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系統識別號 U0026-2008201223041400
論文名稱(中文) 探討登階有氧訓練對於健康老年人在轉彎及跨越障礙物時雙重作業表現之效益
論文名稱(英文) The effects of step aerobics training on dual task performance during turning and obstacle crossing in healthy older adults
校院名稱 成功大學
系所名稱(中) 物理治療研究所
系所名稱(英) Department of Physical Therapy
學年度 100
學期 2
出版年 101
研究生(中文) 陳芳儀
研究生(英文) Fang-Yi Chen
學號 T66991088
學位類別 碩士
語文別 英文
論文頁數 79頁
口試委員 指導教授-卓瓊鈺
口試委員-楊政峰
口試委員-成戎珠
中文關鍵字 老人跌倒  雙重作業  動作幅度  轉彎  跨越障礙物  登階有氧 
英文關鍵字 Falls in elderly  Dual task  Movement amplitude  Turning  Obstacle crossing  Step aerobics 
學科別分類
中文摘要 背景與目的: 轉彎和跨越障礙物對老人而言是具挑戰性的任務,可能會增加跌倒的發生率。過去研究顯示使用雙重作業的設計更能有效的評估老年人的能力以及預防跌倒。然而,尚未有研究探討雙重作業情境下轉彎及跨越障礙物的下肢動作表現。前人研究顯示登階有氧有多重的好處,而對於改善雙重任務能力可能也是一種有效的介入方式。然而,到目前為止,尚未有研究探討登階有氧訓練對雙重作業表現的效益。本篇研究的目的乃在探討健康老年人在轉彎及跨越障礙物時雙重作業的表現,並探討登階有氧訓練是否能改善雙重作業的表現。此外研究者也想探討登階有氧訓練對體能測試和跌倒關注程度的效益。方法: 本實驗從台南的地方社區徵募健康老年人。受試者必須接受臨床評估及三度空間的動作分析檢測,本實驗使用雙重作業的設計,主要的動作任務有走路、轉彎以及跨越障礙物,第二項任務為執行連續減七的算術任務。檢測後受試者依自己的意願分配到登階有氧組或是控制組並接受六周的介入。統計方法會使用三因子變異數重複型分析(重複因子為任務及時間)比較兩組間動作幅度、空間時間參數、認知表現的差異。結果: 經過六周的訓練,在跨越障礙物及轉彎中,多數下肢的額狀和水平面發現登階有氧組的動作幅度顯著增加或是控制組的動作幅度顯著下降(p皆<.0125)。對於認知表現,在雙重作業下,受試者的正確率變低及表現速度變快(p皆<.0083)。而登階有氧組的正確率在經過訓練後有顯著地增加(p<.0125)。對於體能測試,登階有氧組在訓練後的走路速度、有氧適能及左髖屈肌和雙邊踝背屈肌肌力皆有明顯改善(p皆<.0125)。結論: 在轉彎及跨越障礙物時,雙重作業並沒有明顯地影響健康老年人的下肢動作幅度。登階有氧訓練對老年人的應對策略有益,因為他們可以在有挑戰性的情況下使用較大的額狀面及水平面的動作幅度來代償。此外,登階有氧訓練特別能在雙重作業下改善算數任務的正確性。另外,登階有氧訓練對體能測試有效益像是改善走路速度、有氧適能、下肢肌力。因此,登階有氧對於老年人的跌倒預防可能是一種適合的訓練方式。
英文摘要 Background and purposes: Turning and obstacle crossing are challenging tasks that might increase fall occurrence in older adults. Previous studies have shown that using dual task paradigms could effectively evaluate the ability of older adults and prevent falls. However, no study investigated the joint angles of lower limbs during turning and obstacle crossing under dual task condition. Previous studies have shown step aerobics have multiple benefits and may be an effective intervention to improve dual task ability. Nevertheless, no studies have investigated the effect of step aerobics training on dual task performance. The purposes of this study were to investigate the dual task performance of turning and obstacle crossing in healthy older adults and further to determine whether step aerobics training would improve the dual task performance. Additionally, we would like to examine the training effect on physical tests and concern of falling. Methods: Healthy older adults were recruited from local community in Tainan. Subjects received clinical evaluation and 3-D motion analysis. A dual task paradigm was used in this study. The primary tasks consisted of three different motor tasks, including walking, turning, and obstacle crossing. The secondary task was to perform serial 7 subtractions. After the examination, subjects were voluntarily assigned into a step aerobics (SA) group or a control (CT) group and received a 6-week intervention. Three-way ANOVA with repeated measures on time and task factors was used to analyze the movement amplitude, spatiotemporal