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| ???org.dspace.app.webui.jsptag.ItemTag.dcfield??? | Value | Language |
|---|---|---|
| dc.contributor.advisor | 孫秀卿(Shiow-Ching Shun) | |
| dc.contributor.author | Yu-Hsuan Chang | en |
| dc.contributor.author | 張祐瑄 | zh_TW |
| dc.date.accessioned | 2022-11-24T09:26:07Z | - |
| dc.date.available | 2022-11-24T09:26:07Z | - |
| dc.date.copyright | 2022-01-18 | |
| dc.date.issued | 2022 | |
| dc.date.submitted | 2022-01-07 | |
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W., Abernethy, A. P., Somers, T. J. (2017). Optimizing delivery of a behavioral pain intervention in cancer patients using a sequential multiple assignment randomized trial SMART. Contemporary Clinical Trials, 57, 51-57. https://doi.org/10.1016/j.cct.2017.04.001 Kent, D. E., Kinney, B. M. (2021). The effect of high-intensity focused electromagnetic procedure on visceral adipose tissue: Retrospective assessment of computed tomography scans. Journal of Cosmetic Dermatology, 20(3), 757-762. https://doi.org/https://doi.org/10.1111/jocd.13952 Khan, S., Chan, Y. T., Revelo, X. S., Winer, D. A. (2020). The immune landscape of visceral adipose tissue during obesity and aging. Frontiers in Endocrinology, 11(267). https://doi.org/10.3389/fendo.2020.00267 Kouli, G. M., Panagiotakos, D. B., Kyrou, I., Georgousopoulou, E. N., Chrysohoou, C., Tsigos, C., Tousoulis, D., Pitsavos, C. (2017). Visceral adiposity index and 10-year cardiovascular disease incidence: The ATTICA study. Nutrition, Metabolism and Cardiovascular Diseases, 27(10), 881-889. https://doi.org/https://doi.org/10.1016/j.numecd.2017.06.015 Ku, Y. H., Han, K. A., Ahn, H., Kwon, H., Koo, B. K., Kim, H. C., Min, K. W. (2010). Resistance exercise did not alter intramuscular adipose tissue but reduced retinol-binding protein-4 concentration in individuals with type 2 diabetes mellitus. The Journal of Intertional Medical Research, 38(3), 782-791. https://doi.org/10.1177/147323001003800305 Kujawski, S., Kujawska, A., Gajos, M., Klawe, J. J., Tafil-Klawe, M., Madra-Gackowska, K., Stankiewicz, B., Newton, J. L., Kedziora-Kornatowska, K., Zalewski, P. (2018). Effects of 3-months sitting callisthenic balance and resistance exercise on aerobic capacity, aortic stiffness and body composition in healthy older participants. Randomized Controlled Trial. Experimental Gerontology, 108, 125-130. https://doi.org/10.1016/j.exger.2018.04.009 Kuo, C.-H., Harris, M. B. (2016). Abdominal fat reducing outcome of exercise training: fat burning or hydrocarbon source redistribution? Canadian Journal of Physiology and Pharmacology, 94(7), 695-698. https://doi.org/10.1139/cjpp-2015-0425 López-Hernández, L., Pérez-Ros, P., Fargueta, M., Elvira, L., López-Soler, J., Pablos, A. (2020). Identifying predictors of the visceral fat index in the obese and overweight population to manage obesity: A randomized intervention study. Obesity Facts, 13(3), 403-414. https://doi.org/10.1159/000507960 Ladeiras-Lopes, R., Sampaio, F., Bettencourt, N., Fontes-Carvalho, R., Ferreira, N., Leite-Moreira, A., Gama, V. (2017). The ratio between visceral and subcutaneous abdominal fat assessed by computed tomography is an independent predictor of mortality and cardiac events. Revista Española de Cardiología, 70(5), 331-337. https://doi.org/10.1016/j.rec.2016.09.010 Lakka, H.