虛擬實境運動介入對社區高齡者功能性體適能與生活品質之影響

Abstract

背景：虛擬實境 (VR) 被應用在休閒與娛樂的用途。其對於高齡者生、心理健康狀態具有積極改善與維持效益已被研究發現。然而，少有研究設計相關量表，評估高齡者參與時的接受度和使用情形。方法：研究一，參考科技接受模型編製高齡者虛擬螢幕運動參與評估量表，研究對象為具有螢幕使用經驗高齡者 (年齡 ≥ 65歲)；依序進行探索性因素分析、題目鑑別度與內部一致性，確認問卷結構；及使用驗證性因素分析確認因素效度。研究二，高齡者 (平均年齡72.16 ± 4.9歲) 隨機被分配至實驗組 (n = 48) 或對照組 (n = 50) 瞭解虛擬實境運動介入對功能性體適能及生品質之情形。實驗組每週2次，每次約75-90分鐘，共12週VR運動，對照組無進行介入。功能性體適能和生活品質評估，使用高齡者功能性體適能測驗、臺灣版世界衛生組織老人生活品質問卷，參與者於第1週進行前測、第13週進行後測、第24週進行保留測。並採用整體參與者前測功能性體適能成績預測生活品質之關係。結果：研究一，探索性因素分析萃取出五個因素 (外部變數、認知有用與認知易用、使用者態度、行為意圖、實際使用行為) 總解釋變異量66.68%。驗證因素分析修正後共14題，構念效度介於 .19至 .67之間，模型具有良好適配度。研究二，虛擬運動介入後，顯著提升上肢柔軟度、下肢柔軟度、上肢肌力、心肺適能及平衡能力；生活品質構面在感官能力、自主性、社交參與/隔離、感受與經歷死亡以及生活品質總分優於前測。保留測方面，實驗組功能性體適能在下肢柔軟度、上肢肌力、心肺適能及平衡能力仍有維持效果；生活品質皆未發現維持效益。此外，參與者功能性體適能表現與生活品質無線性關係。結論：本研究量表具備初步信效度，可供相關研究使用 (研究一)。虛擬實境運動介入提供了促進高齡者功能性體適能及生活品質重要的結果，未來研究可採用不同VR工具、族群進行更有效的介入 (研究二)。Background: An application of Virtual Reality (VR) is in leisure and entertainment. Based on evaluations of the effectiveness of VR among the elderly, positive results indicated an improvement in physical and mental health. However, a limited number of studies at a relevant scale exist that can be considered to evaluate VR use in older adults. Methods: In study 1, a virtual screen assessment exercise for seniors was developed based on the Technology Acceptance Model (TAM), focusing on senior citizens (≥ age 65years) with prior experience in screen usage. Exploratory factor analysis (EFA), item discrimination, and internal consistency were used to examine the initial factorial structure and used Confirmatory factor analysis (CFA) to confirm factorial validity. In study 2, older adults (mean age 72.16 ± 4.9 years) were randomly assigned to either the experimental group (n = 48) or the control group (n = 50) to investigate the effects of VR exercise on functional fitness and quality of life. The experimental group received VR exercise sessions for 75-90 minutes, twice a week for a duration of 12 weeks. The control group received no intervention. Functional fitness and quality of life were assessed by the Senior Fitness Test and questionnaire from the WHOQOL-OLD, respectively, in pre-test on week 1, post-test (week 13), and a retention test (week 24). The pre-test data were exclusively extracted to examine the association between functional fitness and quality of life. Results: In Study 1, exploratory factor analysis results showed that the five-factor model (External Variables, Perceived Usefulness/ Perceived Ease of Use, Use Attitude, Use Intention, and Actual System Use) accounting for a total explanatory variance of 66.68%. This finding supports the application of the overall measurement model, resulting in a 14 question scale, with a constructed validity ranging from .19 to .67. In Study 2, after engaging in the VR training sessions, the experimental group revealed significant improvement of upper and lower limb flexibility, upper muscle strength, cardiorespiratory fitness, and balance ability from pre-test to post-test. In terms of their QOL, a significant increase from pre-test to post-test in sensory abilities, autonomy, social participation/isolation, and death and dying domains, and total quality of life score were observed in the experimental group. In the retention periods, the experimental group also showed better performance in lower limb flexibility, upper limb muscle strength, cardiorespiratory fitness, and balance ability than the pre-test but not in the quality of life. Furthermore, there was no significant association between functional fitness and quality of life. Conclusions: The suggests that study 1 has preliminary reliability and validity, which could be used for related research in the future. In Study 2, the results provided an important insight into the VR promotion of senior functional fitness and quality of life for older adults. Future research is encouraged to examine more effective interventions targeting VR tools and different participants.