呼吸訓練運動介入對社區年長者肺功能與生活品質之成效

背景：老年人口逐漸上升，對於年齡老化容易會導致系統性問題，例如肌肉減少症、免疫力下降、虛弱程度增加、及肺功能下降。先前研究指出透過呼吸肌運動訓練能夠有效改善呼氣肌力量、吸氣肌耐力、及肺活量，進而提升或維持年長者身體活動及生活品質。目的：本研究旨在比較社區年長者執行腹部橫膈呼吸法結合誘發性肺計量器與一般社區中心所教導的腹部橫膈呼吸法之呼吸訓練的肺功能與生活品質的成效。方法：採類實驗研究設計，於中區某社區民眾年齡大於65歲長者為收案對象，以隨機分派實驗組與對照組，實驗組接受腹部橫膈呼吸法結合誘發性肺計量器之呼吸訓練介入，對照組則一般社區中心所教導的腹部橫膈呼吸法之呼吸訓練。研究中使用四項評估工具，包含人口學變項、呼吸功能指標 (肺活量、用力肺活量、用力呼氣1秒量、最大自動換氣)、呼吸困難量表、與生活品質量表。採用獨立樣本t檢定、配對t檢定、及重複測量分析進行資料分析。所有資料分析使用SPSS 22.0版執行。結果：共納入 154 位研究參與者(實驗組 77 位，對照組 77 位)，結果發現所有參與者肺功能與性別、疾病史有顯著差異，亦即。實驗組與對照組接受介入後，兩組在肺功能指標(肺活量、用力肺活量、用力呼氣1秒量、最大自動換氣)都有顯著提升，而呼吸困難亦有顯著下降。生活品質方面，實驗組於介入後有顯著提升，而對照組生活品質得分有上升，但未達顯著差異。進一步分析兩組介入後的比較，在肺功能的指標與生活品質均無顯著差異，而呼吸困難有顯著差異。結論：兩種呼吸衛教介入，均可提升肺功能與生活品質，並降低呼吸困難的感受，因此對年長者推動呼吸訓練方式是可行的。

Background: The elderly population is gradually increasing, and aging can easily lead to systemic problems, such as sarcopenia, decreased immunity, increased frailty, and decreased lung function. Previous studies have shown that respiratory muscle exercise training can effectively improve expiratory muscle strength, inspiratory muscle endurance, and vital capacity, thereby improving or maintaining the physical activity and quality of life (QOL) of elderly individuals.Objective: This study aimed to compare the effectiveness of respiratory training in diaphragmatic breathing (DB) combined with induced spirometry and DB taught at general community centers on lung function and QOL among community-dwelling elderly individuals.Methods: Adopting an experimental research design, community-dwelling elderly individuals aged > 65 years in the Central District were selected as participants, and the experimental and control groups were randomly assigned. Patients in the experimental group underwent DB combined with spirometry. The control group received DB training at general community centers. This study used four assessment tools; demographic variables, lung function indicators (vital capacity, forced vital capacity, forced expiratory volume in 1 s, and maximum automatic ventilation), dyspnea scale, and QOL scale. Data analysis was performed using independent samples t-test, paired t-test, and repeated-measures analysis. All data analyses were performed using SPSS version 22.0.Results: A total of 154 participants were included (77 in each of the experimental and control groups). There were significant differences in lung function, sex, and disease history among all participants. After the experimental and control groups received the intervention, the lung function indicators of both groups significantly improved, and dyspnea significantly reduced. Regarding the QOL, the experimental group improved significantly after the intervention, whereas that of the control group increased; however, there was no significant difference. Further analysis of the comparison between both groups after the intervention showed no significant difference in lung function indicators and QOL, but there was a significant difference in dyspnea.Conclusion: Respiratory health education interventions can improve lung function and QOL and reduce the feeling of dyspnea. Therefore, it is feasible to promote breathing training methods for elderly individuals.