規律運動對於不同型態慢性病中老年人步功能的改善差異之初

A Preliminary Study on Regular Exercise for Different Types of Chronic Disease Affecting Elderly Gait Functional Differences

在全球人口快速老化的趨勢下，如何有效的增進中高齡者日常功能性活動並降低醫療支出成本已成為全人照護之重要議題。大多數的中老年人可能都伴隨著心血管疾病、糖尿病或是骨質酥鬆症等慢性疾病，同時跌倒亦是其經常面臨的健康問題。隨著年齡的增長，感覺系統功能中的肌肉骨骼系統也會逐漸退化，使得肌力降低、肌纖維數目減少進而導致平衡能力的降低而造成跌倒。根據研究顯示，年齡越大者其跌倒發生率與其所帶來後遺症也隨之增加，在可以改善肌力或步態功能的諸多方式中，規律運動是最簡便的方式；運動除了可改善肌力外，也可降低跌倒的發生率。本研究之目的在探討不同型態的中老年慢性病患，利用環狀阻力訓練器材與搭配有氧登階運動，進行每週3次，共12週的運動介入，同時招募年齡相近的對照組提供運動衛教。分別於運動前、後進行步態功能測量。所有資料以重覆量數變異數分析法進行平均數之比較與配對T檢定。研究發現：1. 規律的阻力運動搭配有氧運動應有助於中、老年慢性病患改善步態功能以降低跌倒的風險。2. 在運動組中，罹患心血管疾病（p=0.020）以及骨質酥鬆症（p=0.008）的病患改善情況比起罹患糖尿病的中、老年人效果較好，且介入運動前、後的改善差異均達統計上的顯著差異。

As the global population rapidly ages, determining how to maintain and increase the activities of daily living and decrease the cost of medical care for the elderly has become a critical issue of holistic healthcare. Many elderly suffer from chronic diseases such as cardiovascular disease (CVD), diabetes mellitus (DM) or osteoporosis (OP), and falling is also one of their health problems. With aging, lower limb muscle degeneration results in the decline of balance ability. Once balance and gait function decrease, humans will fall easily. Previous studies suggested that the occurrence of falling and its sequela greatly influence the elderly. Regular exercise is the easiest method for improving the muscle strength and other functional performances by older adults; it can decrease the occurrence of falling. The purpose of this paper is to investigate different types of chronic disease to determine the gait function differences among the elderly. Circuit hydraulic exercise, which combines hydraulic resistance and aerobic stepping, was practiced three times a week for a total of twelve weeks of exercise training. The present study recruited a control group which matched the age and gender of the experimental group. The assessment of gait function was conducted at two points: pre-exercise and post-twelve-weeks. All data were analyzed with repeat measure ANOVA test and Paired-T test. According to our data, there were two conclusions: 1. Regular resistance training and aerobic exercises enhanced gait function in elderly people to avoid falls. 2. Preliminary finding, cardiovascular disease (pre-training vs. post-training, p = 0.020) and osteoporosis (p = 0.008) attained more statistical significant difference than did diabetes mellitus disease regarding the exercise groups.