利用動態活動設計提升精神科日間病人下肢肌耐力

Using Dynamic Activities Design to Improve Lower Extremity Muscular Endurance in a Psychiatric Day Care Center

精神科病人之身體活動量明顯低於一般人，長期處於低活動量的作息，肌力及肌耐力會因年齡增長而快速變差，影響病人活動參與及功能復原。本專案的目的在於利用動態活動設計提升病人下肢肌耐力，病人常抱怨腳無力不想參加活動，造成2021年6月至8月動態活動平均出席率僅38.5%，調查發現本病房65位病人下肢肌耐力符合標準僅50.8%，導因：不知道參與動態活動目的、動態活動設計無誘因、時間及強度不足、體力無法負荷、運動器材不足、缺乏動機、不知道如何居家運動及藥物副作用影響肌肉無力。為提升下肢肌耐力，改善方案：舉辦衛教課程、增修中強度動態活動於團體治療、教導居家運動、建立增強獎勵制度及跨團隊共同評估調藥機制，措施介入後下肢肌耐力提升至72.3%。本專案有成效且可維持，建議精神復健機構應強化中強度動態活動，以因應病人下肢肌耐力弱化的趨勢，提高活動參與度，延緩疾病對功能的影響，以利回歸家庭及社會。

The level of physical activity among psychiatric patients is significantly lower than that of the general population. Prolonged inactivity can accelerate the decline of muscle strength and endurance with age, hindering patients' participation in activities and delaying functional recovery. This project aimed to improve lower extremity muscular endurance through the implementation of dynamic activities. Patients frequently reported lower limb weakness and a reluctance to engage in such activities, resulting in a low average attendance rate of 38.5% for dynamic sessions between June and August 2021. This prompted efforts to identify and address the barriers to participation. An assessment of 65 patients in the ward showed a pass rate of only 50.8% for lower extremity muscular endurance. Contributing factors included unclear participation goals, lack of incentives, insufficient activity intensity and duration, physical fatigue, poor adherence to home exercises, limited equipment, and medication side effects causing muscle weakness. To address these issues, the project implemented health education courses, incorporated moderate-intensity exercises into rehabilitation plans, taught home exercise techniques, enhanced the reward system, and utilized a multidisciplinary team to evaluate medication regimens. As a result, the pass rate improved to 72.3%, demonstrating the project's effectiveness and sustainability. It is recommended that rehabilitation programs prioritize moderate-intensity dynamic exercises to prevent lower limb decline, increase participation, delay disease-related functional impairment, and support patients’reintegration into family and community life.