-M., Lakka, T. A., Tuomilehto, J., Sivenius, J., Salonen, J. T. (2000). Hyperinsulinemia and the risk of cardiovascular death and acute coronary and cerebrovascular events in men: The kuopio ischaemic heart disease risk factor study. Archives of Internal Medicine, 160(8), 1160-1168. https://doi.org/10.1001/archinte.160.8.1160 Lambert, J. E., Parks, E. J. (2012). Postprandial metabolism of meal triglyceride in humans. Biochimica et biophysica acta, 1821(5), 721-726. https://doi.org/10.1016/j.bbalip.2012.01.006 Lashkardoost, H., Hoseyni, F., Rabbani, E., Moqadam, F., Hosseini, L., Azizi, S., Hamedi, A. (2019). Hypertension and its relation with waist to hip ratio in women referred to bojnurd urban health centers in 2014. The Open Hypertension Journal, 11, 1-5. https://doi.org/10.2174/1876526201911010001 Lee, A. S., Johnson, N. A., McGill, M. J., Overland, J., Luo, C., Baker, C. J., Martinez-Huenchullan, S., Wong, J., Flack, J. R., Twigg, S. M. (2020). Effect of high-intensity interval training on glycemic control in adults with type 1 diabetes and overweight or obesity: A randomized controlled trial with partial crossover. Diabetes Care, 43(9), 2281-2288. https://doi.org/10.2337/dc20-0342 Lee, D. H., Park, K. S., Ahn, S., Ku, E. J., Jung, K. Y., Kim, Y. J., Kim, K. M., Moon, J. H., Choi, S. H., Park, K. S., Jang, H. C., Lim, S. (2015). Comparison of abdominal visceral adipose tissue area measured by computed tomography with that estimated by bioelectrical impedance analysis method in Korean subjects. Nutrients, 7(12), 10513-10524. https://doi.org/https://doi.org/10.3390/nu7125548 Lei, H., Nahum-Shani, I., Lynch, K., Oslin, D., Murphy, S. A. (2012). A 'SMART' desi……… | |
| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/81712 | - |
| dc.description.abstract | "背景：內臟脂肪堆積與肥胖有高度相關且會導致高血壓、心血管疾病及胰島素阻抗，根據文獻可知藉由運動可以有效改善。然而，目前最佳降低內臟脂肪的運動策略仍無一致的共識。 目的：本研究主要的目的為發展與測試針對肥胖的社區民眾有效降低內臟脂肪的運動種類和處方內的運動次序。研究目標包含確認最佳降低內臟脂肪的運動策略，以及探討降低內臟脂肪的重要因素。 方法：以立意取樣招募台灣南部40至64歲、無飲食熱量限制之男性體脂超過25%及女性體脂超過30%的社區居民。以序貫多重隨機試驗方法(sequential multiple assignment randomized trial, SMART)進行為期共16週、二階段各8週的運動介入。受試者於第一階段接受隨機分配至每週3次(含兩次監督下的運動和一次在家運動)、為期8週的30分鐘至少中強度有氧運動組或20分鐘間歇運動組。以身體組成分析儀進行測量，若其內臟脂肪比起受試前未降低大於3%，則於第二階段1:1隨機分配至中強度有氧運動合併額外的10分鐘抗阻力運動組或交換進入第一階段另一組的治療組(高強度間歇運動或有氧運動)。若受試者於第一階段介入後內臟脂防降低大於3%，則持續維持第一階段的運動直至16週。內臟脂肪測量的時間點包含研究介入前(T0)、第一階段結束後(T1)及第二階段結束後(T2)。所收集的資料以廣義估計式(Generalized estimating equations) 和羅吉斯迴歸 (logistic regression) 分析最佳降低內臟脂肪的運動種類及探討預測第一階段內臟脂肪降低的重要因素。 研究結果：本研究共招募116位個案並接受第一階段的隨機分派至有氧運動組(58位)及高強度間歇運動組(58位)。