運動介入對高齡者平衡能力與步態之影響：系統性回顧

The influence of exercise interventions on balance and gait in older adults: A systematic review

行走步態被視為身體健康與生活功能的重點指標，透過運動治療以延緩老化速度與改善生理病痛為目前臨床醫學趨勢，若能事先瞭解不同形式運動介入對行走平衡與步態的改善效益，則可提升高齡者行走穩定性以減少跌倒發生機率。本研究目的為釐清不同運動介入對高齡者平衡能力與步態之效益，以關鍵字搜尋國內、外期刊資料庫，共納入16 篇期刊進行探討，將運動介入對高齡者步態、平衡相關結果進行分類彙整，文獻結果顯示改善動、靜態平衡能力與步態表現取決於介入型態及強度，採用大量低姿勢重心轉移之太極拳與八段錦運動對壓力晃動中心與穩定限度改善具備良好的效益。此外，結合阻力與平衡的複合式運動介入有助於改善高齡者足底壓力分布與降低步態變異性，雖然可根據療效指標來判斷複合式運動介入的整體效益，但仍無法確切釐清複合式運動介入的劑量與反應關係。因此，需更進一步探究複合式運動介入對平衡能力與步態的具體效益。此外，建議未來高齡運動處方可著重於下肢多關節動作訓練為主，透過低負荷阻力器材與擾亂重心的動態活動編排，有利於調整運動強度，提升高齡者平衡能力與步態穩定性，達到預防及延緩老化之效益。

Walking gait is regarded as a key metrics of good health and life function. It is the current clinical trend to slow down the aging rate and improve physiological pain through exercise therapy. If the benefits of different forms of exercise interventions on walking gait and balance can be recognized in advance, the walking stability of elder people can be improved. This helps to decrease the probability of falling. The purpose of this study is to identify the benefits of different exercise interventions on the balance and gait in older adults. Both the domestic and the foreign journal databases were searched by keywords, and included 16 journals for discussion. The results that related to gait and balance of the elderly with exercise intervention were classified and aggregated. Literature results showed that the improvement of dynamic and static balance and gait performance were depended on the type and intensity of the intervention. Tai Chi and Eight Brocades exercises use a lot of low-position center of gravity transfer. They both have good effects on the improvement of the pressure swing center and the stability limit. In addition, a combination of resistance and balance compound exercise program can help improve plantar pressure distribution and reduce the variability of gait in elders. Even though the overall benefits of the compound exercise program can be determined according to efficacy indicators, the exact dose-response relationship of the compound exercise program is still unclear. Therefore, the specific benefits of a compound exercise program on balance and gait need to be further explored. Moreover, it is suggested that prescriptions of the elderly exercise in the future can focus on lower limb multi-joint exercise training. Through the low-load resistance equipment and the dynamic activity scheduling that disrupts the center of gravity, the exercise intensity can be easily adjusted. The balance ability and the gait stability of the elderly will be improved, then achieve the benefits of preventing and delaying aging.