| Abstract: | 研究指出規律運動不僅可以改善肌肉骨骼系統之關節活動度與柔軟度，帶來身體上的敏捷性，並提升心肺功能，增加全身的氧供給量，亦能改善新陳代謝率。對於年長者而言，運動效能可增進負擔日常生活的肢體的工作能力。目前用來評估運動能力的健康指標主要為全身性的生理監測，相對的，本研究欲使用非侵入式雷射都卜勒血流計搭配近紅外光譜儀量測局部組織含氧量和體表血流量，以局部循環生理的資訊作為運動效能的判斷依據。本研究藉由踝關節拉伸運動實驗與銀髮族下肢輕運動實驗兩個臨床試驗進行評估。在踝關節運動對小腿微循環血流量實驗中，觀察10名22至23歲的男大學生在主動式踝關節運動前後的血流量與肌肉含氧飽和度的變化，藉此分析運動的成效。以訊號分析程式計算獲得的生理參數值包含平均血流訊號(MMBF)、脈動血流訊號(PMBF)及血流脈動比率(PP)與組織氧飽和指數(TSI)，說明拉伸運動的影響。結果發現，相較於主動式踝關節運動前(M0)，在運動後(M2)使用高功率與低功率測得之MMBF皆有顯著下降，而TSI參數則為顯著上升(P=0.003)。在輕運動對銀髮族下肢功能評估實驗中，招募17名年齡平均值在78.3歲健康的老年人，9名運動組參與為期6週搭配芙瑞公司的輕運動器材進行的下肢阻力運動的訓練計劃，其餘8名為控制組。在第0週與第7週分別量測股四頭肌部位的肌肉氧飽和度(SmO2)經過15分鐘運動負荷的變化。結果顯示在第0週時，運動組與對照組在經過15分鐘運動負荷後SmO2無顯著差異，經過6週運動計畫後，運動組在15分鐘運動負荷下SmO2仍無明顯改變，但對於對照組而言，15分鐘運動負荷造成SmO2顯著的下降(P=0.02)。6週的運動課程前(第0週)與後(第7週)的環境溫度分別為25.8 ℃和19.9 ℃，有顯著性的下降。經由本研究得知，透過在輕運動前後生理參數相對的變化量，可證實低強度下肢運動的介入對於不同年齡層的下肢微循環有促進的成效，組織含氧飽和度和體表血流量兩項微循環生理參數可當作下肢部位氧氣供給及血液滯留嚴重程度的早期評估指標。
Research indicates that regular exercise can not only improve the range of motion and flexibility of the musculoskeletal system, bring physical agility, improve heart and lung functions, and increase the oxygen supply to the body, but can also improve the metabolism rate. For the elderly, exercise can enhance the effectiveness to burden daily physical abilities. Currently used health indicators for evaluating exercise capacity are mainly for physiological monitoring systems. In contrast, this study intends to use a non-invasive laser Doppler flowmetry with near-infrared spectroscopy for measuring local tissue oxygen and body-surface blood flow and judging the effectiveness of exercise with the local loop physiological information.The evaluation in this study is preceded through two clinical experiments of ankle stretching exercise and seniors’ lower extremity light exercise. In the experiment of ankle exercise to the calf microcirculation blood flow, the blood flow before and after the active ankle exercise and the changes of muscle oxygen-saturation of 10 male college students, aged 22-23, are observed, thereby to analyze the effectiveness of the exercise. The impact of stretching exercise are explained with the physiological parameters calculated by signal analysis programs including mean flow signal (MMBF), pulsating blood flow signal (PMBF), blood flow pulsation ratio (PP) and tissue oxygen saturation index (TSI). The results show that MMBF of active ankle motion measured with high power and low power drops significantly after exercise (M2), compared to it before exercise (M0), while the TSI parameters significantly increases (P=0.003). For the evaluation experiments in the light exercise for seniors’ lower extremity functions, 17 healthy elders with the average age of 78.3 are recruited, including 9 of them in the exercise group involving in a six-week training program of lower extremity intensity-resistance exercise with the light exercise facilities of Floriey Industry International Co., Ltd. and the remaining 8 in the control group. The changes of quadriceps muscles oxygen saturation (SmO2) after 15 minutes of exercise load are measured at Week 0 and Week 7. The results show that both groups do not reveal significant difference in SmO2 at week 0, however, the 15 minutes of exercise cause significant decrease of SmO2 (P=0.02) for the control group after the 6 week program, but not for the exercise group. The ambient temperature before (week 0) and after (Week 7) the six week exercise classes appears significant decrease from 25.8 ℃ to 19.9 ℃.Through this study, the relative changes of physiology parameters before and after the light exercise prove that low-intensity low extremity exercise intervention could promote the lower limb microcirculation at different ages. The microcirculation physiological parameters of tissue oxygen saturation and body-surface blood flow can be regarded as the early evaluation indicators of oxygen supply and blood retention for lower limbs. |