共有53位個案完成第一階段的有氧運動，其中34人有氧運動在第一階段結束後內臟脂肪下降3%以上，故第二階段持續有氧運動直至16週結束(組別A)；無明顯效果者則接受第二次的隨機分派至有氧合併抗阻力運動組(9位，組別B)或高強度間歇運動組(10位，組別C)。共有54位個案在第一階段完成高強度間歇運動，其中29人內臟脂肪下降3%以上，故第二階段持續高強度間歇運動直至16週結束(組別D)；無明顯反應者則接受第二次的隨機分派至有氧合併抗阻力運動組(14位，組別E)或有氧運動組(11位，組別F)。研究整體的流失率為12.93%，包含9位在第一階段和6位在第二階段過程中退出。各組個案對於運動的遵從性為68.18%至80.15%。第一階段8週後的運動結果顯示，有氧運動降低內臟脂肪的效果優於高強度間歇運動(β = −4.10, P = 0.029)。針對第一階段對有氧運動無明顯效果者，組別C的內臟脂肪下降成效在第二階段優於組別B (β = -7.36, P = 0.006)；針對第一階段對高強度間歇運動無明顯效果者，第二階段中組別E和組別F降內臟脂肪則無明顯差異。為期二階段16週最佳的運動策略，組別A和組別D兩組無統計上差異，並且在第一和第二階段皆優於其他四組。羅吉斯迴歸結果顯示接受有氧運動的個案在運動介入前內臟脂肪≧100 cm2者，比起內臟脂肪< 100 cm2有較高的勝算比(OR = 8.80, p = 0.019)、以及三酸甘油脂 <150 mg/dl者，比起三酸甘油脂 ≧150 mg/dl者有較高的勝算比(OR = 0.10, p = 0.007)在第一階段後內臟脂肪降低3%以上。 結論：結果顯示中年肥胖社區居民(男性體脂≧25%、女性體脂≧30%)進行每週三次，每次30分鐘至少中等強度的有氧運動或高強度間歇運動20分鐘，在平均運動遵從性75%，有氧運動是短期8週降內臟脂肪較佳的運動種類。若居民對於第一階段的有氧運動無明顯效果，則第二階段進行高強度間歇運動的效果優於有氧合併抗阻力運動。針對為期二階段16週最佳的運動策略，二階段維持相同的有氧運動或高強度間歇運動的效果，比起16週中曾有變更運動種類的效果較佳。居民於運動介入前內臟脂肪≧100 cm2及三酸甘油脂<150 mg/dl是顯著影響8週有氧運動是否降低內臟脂肪的重要因素。 臨床應用：健康專業人員針對中年肥胖社區居民設計降內臟脂肪的運動處方，短期8週的處方可設計每周三次、每次30分鐘的至少中強度有氧運動；若拉長至16週的處方，除持續執行有氧運動外，20分鐘的高強度間歇亦為有效降內臟脂肪的運動策略。研究結果可供健康政策決策者制定運動指引之參考。" | zh_TW |
| dc.description.provenance | Made available in DSpace on 2022-11-24T09:26:07Z (GMT). No. of bitstreams: 1 U0001-0601202216383800.pdf: 3758696 bytes, checksum: 0582e901d0762b44a1adac76b62646cc (MD5) Previous issue date: 2022 | en |
| dc.description.tableofcontents | "論文口試委員審定書…………………………………………………………………….. i Acknowledgement……………………………………………………………………….... ii Chinese Abstract…………………………………………………………………………... iii English Abstract…………………………………………………………………………... v Abbreviations……………………………………………………………………...…….... viii Chapter 1 Introduction 1 1.1 Background……………………………………………………………………….... 1 1.2 Research Purposes………………………………………………………………….. 4 Chapter 2 Literature Review 5 2.1 Role of VAT………………………………………………………………………… 5 2.2 Associations Among VAT, Obesity, and Metabolic Syndrome…………………….. 7 2.3 Effects of Exercise Modality on VAT Reduction……………….............................. 10 2.4 Studies on the Required Exercise Dose to Reduce VAT…………………………… 12 2.5 Key Factors Influencing the Effects of Exercise Interventions…………………….. 13 2.6 Common Anthropometric and Biological Parameters Influenced by Exercise……. 14 2.7 Studies on the Use of the SMART Design With Adaptive Interventions …………. 19 Chapter 3 Methods 20 3.1 Research Framework……………………………………………………………….. 20 3.2 Study Design……………………………………………………………………….. 21 3.3 Definitions………………………………………………………………………….. 25 3.4 Participants…………………………………………………………………………. 27 3.5 Data Collection and Procedure……………………………………………………... 28 3.6 Setting……………………………………………………………………………..... 30 3.7 Intervener…………………………………………………………………………... 31 3.8 Intervention………………………………………………………………………… 32 3.9 Measures……………………………………………………………………………. 35 3.10 Main Outcome Indicator………………………………………………………….. 40 3.11 Data Analysis……………………………………………………………………… 41 3.12 Ethical Considerations…………………………………………………………….. 