本研究先是了解血液循環與肌肉運動之間的關係，更深入了解特定細胞之間的代謝功能，預防可能導致的種種慢性病。為了幫助中老年者改善血液循環、預防血管硬化與促進血糖控制，本研究使用自主之阻力運動來幫助中老年人增加自身肌肉纖維，改善身體血液循環與代謝功能，並且協助血液中的血糖控制。接著能夠改善身體機能，降低慢性病形成的病因，預防老年慢性病纏身。
本研究設計一套專門給下肢的互動式運動輔助遊戲裝置，結合運動與體感遊戲，增加使用者對於運動訓練的興趣。裝置的部分使用三軸感應器以及藍芽的傳輸進行遊戲判定，配合螢幕遊戲來進行阻力訓練。
訓練肌肉可以將血糖轉化進入肌肉中成為能量，增加GLUT4轉運蛋白的運作，達到血糖控制的效果。肌肉的運動也會促進全身的血液循環，燃燒多餘熱量，預防內皮細胞功能障礙所造成的動脈粥狀硬化，減少血管與身體內的脂質，避免中風與組織壞死。運動部位以下肢肌肉為主，目的是為了預防老年失能。運動的訓練部位有股四頭肌和臀大肌，這些肌肉的訓練可以強化身體的支撐與走路功能，防止老化造成的肌少症問題。
研究結果證明本研究裝置對於血糖的平均值有些微下降但是沒有顯著結果，推測是因為年紀對胰島素的敏感度有所影響。但是對於脈搏和血流速度的提升都呈現顯著結果。

In this study, we analyzed the relationship between blood circulation and muscle movement, and then gained a deeper understanding of the metabolic functions between cells. Because of the modern people's high oil, high salt and high sugar diet, this study aims to prevent possible chronic diseases. To help middle-aged and elderly people improve blood circulation, prevent vascular sclerosis and promote glycemic control, this study uses autonomous resistance exercises to help middle-aged and older people increase their muscle fibers, improve blood circulation and metabolism, and assist in blood sugar control. Then improve the body function, reduce the cause of chronic disease formation, and prevent chronic diseases in the elderly.
In this study, an interactive sports game dedicated to the lower limbs was designed to combine the sports and somatosensory games to increase the user's interest in sports training.
Training muscle can transform blood sugar into muscle and become energy, increase the operation of GLUT4 transporter, and achieve blood sugar control. Muscle movement also promotes blood circulation throughout the body, burns excess heat, prevents atherosclerosis caused by endothelial cell dysfunction, reduces blood vessel lipids, and avoids stroke and tissue necrosis. The movement of the lower limb muscles is mainly for the purpose of preventing disability in the elderly. The training part of the exercise is the quadriceps and gluteus maximus, strengthening the support and walking functions of the body, and preventing the problem of muscle deficiency caused by aging.
The device can help control blood sugar, reduce the risk of diabetes and stroke, and enhance the muscle strength of the lower limbs, help prevent the reduction of muscle strength caused by aging, and ultimately achieve health control and successful aging.

Avin, K. G., Hanke, T. A., Kirk-Sanchez, N., McDonough, C. M., Shubert, T. E., Hardage, J., & Hartley, G. (2015). Management of falls in community-dwelling older adults: clinical guidance statement from the Academy of Geriatric Physical Therapy of the American Physical Therapy Association. Physical therapy, 95(6), 815-834.
Beckman, J. A., Creager, M. A., & Libby, P. (2002). Diabetes and atherosclerosis: epidemiology, pathophysiology, and management. Jama, 287(19), 2570-2581.
Bieryla, K. A., & Dold, N. M. (2013). Feasibility of Wii Fit training to improve clinical measures of balance in older adults. Clinical interventions in aging, 8, 775.
Bonnechère, B., Van Vooren, M., Jansen, B., Van Sint, J. S., Rahmoun, M., & Fourtassi, M. (2017). Patients' Acceptance of the Use of Serious Games in Physical Rehabilitation in Morocco. Games for health journal, 6(5), 290-294.
