樓梯運動對高齡者功能性體適能之影響

Effects of stair exercise on functional physical fitness in the elderly

緒論：老年人口是全球面臨的問題之一，隨著年齡增長產生的老化現象導致老年人肌力、平衡、敏捷等能力之下降，因而容易引起走路跌倒，輕則受傷但嚴重有可能骨折甚至死亡。因此，本文目的在於探討6週上、下樓梯運動是否可有效促進高齡者功能性體適能 (functional physical fitness, FPF)。方法：招募16名60歲以上高齡者，並隨機分成:下樓梯組和上樓梯組 (n = 8人/組)。進行六週漸增負荷 (每週兩天，每週負荷增加 10 層樓) 樓梯運動。樓梯運動前和後第四天，各進行一次FPF測驗：30秒椅子坐站、坐姿柔軟度、2分鐘原地踏步、8英呎起身繞行、6 公尺側併步、開、閉眼單腳站立。樓梯運動過程以Polar心率錶及每次完成樓梯運動後立即使用運動自覺量表 (rating of perceived exertion, RPE) 分別測量心跳率 (heart rate, HR) 與疲勞反應。所有結果以二因子混合設計變異數分析進行比較。結果：上、下樓梯組 (65 ± 5 歲) 經過6週運動介入後，30秒椅子坐站、坐姿柔軟度、2分鐘原地踏步、8英呎起身繞行、6 公尺側併步、閉眼單腳站立後測均未優於前測 (p > .05)。然而在開眼單腳站立，上樓梯組 (23.9 ± 8.8 vs. 30 ± 0 秒, p < .05) 和下樓梯組 (19.6 ± 11.0 vs. 30 ± 0 秒, p < .05) 後測成績明顯優於前測，但是不同二組之間無統計差異 (p > .05)。6週上樓梯運動強度 (HR: 85.6 ± 8.3 bpm，RPE: 8.6 ± 2.3) 明顯大於 (p < .05) 下樓梯運動方式 (HR: 72.9 ± 6.9 bpm，RPE: 7.0 ± 0.9)。結論：本研究結果發現，進行6週上、下樓梯運動介入之後，均能有效提升高齡者平衡能力，未來可做為推廣老年人抗跌倒之有效運動之一。其中又以下樓梯方式所產生的生理壓力、能量消耗和疲勞程度較小。

Introduction: Aging is a worldwide problem. Aging reduces muscle strength, balance, and agility. The risk of falling also increases with aging, which may cause fractures or even death. Thus, this study was conducted to investigate the effects of a 6-week stair-descending or ascending exercise on functional physical fitness in elderly people. Methods: Sixteen healthy elderly people (aged 65 ± 5 years) participated in the study and were allocated randomly to the stair-descending or ascending group (n = 8/group). The participants performed the stair-descending or ascending exercise twice per week for six consecutive weeks. The exercise began with 10 floors and gradually incremented 10 floors every week until the sixth week. Functional physical fitness, including muscle strength, flexibility, cardiorespiratory endurance, balance, and agility, was examined before and 4 days after the exercise interventions. The participants’ heart rates and rated perceived exertion (RPE) responses were measured during and immediately after each session of the stair exercise. The data were analyzed using a mixed-design two-way ANOVA. Results: No significant difference was observed between the baseline and postintervention in the 30-second chair-stand test, chair sit-and-reach test, 8-foot up-and-go test, 6-m tandem walk, one-leg stance test with eyes closed, or 2-minute step test in either group (p > .05). A significant difference (p < .05) was observed between the baseline and postexercise in the one-leg stance test with eyes open of the stair-ascending (23.9 ± 8.8 vs. 30 ± 0 second, p < .05) and descending groups (19.6 ± 11.0 vs. 30 ± 0 second, p < .05), without any significant difference between the two groups (p > .05). The heart rates and RPE responses in the stair-ascending group (HR: 85.6 ± 8.3 bpm, RPE: 8.6 ± 2.3) were significantly lower (p < .05) than those in the stair-descending group (HR: 72.9 ± 6.9 bpm, RPE: 7.0 ± 0.9). Conclusion: This study shows that both stair-ascending and descending exercise interventions improved the static balance in elderly people; however, the exercise intensity and fatigue were lower during the stair-descending exercise than during the stair-ascending exercise. Thus, the stair-descending exercise may be provided to the elderly population as an efficient exercise for preventing falls in the future.