parameters, and cognitive performance between 2 groups. Results: After 6 weeks of training, either movement amplitude of SA group significantly increased or movement amplitude of CT group significantly decreased on most frontal and horizontal planes of lower limbs during obstacle crossing and turning (all p<.0125). For cognitive performance, the accuracy was lower and the speed was faster on dual task (all p<.0083). In SA group, the accuracy significantly increased after training (p<.0125). SA group showed improvements in physical tests, including walking speed, aerobic fitness, and muscle strength of left hip flexors and bilateral ankle dorsiflexors after training (all p<.0125). Conclusion: For turning and obstacle crossing, dual task paradigm did not obviously affect movement amplitude of lower limbs in health older adults. Step aerobics training showed benefits on the coping strategy of the older adults, since they could use larger movements on frontal and horizontal planes to compensate for challenging situations. Besides, step aerobics training also had benefits for improving accuracy of arithmetic task, especially under dual tasks. Moreover, step aerobics training had effect on physical tests such as improving walking speed, aerobic fitness, and muscle strength of lower limbs. Therefore, step aerobics could be an appropriate training program for falls prevention in health older adults.
論文目次 Abstract I
Chinese abstract III
Acknowledgement V
Table of contents VI
List of tables IX
List of figures XI
Chapter 1 Introduction 1
1.1 Falls in elderly 1
1.2 Dual task paradigm 2
1.3 Turning 3
1.4 Obstacle crossing 5
1.5 Step aerobics training 6
1.6 Motivation and purposes 8
Chapter 2 Methods 10
2.1 Subjects 10
2.2 Experimental procedure 10
2.3 Instrumentation 11
2.3.1 Motion capture system 11
2.3.2 Dynamometer 12
2.4 Clinical evaluation 12
2.4.1 Ten-meter walking test (10MWT) 12
2.4.2 Time up and go test (TUG) 13
2.4.3 Berg balance scale (BBS) 13
2.4.4 Two-minute step test (2MST) 13
2.4.5 Grip and strength of lower limbs 14
2.4.6 Falls Efficacy Scale International (FES-I) 14
2.5 Dual task Paradigm 15
2.6 Intervention 16
2.7 Data analysis 17
2.8 Statistical analysis 19
Chapter 3 Results 21
3.1 Subjects Characteristics 21
3.2 Performance of physical tests and concern of falling 22
3.3 Muscle strength 22
3.4 Movement amplitude of lower limbs 23
3.4.1 Obstacle crossing: leading phase 23
3.4.2 Obstacle crossing: trailing phase 24
3.4.3 Turning 28
3.5 Spatiotemporal parameters 30
3.5.1 Temporal parameters 30
3.5.2 Spatial parameters 31
3.6 Cognitive task performance 32
Chapter 4 Discussion 34
4.1 The effect of dual task paradigm 35
4.1.1 Motor performance 35
4.1.2 Cognitive performance 37
4.2 The effect of SA training 38
4.2.1 Motor performance 38
4.2.2 Cognitive performance 41
4.2.3 Physical tests and concern of falling 41
4.3 Limitations and future study 44
Chapter 5 Conclusion 46
References 47
Appendix 77
Author’s background 79
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