運動訓練對老年人憂鬱症狀、生活功能、生活品質及自我效能的效果

Abstract

研究背景及目的：老年人憂鬱情況普遍，很多文獻探討運動訓練對老年人運動能力和生活功能的影響，欠缺對其他健康面向的研究。本研究目的在探討運動訓練的介入對老年人憂鬱症狀、生活功能、生活品質及自我效能的效果，以作為日後對於老年人運動介入方式之參考。方法：以方便取樣徵集50名65歲以上之老年人，隨機分配運動組與控制組。其中運動組接受為期8週每週3次之漸進及結構式的小團體運動訓練，每次約30-40分鐘，並以自覺用力係數12-14作為強度的監測。所有受試者皆在第一次評估之8週後進行第二次評估。觀測因子包括憂鬱症狀（台灣老年憂鬱量表）、認知功能（短式智能評估）、生活功能（包括活動限制量表及30秒重覆座椅起立測試、計時起走測試、六分鐘行走測試三項實際測量項目）、生活品質（SF-36台灣版）與運動自我效能。統計分析採用共變數分析檢驗組別對於各觀測因子在介入前後改變量的影響，其中初測結果有顯著差異的變項以前測值做調整。以皮爾森相關分析探討依變項改變量之間的相關性。結果：8週後兩組於憂鬱症狀、認知功能、生活品質及運動自我效能的改變量並無差異。運動組唯在生活功能限制（p=0.013）及30秒重覆座椅起立測試（p＜0.001）的表現相較於控制組有顯著的進步。憂鬱程度的改變情形則與功能限制的進步之間有顯著相關（r=0.303）。結論：老年人確實能藉由8週的運動訓練介入在生理功能的一些表現上有顯著的進步，憂鬱情形的改變與生活功能的限制的改變有顯著相關。然而情緒、認知、生活品質及運動自我效能在組間的改變則無顯著差別。

Background and purpose: Depression is commonly seen in the elderly. Many studies have investigated the effects of exercise on exercise capacity and physical functions. Other dimensions of health, especially the depressive symptoms, are less discussed. The purpose of this study was to investigate the effects of exercise training on depression symptoms, functional status, quality of life, and self-efficacy in the elderly. Methods: A convenient sample of 50 sedentary elderly subjects aged 65 years or older was recruited and randomized into intervention group and control group. Participants in the intervention group received a progressive and structured, small-group exercise training 3 times a week, 30-40 min a day at intensity of rate of perceived exertion (RPE) 12-14 for 8 weeks. All subjects were assessed by Taiwanese Geriatric Depression Scale (TGDS), Mini-Mental State Examination (MMSE), Groningen Activity Restriction Scale (GARS), Short-form 36 (SF-36), and self-efficacy at baseline and 8 weeks after. In addition, tests of 30-second Chair Sit-To-Stand (STS), Timed Up and Go (TUG), and Six-Minute Walk (6MW) were used to evaluate their functional status. Analysis of covariance (ANCOVA) was performed to identify the effect of time and intervention on differences of dependent variables, adjusted by the pretest values that were significantly different at baseline. Relationship between the changes of each variable was analyzed by Pearson correlation coefficient. Results: There were significant improvements in GARS (p=0.013) and the performance of STS (p<0.001) in the exercise group compared to the control group. No significant differences in TGDS, MMSE, TUG, 6MW, SF-36, and self-efficacy were found between groups. Changes in TGDS were significantly related to the changes in restriction of daily life (r=0.303). Conclusion: The elderly can benefit from 8-week exercise training with improvements mainly in physical function that was correlated with the changes in depression.