44 Chapter 4 Results 45 4.1 Demographic and Clinical Characteristics at Baseline…………………….............. 45 4.2 Adherence to Exercise Sessions and Diet Diary Record…………………………… 51 4.3 Optimal Exercise Modality for the First 8-Week Stage……………………………. 54 4.4 Optimal Exercise Modality for First-Stage Nonresponders………........................... 62 4.5 Optimal Sequence of Exercise Regimes Among Those Regimes Embedded in the SMART……………………………………………………………………………... 69 4.6 Baseline Demographic Characteristics and Clinical Data for the Prediction of VAT Reduction During the First 8 Weeks of Exercise………………………….…........... 89 Chapter 5 Discussion 94 5.1 Attrition Rate and Adherence to Exercise Interventions…..……………………….. 96 5.2 Optimal Exercise Modality for VAT Reduction During the First 8 Weeks…............ 97 5.3 Optimal Alternative Exercise Modality for Reducing VAT in First-Stage Nonresponders……………………………………………………………………….. 100 5.4 Optimal Sequence of Exercise Regimes for VAT Reduction………………………. 102 5.5 Baseline Factors for Predicting VAT Reduction After the First Stage……………... 104 5.6 Study Limitations…………………………………………………………………... 106 5.7 Clinical Implications……………………………………………………………….. 108 Chapter 6 Conclusion 110 References 111 Appendix 146 Appendix 1: Approval of Research Ethics ……………………….................................. 146" | |
| dc.language.iso | en | |
| dc.subject | 內臟脂肪 | zh_TW |
| dc.subject | 高強度間歇運動 | zh_TW |
| dc.subject | 序貫多重隨機試驗方法 | zh_TW |
| dc.subject | 有氧運動 | zh_TW |
| dc.subject | 運動 | zh_TW |
| dc.subject | 抗阻力運動 | zh_TW |
| dc.subject | visceral adipose tissue | en |
| dc.subject | resistance exercise | en |
| dc.subject | high-intensity interval training | en |
| dc.subject | aerobic exercise | en |
| dc.subject | sequential multiple assignment randomized trial | en |
| dc.subject | exercise | en |
| dc.title | 發展與測試運用SMART設計運動介入對降低肥胖社區居民內臟脂肪之成效 | zh_TW |
| dc.title | Developing and Testing the Effect of Exercise Intervention Using a SMART Design on Reducing Visceral Adipose Tissue in Community Residents with Obesity | en |
| dc.date.schoolyear | 110-1 | |
| dc.description.degree | 博士 | |
| dc.contributor.oralexamcommittee | 吳芎歷(Hsin-Tsai Liu),李芸湘(Chih-Yang Tseng),洪弘,徐瑋勵 | |
| dc.subject.keyword | 內臟脂肪,運動,序貫多重隨機試驗方法,有氧運動,高強度間歇運動,抗阻力運動, | zh_TW |
| dc.subject.keyword | visceral adipose tissue,exercise,sequential multiple assignment randomized trial,aerobic exercise,high-intensity interval training,resistance exercise, | en |
| dc.relation.page | 147 | |
| dc.identifier.doi | 10.6342/NTU202200020 | |
| dc.rights.note | 未授權 | |
| dc.date.accepted | 2022-01-10 | |
| dc.contributor.author-college | 醫學院 | zh_TW |
| dc.contributor.author-dept | 護理學研究所 | zh_TW |
| Appears in Collections: | 護理學系所 | |
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| U0001-0601202216383800.pdf Restricted Access | 3.67 MB | Adobe PDF |
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