| 摘要: | 論 文 摘 要
論文名稱：探討老化對於動作功能數據的影響
學位學程名稱：臺北醫學大學長期照護碩士學位學程
研究生姓名：李郁宣
畢業時間：112 學年度 第一學期
指導教授：林玨赫 臺北醫學大學國際高齡健康暨長期照護博士學位學程
副教授
研究背景：台灣已於2018年成為高齡社會，老年人口超過聯合國定義總人口比率14％，預估2025年進入超高齡社會。老化除了造成高齡者肌肉無力、平衡下降，也可能會導致跌倒，失能或日常功能動作衰退。目前用於評估長者功能損傷之量表包括日常生活功能量表activities of daily living(ADL)，巴氏量表Barthel Index。然而，這些量表較主觀且以評分為判斷，難以用於精準辨識長者因老化導致功能變化。因此，藉由動作功能執行的運動學數據量測，可能有助於長者因老化所造成的功能變化。
目的：探討老化對於動作功能數據的影響。
方法：本研究為橫斷性研究，本研究招募50位社區65歲以上健康老年人及50位20歲至64歲年輕人共100位。以慣性感測單元Inertial Measurement Units (IMUs)量測臨床功能量表(ADL, Barthel Index)內之動作功能運動學數值，包含時間，角度與穩定值。使用無母數檢定分析老年人及年輕人於動作功能之運動表現差異。統計軟體為SPSS 18版本，研究檢定以p<0.05達顯著差異。
結果：相較年輕人，老年人拿到水杯的整體時間（p=0.014）、拿到水杯的動作百分比（p=0.005）更多。手指對鼻測試使用慣用手指鼻來回平均時間（p<0.001）、非慣用手指鼻來回平均時間（p=0.01）更長。穿衣時右肩膀最大內轉角度（p=0.01）更大。轉位階段中左髖關節（p=0.003）與右髖關節（p=0.003）屈曲平均角度更小、左膝關節（p=0.003）與右膝關節（p=0.003）屈曲平均角度更小，髖關節穩定度較差。快速起身至站穩，左髖關節屈曲更僵硬（p=0.018）。30秒椅子坐立每次坐姿左髖關節（p=0.004）、左膝關節（p<0.001）屈曲平均角度與右髖關節（p=0.001）、右膝關節（p<0.001）屈曲平均角度更小。前後腳站立之右腳在前，右膝屈曲平均角度（p=0.006）、右髖（p=0.016）屈曲標準差。右腳前之前後腳站立發現此表顯示右膝屈曲平均角度（p=0.006）、右髖屈曲CV（p=0.016）更大更不穩定。左腳前之前後腳站立髖內轉平均角度（p=0.013）較小。右腳單腳站，站立腳屈曲平均角度（p=0.048）較大。左腳單腳站，站立腳屈曲平均角度（p=0.048）較小。十公尺行走，軀幹穩定度（p=0.019）僵硬、左膝屈曲平均角度（p=0.046）與右髖屈曲平均角度（p<0.001）較小。上樓梯第二步踩階之膝蓋屈曲角度（p=0.002）與第三步踩階之膝蓋屈曲角度（p=0.006）較小。
結論：老化對於老年人日常動作功能活動造成多種影響，伸手取物的移動速度更慢，穿衣上肢肩膀內轉更大，使用坐到站動作的活動軀幹和髖關節活動度受到更多限制，單腳站膝關節角度變化更大，而在量表評估測試分數中難以看出這些變化。
關鍵字：高齡者、慣性測量單元、日常生活活動
Abstract
Title of Thesis: The Impact of Aging on Motor Function Data
Institution: Master Program in Long-Term Care, Taipei Medical University
Author: Yu-Shuan Lee
Thesis directed by: Associate Professor, Chueh-Ho Lin
Research background: Taiwan has become an elderly society in 2018. The elderly population exceeds 14% of the total population ratio defined by the United Nations. It is expected to enter a super-aged society in 2025. In addition to causing muscle weakness and decreased balance in the elderly, aging may also lead to falls, disability, or decline in daily functional movements. Scales currently used to assess functional impairment in the elderly include activities of daily living (ADL) and Barthel Index. However, these scales are subjective and based on scores, making it difficult to accurately identify functional changes in the elderly due to aging. Therefore, the measurement of kinematic data performed through motor functions may be helpful for the functional changes caused by aging in the elderly.
Purpose: The impact of aging on motor function data.
Methods: This study is a cross-sectional study. This study recruited 50 healthy elderly people aged over 65 years old and 50 young people aged 20 to 64 years old in the community, a total of 100 people. Inertial Measurement Units (IMUs) are used to measure the movement function kinematic values in the Clinical Function Scale (ADL, Barthel Index), including time, angle and stability values. Use the parentless test to analyze the difference in motor performance between the elderly and young people in motor functions. The statistical software was SPSS version 18, and the research test used p<0.05 to achieve significant differences.
Results: Compared with young people, older people took more time to get the water cup (p=0.014) and the percentage of actions to get the water cup (p=0.005). In the finger-to-nose test, the average nose-to-nose time with the dominant finger (p<0.001) and the average nose-to-nose time with the non-dominant finger (p=0.01) were longer. The maximum internal rotation angle of the right shoulder (p=0.01) was greater when dressing. In the transposition stage, the average flexion angles of the left hip joint (p=0.003) and right hip joint (p=0.003) were smaller, and the average flexion angles of the left knee joint (p=0.003) and right knee joint (p=0.003) were smaller. Hip joint stability is poor. The average flexion angles of the left hip joint (p=0.004) and left knee joint (p<0.001) during each sitting position in 30 seconds of chair sitting were more significant than the average flexion angles of the right hip joint (p=0.001) and right knee joint (p<0.001). Small. Standing with the right foot in front, the average right knee flexion angle (p=0.006) and the right hip (p=0.016) standard deviation. When standing with the right foot forward and backward, it was found that this table shows that the average right knee flexion angle (p=0.006) and right hip flexion CV (p=0.016) are larger and more unstable. When standing on one foot with the right foot, the average angle of standing foot flexion (p=0.048) was larger. When walking ten meters, the trunk stability (p= 0.019) is stiff, and the average left knee flexion angle (p=0.046) and right hip flexion angle (p<0.001) are smaller. The knee flexion angle of the second step up the stairs (p=0.002) and the knee flexion angle of the third step (p=0.006) were smaller.
Conclusion: Aging has a variety of effects on the daily functional activities of the elderly. The movement speed of reaching for objects is slower, the shoulder rotation of the upper limbs when dressing is greater, the mobility of the trunk and hip joints using sit-to-stand movements is more restricted, and the mobility of the trunk and hip joints is more limited. Knee angle changes were greater during foot stance, and these changes were difficult to detect in scale assessment test scores.
Keywords: Elderly, Inertial Measurement Units, Activities of Daily Living |
