Otago運動提升長期照顧機構住民下肢肌力之成效

Effects of the Otago Exercise Program on Lower Extremity Strength in Residents of a Long-Term Care Institution

背景：跌倒是老年人最常發生的問題，而增強老年長者下肢肌力為預防跌倒首要任務。目的：探討老年長者介入Otago運動提升下肢肌力之成效。方法：為重複測量研究，採兩組，所有參與長者維持一般正常活動，而實驗組再由物理治療師帶領團體式Otago運動訓練，內容包含暖身、肌力、平衡及行走訓練，每次45分鐘，每週3次，為期6個月，共78次。於研究開始時、3及6個月進行30秒坐站測驗及下肢肌力測量。結果：共20位平均年齡超過80歲之長者，兩組各10位，Otago運動出席率92.8％。研究開始前實驗組下肢肌力較弱，經6個月Otago運動，於膝伸直肌、膝彎曲肌、腳踝背屈、腳踝蹠屈四處肌力皆明顯提升，且顯著優於對照組（組別及時間交互作用p值皆小於.05）。而30秒坐站次數於研究開始前亦是實驗組表現較差，但經6個月運動，對照組呈微幅衰退，而實驗組持續進步且成效顯著優於對照組。結論／實務應用：每週3次、持續6個月的Otago運動可協助高齡長者顯著提升下肢肌力，建議長期照顧機構將Otago運動作為預防跌倒的策略之一。

Background: Falls are a very common problem in older adults. Improving lower extremity muscle strength is the primary objective of fall-prevention programs. Purpose: The aim of the study was to evaluate the effects of the Otago Exercise Program (OEP) on the lower extremity muscle strength of residents living in a long-term care institution. Methods: In this repeated measurement study, participants were allocated into either the experimental group (EG) or the control group (CG). All of the participants maintained normal activities, and EG participants were additionally enrolled in a 6-month group OEP led by a physiotherapist. The OEP, comprising warm-up exercises, strength training, balance training, and walking training, requires about 45 minutes per session, 3 times a week. A total of 78 OEP sessions were performed during the 6-month intervention. A 30-Second Sit-to-Stand Test and lower extremity muscle strength measurements were performed at baseline, after 3 months, and after 6 months. Results: The twenty participants in this study had a mean age over 80 years and were recruited from a long-term care institution in southern Taiwan. There were ten participants in each group, and the mean total OEP session attendance for EG participants was 92.8%. Although the EG had lower extremity muscle strength than the CG at baseline, the EG had achieved significant improvements in the muscle strength values for the knee extensor, knee flexor, ankle plantar flexors, and dorsiflexors after 6 months (group x time interaction, p < .05). In addition, the results of the 30-second sit-to-stand test for the EG were poor at baseline and significantly better after 6 months, while the results for the CG worsened between baseline and 6 months. Conclusions/ Implications for Practice: The results of this study support that participating in a group-based OEP three times per week over 6 months effectively improves lower extremity muscle strength in older adults. Therefore, OEP should be incorporated into fall-prevention programs organized in long-term care institutions.