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系統識別號 U0026-1807201615525200
論文名稱(中文) 活動促進系統對代謝異常者身體活動促進之成效
論文名稱(英文) The Effectiveness of an Activity Promotion System on Increasing Physical Activity in Subjects with Metabolic Abnormalities
校院名稱 成功大學
系所名稱(中) 健康照護科學研究所
系所名稱(英) Institute of Allied Health Sciences
學年度 104
學期 2
出版年 105
研究生(中文) 楊雅萍
研究生(英文) Ya-Ping Yang
學號 ta8021041
學位類別 博士
語文別 英文
論文頁數 65頁
口試委員 指導教授-王靜枝
共同指導教授-楊宜青
召集委員-王琪珍
口試委員-林文元
口試委員-陳桂敏
中文關鍵字 身體活動  活動促進  自我管理  代謝異常  體重過重 
英文關鍵字 physical activity  activity promotion  self-management  metabolic abnormalities  overweight 
學科別分類
中文摘要 目的:本研究的目的為探討活動促進系統對於代謝異常者增加身體活動之成效。方法: 本研究為隨機試驗交叉研究設計,為期6個月。共招募53位受試者,以隨機分派方式分成A組及B組,A組受試者於前3個月使用活動促進系統(Activity Promotion System)包括穿載式感測器(可測量全日身體活動,包括睡眠時間、靜態、輕度、中度和劇烈身體活動)和線上的即時回饋系統,於後3個月為接受傳統健康教育的常規照護。B組的受試者則先接受常規照護後再使用活動促進系統。測量兩組介入前1週、不同介入措施介入後3個月及6個月的各項身體活動及代謝異常指標的變化。以獨立t檢定分析測試活動促進系統使用期間的效果;廣義估計方程式用於分析研究期間AB兩組之間的差異。差異中的差異分析用於組內和組間使用活動促進系統使用與常規照護的差異比較。結果:本研究發現受試者使用活動促進系統後,顯著減少靜態活動時間、增加輕度活動、每日活動總量和每日活動步數。對於代謝異常等生理指標,受試者腰圍於使用活動促進系統顯著減少。結論:活動促進系統對於代謝異常者而非糖尿病或心血管等疾病狀態者具有減少靜態活動時間並增加身體活動之效果。未來需有增加樣本數及長期的隨機對照研究,來進一步佐證活動促進系統臨床運用的有效性。
英文摘要 Objective: The aim of this study is to examine the effectiveness of Activity Promotion System (APS) on promoting physical activity (PA) for subjects with metabolic abnormalities.
Methods: We designed a 6-month randomized controlled trial with a cross-over design, and finally recruited 53 subjects. Subjects in group A used APS with a wearable device (which could measure whole-day physical activities including sleep time, sedentary, light, moderate and vigorous PA) and web-based feedback system in the first 3 months and followed by usual care with traditional health education in the next 3 months. Subjects in the group B took turn to receive the above programs in a reverse order. Physical activities and metabolic abnormalities were measured prior to the intervention, 3 months after the first intervention, and 6 months after the other intervention respectively. Independent t test was used to test the effects APS using. Generalized Estimating Equation (GEE) was used to analyze differences between two groups across research period. Difference in differences (DID) analysis were used to compare the difference within and between groups.
Results: This study found that the APS had short-term effects on decreasing sedentary time and increasing mild PA, moderate PA, total PA, and daily steps counts. The secondary outcome measures of metabolic abnormalities, APS provide a positive effect on decreasing waist circumference.
Conclusion: This APS appeared to decrease sedentary time and to increase PA for people with only metabolic abnormalities but not with metabolic syndrome, diabetes or cardiovascular disease. However, long-term studies with APS and larger sample size are needed to further confirm the effectiveness of this innovative activity promotion system.
論文目次 Abstract I
中文摘要 III
Acknowledgement V
Table of Contents VII
List of Tables IX
List of Figures X
Chapter 1 Introduction 1
1.1 Background 1
1.2 Research purpose 4
1.3 Operational definition 4
Chapter 2 Literature review 9
2.1 Prevalence of MetS and metabolic abnormalities 9
2.2 Negative impact of metabolic abnormalities and MetS 10
2.3 Lifestyle and metabolic abnormalities 12
2.4 PA and MetS 13
2.4.1 The impact of physical activities 13
2.4.2 The impact of sedentary behavior and physical inactivity 15
2.5 Strategies for PA promotion intervention 17
2.6 Mobile devices using for PA promotion 18
2.7 Summary 19
Chapter 3 Methods 21
3.1 Study design 21
3.1.1 Study setting 21
3.1.2 Study subjects 21
3.1.3 Instrument 22
3.2 Procedure of the study 25
3.2.1 Procedure of RCT 25
3.2.2 The Activity promotion system (APS) 28
3.2.3 Usual care (UC) 33
3.3 Data analysis 33
3.4 Ethical approval 34
Chapter 4 Results 35
4.1 Demographic characteristics of subjects 35
4.2 Effects of period with and without APS on outcome measurements 37
4.3 Effects of APS vs. UC between-group and within-group on outcome measurements 40
4.3.1 Effects of APS vs. UC within-group on outcome measurements in group A 40
4.3.2 Effects of UC vs. APS within-group on outcome measurements in group B 42
4.3.3 Effects of APS vs. UC between-group on outcome measurements from T1 to T2 43
4.3.4 Effects of UC vs. APS between-group on outcome measurements from T2 toT3 44
Chapter 5 Discussion 48
5.1 Positive outcomes 48
5.2 Outcomes which were not significantly improved 51
5.3 Limitations and future research 52
5.4 Conclusion 53
5.5 Implications for Practice 53
Reference 55
Appendix 1 63
Appendix 2 64
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