高齡者使用體健設施與多元性運動介入之效益

Abstract

營造更適宜的環境並系統性地規劃具體運動方案之策略，是國家公共衛生與運動發展的社區介入重要策略。公園體健設施已成為促進高齡者健康的有效環境因子，可藉由多元性運動訓練的導入，達到高齡者健康促進的益處。本研究目的包含：1) 阻力調節效果的體健設施與多元性運動訓練模組整合，對高齡者的健康影響情形；2) 體健設施之運動課程模組介入的延續使用之策略。為達研究目的，本研究採用兩階段的實驗設計進行驗證：1) 採用單組前後測研究設計，驗證本研究設計之社區公園體健設施多元性運動課程模組，結合油壓式阻力器材的效益 (n=39)；2) 採用準實驗研究設計，規劃個人化的訓練內容，探討個別化課表是否可作為延續使用意願的可行方案 (n= 36, EG= 18)，以重複量數單因子變異數分析、共變數分析等方法進行分析。研究結論如下。(一) 體健設施的阻力調節可能限制高齡者肌肉質量促進與體脂肪降低之效果，但提供個人化課表有助於提升肌肉質量與下肢肌力，且可延續身體功能方面的平衡能力。(二) 體健設施之運動課程無法提升中等至高強度、高強度的身體活動量及跌倒自我效能，但提供個人化課表可能有較高的身體活動量及較高的跌倒自我效能。(三) 體健設施之運動課程可提升高齡者對體健設施的動機與態度之整體平均分數，且可增加對政府政策的認同，但對當前政策推動結果的滿意程度降低；提供個人化課表更有機會使高齡者產生實際前往公園操作與複習體健設施的時間。(四) 提供個人化課表有助於增加運動方案介入結束後的效益，即有較高的前往公園次數與平均複習的時間。建議未來研究將可採用客觀儀器掌握身體活動強度，釐清高齡者於複習操作時所產生的身體活動量之強度，並探討對體健設施的態度與動機的改變因素，進一步制定其他可持續引發高齡者使用體健設施意願的策略。相關政策單位於建置公園體健設施時，可考慮增加使用時的阻力強度回饋機制，並檢視效益較高的特定器材，以利最佳化的發揮社區環境建設。Creating appropriate environments and systematically planning specific exercise programs are important for community interventions in the domains of public health and sports development. Outdoor fitness equipment (OFE) in parks is effective for promoting health outcomes among older adults, especially when integrated with multi-component exercise training (MET) programs. This study aimed to investigate the impacts of integrating resistance-adjustment with OFE and MET programs on older adults' health, and to explore strategies for the sustainable use of exercise program modules in OFE. A two-stage experimental design was employed, including a pre-post-test study with 39 participants and a quasi-experimental design with 36 participants (experimental group = 18). Data analysis was conducted using methods such as one-way analysis of variance and analysis of covariance. The conclusions of this study are as follows: 1. Resistance-adjustment through the use of OFE may limit the effectiveness of promoting muscle mass and reducing body fat among older adults. However, providing individual training programs can improve their muscle mass and lower-limb muscle strength, and extend their physical balance.2. The exercise programs involving OFE did not significantly increase the participants’ moderate-to-vigorous physical activity (MVPA) and vigorous physical activity (VPA) levels or falls efficacy. However, providing individual training programs may result in higher physical activity levels and falls efficacy scores.3. The exercise programs involving OFE can enhance older adults' overall scores in terms of motivations and attitudes toward OFE use, as well as increasing their identification with government policies. However, their satisfaction with the current policy outcomes had lowered. Providing individual training programs increases the likelihood of older adults to visit parks and use OFE. 4. Providing individual training programs contributes to post-intervention benefits, including higher park visitation frequency and average duration of OFE usage. Future studiesshould utilize objective instruments to measure the intensity of physical activity among older adults when using OFE. Additionally, it is important to explore the factors that influence the changes in their attitudes and motivations toward OFE, so as to develop effective strategies for encouraging the sustainable use of OFE among older adults. Policy makers involved in OFE installation should consider incorporating mechanisms for providing resistance intensity feedback during usage as well as evaluating equipment that offers greater benefits to optimize community environments.