 59.1±7.9kg), and 74 control subjects (77.8±5.8yrs, 154.5±7.1cm, 57.7±11.3kg), were screened through purposive sampling method, and recruited for the 12-week of integrated functional fitness exercise intervention (90 min, 3 times per week, including 1 class home-based, and 2 group classes). Data were collected before and after the intervention. Independent Group T-test was used for the homogeneity test for the experimental and control group. One-way ANCOVA was utilized for the data analysis to explore the effects on health-related quality-of-life, and functional fitness. The significant level was α=.05. Results:1.No significant(p>.05) differences were found in the Health-related quality of life among elderly from different Stage of change, and different levels of physical activity; however, significant differences(p<.05) were found in Upper Body Flexibility, and Dynamic Balance among elderly of different Stage of Change; Moreover, Aerobic Endurance, Dynamic Balance were found significant different(p<.05) among elderly of different exercise levels;2.Aerobic Endurance, Dynamic Balance were significant predictors(p<.05) of Health-related Quality of life;3.Older adults experiencing 12-week integrated functional exercise intervention was significantly(p<.05) higher in BMI, Lower Body Muscular Strength, and Aerobic Endurance of functional fitness, and higher in most of the variables of health-related quality of life (including physical function role limitation, vitality, emotional function role limitation, social function, physical health, mental health, and total health), except Bodily Pain, General Health, and Mental Health. Conclusions:Through effective impementatioanl strategies, integrated group exercise program training could enhance lower body strength, and aerobic capacities, in turn, increase the health-related quality of life of rural community elderly. These results suggest that integrated implementation strategies are needed to promote increased in physical activity participation for more elderly communities, thus enhanced their physical and emotional health for a biggerpopulation of rural older adults. This study provides evidence for the future study of preventive medicine in rural community elderly.
第壹章 緒論
第一節 研究背景與動機 1
第二節 研究目的 8
第三節 研究假設 9
第四節 名詞操作性定義 9
第五節 研究範圍與限制 12
第六節 研究的重要性 14
第貳章 文獻探討
第一節 人口老化之健康問題及身體活動因應對策 16
第二節 運動處方介入建議與原則 23
第三節 功能性體適能與相關研究 31
第四節 運動階段之運用與相關研究 46
第五節 健康生活品質與相關研究 51
第參章 研究方法與步驟
第一節 研究對象 63
第二節 研究設計 64
第三節 實驗架構與流程 65
第四節 研究工具 67
第五節 全面性團體運動處方介入課程設計 75
第六節 資料處理與分析 90
第肆章 研究結果 92
第一節 第一階段研究對象之基本生理參數與背景資料分析 93

第二節 第一階段研究對象個人背景資料與運動階段之差異比較 96
第三節 第一階段研究對象個人背景資料與身體活動程度之差異比較 99
第四節 第一階段研究對象運動階段與功能性體適能之差異比較 101
第五節 第一階段研究對象運動階段與健康生活品質之差異比較 106
第六節 第一階段研究對象身體活動程度與功能性體適能之差異比較 113
第七節 第一階段研究對象身體活動程度與健康生活品質之差異比較 117
第八節 基本生理參數與功能性體適能預測健康生活品質變項之探討 124
第九節 第二階段運動處方介入研究對象之基本生理參數與背景資料分析 125
第十節 團體運動處方介入對功能性體適能之影響 129
第十一節 團體運動處方介入對健康生活品質之影響 136
第伍章 討論 144
第一節 不同運動行為對功能性體適能與健康生活品質之探討 145
第二節 基本生理參數與功能性體適能預測健康生活品質變項之探討 151
第三節 團體運動處方介入訓練對功能性體適能之探討 154

第四節 團體運動處方介入訓練對健康生活品質之探討 162
第陸章 結論與建議
第一節 結論 166
第二節 建議 168
參考文獻 170
附錄一 受試者參與須知與同意書 193
附錄二 「運動行為與健康生活品質之研究」問卷 197
附錄三 運動安全問卷與功能性體適能檢測表 203
附錄四 老年女性功能性體能檢測項目之常模 205
附錄五 老年男性功能性體適能測驗項目之常模 206

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