視覺障礙者的身體活動及其個人及環境之阻礙和促進因素

Objectively measured physical activity and associated factors in individuals with visual impairments

緒論：缺乏身體活動是視覺障礙者一個嚴重的健康問題。本研究目的旨在一、比較 視覺障礙者之身體活動在身體結構和功能方面的差異；二、探討視覺障礙者身體活動的 個人和環境阻礙及促進因素。方法：三十名視覺障礙者 （41.67 ± 11.09 歲） 參與本研究。 以 ActiGraph 加速度計測量身體活動 [身體活動總量、步數、靜態活動 （sedentary activity, SA） 分鐘 （min） 及百分比 （%）、輕度身體活動 （light physical activity, LPA） 分鐘 （min） 及百分比 （%） 、中等費力以上身體活動 （moderate-to-vigorous physical activity, MVPA） 分鐘 （min） 及百分比 （%）]；以運動和身體活動阻礙和促進因素問卷來了解相關因素；以 無母數統計 Mann-Whitney U test 及 Kruskal Wallis test 來比較。結果：一、重度視覺障礙 者的 MVPAmin 低於中度 （p < .05） 及輕度 （p < .05） 視覺障礙者，重度視覺障礙者的 MVPA% （p < .05） 及步數 （p < .05） 低於輕度視覺障礙者；二、高學歷視覺障礙者的 LPAmin 高於低學歷視覺障礙者 （p < .05）；三、10 年以下視覺障礙者的 SAmin 高於 11 年 以上者 （p < .05）；四、「因為視覺障礙無法運動」及「交通」是目前有從事運動者最主要 的個人及環境阻礙因素；「害怕受傷」及「交通」則是目前沒有從事運動者最主要的個人 及環境阻礙因素；五、「促進健康/提升體適能」是開始及維持參與運動者最常被提及的個 人促進因素，「朋友/同事的支持」及「其他」則是最常被提及的環境促進因素。結論：大 多數視覺障礙者未達每日身體活動建議量且視覺障礙愈嚴重、罹患時間愈短者，身體活 動愈不足；減少阻礙因素 （如：交通），同時考量促進因素 （如：無障礙環境），能增加 身體活動參與機會，進而提升健康狀態與生活品質。

Introduction: Low levels of physical activity (PA) constitute a serious health issue in individuals with visual impairment (VI). The purposes of this study were (1) to compare PA differences related to the body structures and functions of adults with VI, and (2) to determine barriers to and facilitators of PA participation in adults with VI. Methods: Thirty adults with VI (age: 41.67 ± 11.09 years) agreed to participate. An ActiGraph accelerometer was used to assess the PA levels [in terms of counts per minute, steps, and minutes and percentage of time spent in sedentary activity (SA), light physical activity (LPA), and moderate-to-vigorous PA (MVPA)] of the participants, and a questionnaire was administered to determine the barriers to and facilitators of PA for people with VI. The data were analyzed using the Mann-Whitney U Test and the Kruskal-Wallis Test. Results: (1) The daily average accumulated MVPAmin was significantly lower in the participating adults with severe levels of VI than in those with moderate (p < .05) and mild (p < .05) levels of VI, and the MVPA% (p < .05) and steps (p < .05) were also significantly lower in the adults with severe levels of VI than they were in the adults with mild levels of VI. (2) The LPAmin of the participating adults with VI with higher education levels was higher than that of the participants with lower education levels (p < .05). (3) The SAmin of the participating adults with 10 year ≦ s of VI was greater than that of those of with 10 years of VI ≧ (p < .05). (4) ''not being able to exercise because of disability'' and ''transportation'' were frequently mentioned as personal and environmental barriers, respectively, to PA, and (5) ''increasing health/physical fitness'' and ''support from friends and colleagues'' as well as ''other'' were the most frequently mentioned personal and environmental facilitators for initiating/maintaining PA participation, respectively. Conclusion: The majority of the investigated adults with VI did not accumulate the recommended amount of daily MVPA, and the severity as well as the duration of VI affected the PA levels of the investigated adults with VI. Various factors, such as transportation and accessible environments, should be addressed in any interventions intended to increase PA levels among adults with VI.