臺灣博碩士論文加值系統

本研究以「活躍老化」的理論觀點，(1)了解國際間的多元體適能，對於高齡者易跌倒、行動障礙、認知障礙、憂鬱四大弱勢族群，改善障礙的正向影響原因；(2)探討國際間高齡多元體適能對生活品質的相關因素；(3)找出台灣多元體適能與國際相比不足之處並建議。
本研究方法採系統性文獻回顧的方式，中英文關鍵字搜尋並另設定篩選條件為: (1) 60 歲以上長者。(2)體適能活動的介入須為多元體適能，但不限活動型態、介入頻率、強度及時間。(3)以實驗型及類實驗型研究為主。(4)文獻標準以指標型期刊為主(如：SSCI)，次級期刊為輔(如：SCIE)，最後納入英文文獻共 26 篇，研究對象涵蓋12個國家，再分為高齡易跌倒、行動障礙、認知障礙、憂鬱，四大弱勢族群國際間的多元體適能各國型態及高齡多元體適能構面對生活品質的影響因素，共五大主題，並依序編碼來做探討。
研究結果顯示：1.國際間高齡四大弱勢族群多元體適能正向影響因素有(1)易跌倒族群：遠端科技監控訓練，對於長者皆會改善跌倒率，現今不再像之前只有單一訓練模式搭配一個指導老師，設計主要針對下肢平衡和力量的訓練為主。(2)行動障礙族群：步態速度是調整焦點，若居家多元體適能訓練計畫，管理的部分傾向搭配跨專業監督，也可降低行動障礙率。(3)認知障礙族群：注重社會化互動課程，以利參與度及記憶量改善，若採家庭鍛鍊計劃，需搭配電話遠端監控，和家屬一起配合，才能保持參與者長久的依從性。(4)憂鬱族群：有預定電話健身教練(TLC-LIFT 系統)監督，或無法久坐的長者可搭配床上低強度且持續的活動，加上新型遊戲監督系統，對於體能及憂鬱也有顯著改善，甚至到醫療人員監督的效果。2.國際間高齡多元體適能對生活品質影響:多元體適能介入的頻率、介入時間、研究對象依從性、研究設計是否都有介入體適能部分、憂鬱、焦慮、疼痛、虛弱、體能活動，即為影響生活品質的因素。3.〔研究貢獻〕研究對象為台灣文獻與國際間比較後需改善之處：研究對象為台灣文獻的樣本數偏少、較少注重跨學科團隊管理及後續電話監督、介入頻率或介入期低，皆可能是造成實驗依從性低的原因，同時為影響長者持續參與多元體適能的動機因素。

Purpose: On the basis of the “active ageing” theory, this study aims to (1) understand the positive influence of multiple physical fitness on underprivileged groups of elders with high risk of falls, mobility impairment, cognition problems, and depression around the globe; (2) explore the factors of multiple physical fitness for seniors in quality of life internationally; (3) find out the deficiencies of multiple physical fitness in Taiwan compared to the international standards and give suggestions.

Methods: A systematic literature review and keyword research was conducted in both Chinese and English. Advanced criteria were filtered by: (1) the elderly over 60 years old, (2) the intervention of physical activity must be multiple physical fitness, but not limited to specific types, frequency, intensity, and the length of time, (3) mainly experimental and quasi-experimental studies, (4) the reference was included in prominent index such as SSCI or SCIE. Eventually 26 articles were obtained. Research subjects, the elderly, were selected from 12 nations and were divided into four groups: those with high risk of falls, mobility impairment, cognition problems, and depression. International patterns of multiple physical fitness, and the influential factors of seniors’ multiple physical fitness in quality of life, were coded and categorized into 5 dimensions to discuss.

Results: 1. The positive impact of multiple physical fitness on the four elder-underprivileged groups:
(1)the prone-to-fall group: training with remotely monitoring technology does improve the seniors rate of falls. The modern training style were no longer a single mode with a single instructor, and the exercise would be focused on the balance and strength of lower limbs.
(2)the mobility-impaired group: gait speed would be the target of adjustment. The appliance of cross-professional supervision to the at-home training program could alleviate the problems.
(3)the cognitive-impaired group: courses that emphasize on socialization could improve cognition and memory abilities. A family training program would require remote supervision by phone, and a long-term compliance between the elderly and family members.
(4)the depressive group: distance training and supervision (with the TLC-LIFT system) were applied, even the ones who could not sit long could train with low-intensity exercise in the bed steadily; the latest gaming monitors could also keep up with the quality of professional health care.
2. The impact of seniors’ multiple physical fitness around the world on quality of life: whether or not the frequency, the length of time, the research subjects, and the design of the intervention are effective, could affect the extent of living quality.
3. Research contribution: the cause of low level of treatment compliance could be due to limited number of previous studies on Taiwanese cases, lesser care on cross-professional management and remote supervision, and low frequency of intervention, which could also affect the seniors’ motivation to get involve with multiple physical fitness frequently.

誌謝------------------------------------------------------------------ i
中文摘要 -------------------------------------------------------------- ii
英文摘要 --------------------------------------------------------------- iv
目錄 --------------------------------------------------------------- vii
表目錄 --------------------------------------------------------------- viii
圖目錄 --------------------------------------------------------------- ix
第一章 緒論---------------------------------------------------------- 1
第一節 研究背景與動機-------------------------------------------------- 1
第二節 研究目的-------------------------------------------------------- 4
第二章 文獻探討-------------------------------------------------------- 6
第一節 老人 (Old people)定義------------------------------------------- 6
第二節 活躍老化理論 (An Active Aging Framework) ----------------------- 7
第三節 體適能(Physical fitness)定義------------------------------------ 8
第四節 高齡體適能現況-------------------------------------------------- 11
第五節 多元體適能(Multi-component fitness)訓練型態---------------------- 15
第六節 生活品質 (Quality of life)-------------------------------------- 16
第七節 高齡體適能與生活品質的關係--------------------------------------- 19
第三章 研究方法-------------------------------------------------------- 21
第一節 系統性文獻回顧(Systematic review)概念及特性-------------------- 22
第二節 設定研究問題關鍵字----------------------------------------------- 23
第三節 文獻的納入與排除----------------------------------------------- 24
第四節 研究流程及文獻篩選程序----------------------------------------- 24
第五節 納入的研究文獻-------------------------------------------------- 28
第六節 收錄的文獻數量、期刊等級及分析----------------------------------- 29
第四章 研究結果與討論-------------------------------------------------- 32
第一節 國際間高齡四大弱勢族群多元體適能型態及研究分析--------------- 32
第二節 國際間高齡多元體適能-與生活品質研究分析------------------------ 84
第三節 國際個案依從性高文獻與研究對象為台灣的文獻比較--------------- 102
第五章 結論與建議------------------------------------------------------ 127
參考文獻 --------------------------------------------------------------- 134

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