運動介入對長照機構失能住民日常生活活動功能之成效

Effects of Exercise Program on Activities of Daily Living among Long Term Care Facility Disabled Residents

臺灣於2018年4月進入高齡社會，長照需求也隨之增加。過去研究顯示，運動介入可改善高齡者肌力且預防跌倒，但運動介入對機構失能住民的日常生活的各項活動功能效益仍不明確。本文透過系統性文獻回顧方式，探討運動改善長照機構失能住民日常生活活動功能之成效，使用關鍵字搜尋七個中英文資料庫至2018年10月發表的實驗性研究，經篩選後共納入八篇進行分析，並以modified Jadad quality Scale進行研究品質評價。八篇納入研究之運動型態分為兩類：單類型（n＝4）與多類型（n＝4），運動種類以肌力訓練（n＝5）為最多，頻率以每週3次（n＝6），每次40分鐘（n＝5），持續24週（n＝3）的介入為多。結果顯示，四篇提供單類型運動介入與一篇提供肌力訓練、伸展、平衡與柔軟度運動之多類型運動介入的實驗組住民，其日常生活活動功能有顯著改善，另三篇雖在日常生活活動功能無顯著差異，但運動介入對實驗組個案的移位與協調等功能，仍有顯著改善。本文提供實證依據，支持運動介入改善失能住民的日常生活活動功能的成效。針對未來類似研究之建議，單類型運動可設計每週至少3次，每次40分鐘，持續至少24週以上；多類型運動則可設計每週2次、每次40分鐘，持續12週的運動介入，以有效改善機構失能住民的日常生活活動功能。

In April 2018, Taiwan has become an aged society, and the demand for long-term care services has also increased. Previous research results showed that exercise program can improve older adults' muscle power and prevent falls. However, the effects of exercise programs on disabled residents' activities of daily living still remain uncertain. A systematic review was used in this study to explore the effects of exercise programs on activities of daily living among long term care facility disabled residents. Online literature was searched from seven databases that were published up to October 2018. Based on the inclusion and exclusion criteria, eight articles were selected and thoroughly assessed under the guidelines of the modified Jadad quality scale. The exercise programs were divided into two different types: single mode program (n=4) and multiple mode program (n=4). The strength training (n=5) was the most commonly used mode in the exercise programs. Three times per week (n=6), 40 minutes (n=5) for each section, continuing for 24 weeks (n=3) were the frequency and duration for the majority studies. The results showed that four studies with the single mode exercise program and one study with the multiple mode exercise program had significant better outcomes in activities of daily living for the experimental groups. The findings provided the evidence that exercise programs can improve the activities of daily living for disabled residents. It is recommended that at least 3 times a week, 40 minutes for each section, continuing for 24 weeks will be necessary for single mode exercise program. For multiple mode exercise program, at least twice a week, 40 minutes for each section, continuing 12 weeks will effectively improve the activity of daily living for disabled institutional residents.