跨領域團隊合作照護計畫對於肌少症前期之老年人的成效探討：前驅研究

The Effect of an Intervention Program and Multidisciplinary Care on Pre-Sarcopenia in the Elderly: A Preliminary Study

目的：隨著老化的發生和肌肉質量的流失所造成的肌少症影響老年族群的失能狀況。本研究目的透過跨領域團隊合作，針對肌少症前期之老年人設計結合營養衛教和運動訓練的課程，以期達到預防及延緩肌少症的發生。方法：採單一組別前後測驗，納入65歲以上肌少症前期之老年人參與由跨領域團隊所設計的課程，每周1堂2小時共12堂，課程內容包含營養攝取、肌少症衛教與運動訓練。統計分析以魏克森符號等級檢定法比較課程前後之步行速度、肌握力、30秒坐到站檢測、肌肉量、迷你營養評估量表及自編問卷。結果：21位老年人參與12周課程並進入統計分析。自編問卷顯示在介入後100%皆願意且有信心每週運動3至5次、每日均衡飲食及使用彈力帶運動；而在步行速度(p<0.01)和迷你營養評估量表總分(p<0.01)達顯著提升；肌握力、30秒坐到站和肌肉量雖未達顯著，介入後之得分均較前測進步。結論：本研究發現12周的介入課程可顯著提升肌少症前期之老年人的步行速度及降低營養不良的風險。

Objectives. Sarcopenia is an age-related loss of skeletal muscle mass with progressive decline in muscle strength leading to dysfunction and poor quality of life. Therefore, it is important to prevent or delay its development and progression. The aims of this study was to develop a program combining nutrition and exercise training for older adults with pre-sarcopenia to postpone the progression of disability and improve the physical function. Methods. This study was a one-group pretest-posttest design. We enrolled subjects older than 65 years old with pre-sarcopenia to participate in this program which included nutrition counseling, exercise training and health education offered by an multidisciplinary team one session per week two hours per session for twelve weeks. Outcome was assessed by comparing pre- and post-intervention walking speed, grip strength, the 30-Second Chair Stand Test, muscle mass, Mini Nutritional Assessment and self-administered questionnaire. Results were analyzed by Wilcoxon Signed-Rank test. Results. The self-administered questionnaire showed all the subjects were willing and confident that they could perform the exercises 3-5 times per week, keep balance diet and able to use elastic bands. We found significant improvement in walking speed (p<0.01) and Mini Nutritional Assessment scores (p<0.01). Grip strength, the 30-Second Chair Stand Test and muscle mass were improved, but not significantly. Conclusion. This 12-weeks program involving nutrition and exercise training can improve walking speed and decrease risk of malnutrition in older adults with pre-sarcopenia.