背景：我國老年人口快速增長，老人因身體功能退化加上慢性病的影響，很容易發生失能。?能有效維持老人的獨立性，健康照顧提供者若能針對初期發生衰退者給予有效的早期介入是非常重要的。主要目的：在於驗證一個針對社區中已發生衰弱或輕到中度失能之老年長輩的早期介入計劃的療效及長期追蹤療效。特定目的：第一部份(基線期)：(1)建立所有參與者的身體功能及健康狀況於基線的穩定度及表現、(2)找出與可預測失能的功能表現顯著相關的因子(肌群、平衡、耐力等)以作為規劃介入計畫之參考；第二部分(介入期)：(1)評估社區中老年人早期介入計劃之療效並報告能經由介入而恢復獨立者(reversible)及不能恢復者(irreversible)之特徵；第三部分 (追蹤期)：(1)追蹤此介入計畫的長期療效(detraining effect)、(2)報告基線評估時為無失能且無衰弱老人的兩年間變化情況。受試者：120 位居住於台中市南區社區中的老年(65 歲以上)長輩。必需能聽懂並遵行研究人員指令、能配合執行研究規劃的測試。排除：具不穩定的高血壓或急性心臟梗塞病史、嚴重神經肌肉或呼吸循環疾史、惡性腫瘤、或醫師囑咐應小心限制運動或活動者。步驟：首先針對所有參予者進行基線評估，每六週再評估一次，共4 次。然後，根據基線評估結果將參予者分為：無失能且無衰弱者(無需參與介入計畫，僅接受持續的再評估，n=60)及有失能或有衰弱者(需參與介入計畫，每週二次，持續三個月，n=60)。介入計畫完成後進行一年的追蹤，評估長期的療效。施測者：一位不知受測者介入組別的研究人員擔任。統計分析：以repeated measurement statistical method 分析，有顯著者再做事後分析比較時間及組別的影響。
Background: Older adults are growing fast in Taiwan. Due to the combined effects of physical function decline from aging and comorbidity, older adults are prone to develop physical disability. In order for the health care provider to be able to effectively maintain older adults’independence, an effective early intervention program is very needed. Purpose: To examine the effectiveness of an early intervention program for physical frailty & disability prevention in community-dwelling older adults in Taichung. Specific aims: (1) to establish older adults’baseline performances & long term stability and to identify the physical impairments that significantly associated with the physical functions that could predict future development of disability for intervention plan design; (2) to examine the effectiveness of an early intervention program; (3) to examine the detraining effect of an intervention program. Participants: 120 older adults age at least 65 years old, living in the community with family or alone. Inclusion criteria are (1) able to understand and follow simple commands and (2) able to perform the tests in this study. Exclusion criteria are (1) older adults with unstable high blood pressure or unstable heard disease, (2) cancer, (3) severe neuromuscular or respiratory/circulatory diseases or disorders, (4) need to limit exercise or physical activity participation from physicians. Procedure: This is a two-year prospective follow up study. Firstly, we will finish baseline assessment for participants and re-assessment every 6 weeks to establish the stability of their performance and health status, as well as to finish individualized exercise plan to be administered. Secondly, we will implement the intervention twice weekly for 3 months and re-assess at the end of the second and third month of intervention. Finally, we will follow up the detraining effect of this intervention program every two to three months for a year. Tester: A research assistant who is blinded to the participants’intervention group membership will perform all the tests and re-assessments. Data analysis: Data will be analyzed by repeated measurement statistical method.