Burnie, D. (2000). New Century Human Encyclopedia. Taibei Shi: Mao tou ying chu ban. (in Chinese)
Calver, A., Collier, J., & Vallance, P. (1992). Inhibition and stimulation of nitric oxide synthesis in the human forearm arterial bed of patients with insulin-dependent diabetes. The Journal of clinical investigation, 90(6), 2548-2554.
Carrizzo, A., Izzo, C., Oliveti, M., Alfano, A., Virtuoso, N., Capunzo, M., ... & Frati, G. (2018). The Main Determinants of Diabetes Mellitus Vascular Complications: Endothelial Dysfunction and Platelet Hyperaggregation. International journal of molecular sciences, 19(10), 2968.
Castaneda, C., Layne, J. E., Munoz-Orians, L., Gordon, P. L., Walsmith, J., Foldvari, M., ... & Nelson, M. E. (2002). A randomized controlled trial of resistance exercise training to improve glycemic control in older adults with type 2 diabetes. Diabetes care, 25(12), 2335-2341.
Cdc.gov. (2017). Nutrition, Physical Activity, and Obesity: Data, Trends and Maps | DNPAO | CDC. Available at: https://www.cdc.gov/nccdphp/dnpao/data-trends-maps/index.html
Chodzko-Zajko, W. (2014). ACSM's exercise for older adults. Upper Saddle River, NJ: Wolters Kluwer Lippincott Williams and Wilkins.
Chodzko-Zajko, W. J., Proctor, D. N., Singh, M. A. F., Minson, C. T., Nigg, C. R., Salem, G. J., & Skinner, J. S. (2009). Exercise and physical activity for older adults. Medicine & science in sports & exercise, 41(7), 1510-1530.
Cleland, J. (2007). Orthopaedic clinical examination. Philadelphia: Saunders/Elsevier.
Codella, R., Ialacqua, M., Terruzzi, I., & Luzi, L. (2018). May the force be with you: why resistance training is essential for subjects with type 2 diabetes mellitus without complications. Endocrine, 1-12. doi：10.1007 / s12020-018-1603-7
Coradi, C., Flumignan, C., Laks, R., Flumignan, R., Alvarenga, B., & Figueiredo, G. (2017). Atherosclerosis. Vascular Diseases For The Non-Specialist, 35-45. doi: 10.1007/978-3-319-46059-8_3
Crichton, N. (2001). Visual analogue scale (VAS). J Clin Nurs, 10(5), 706-6.
Daiber, A., Steven, S., Weber, A., Shuvaev, V. V., Muzykantov, V. R., Laher, I., ... & Münzel, T. (2017). Targeting vascular (endothelial) dysfunction. British journal of pharmacology, 174(12), 1591-1619.
Eskin, S. G., Ives, C. L., McIntire, L. V., & Navarro, L. T. (1984). Response of cultured endothelial cells to steady flow. Microvascular research, 28(1), 87-94.
Fang, J. (2015). Elderly’s exercise and health. (pp. 43-46，70-72). Farseeing Publishing Group (in Chinese)
Favaretto, F., Milan, G., Collin, G. B., Marshall, J. D., Stasi, F., Maffei, P., ... & Naggert, J. K. (2014). GLUT4 defects in adipose tissue are early signs of metabolic alterations in Alms1GT/GT, a mouse model for obesity and insulin resistance. PloS one, 9(10), e109540.
Ferrannini, E., Vichi, S., Beck-Nielsen, H., Laakso, M., Paolisso, L., Smith, G., & European Group for the Study of Insulin Resistance. (1996). Insulin action and age: European Group for the Study of Insulin Resistance (EGIR). Diabetes, 45(7), 947- 953.
García-Pinillos, F., Laredo-Aguilera, J. A., Muñoz-Jiménez, M., & Latorre-Román, P. A. (2019). Effects of 12-Week Concurrent High-Intensity Interval Strength and Endurance Training Program on Physical Performance in Healthy Older People. The Journal of Strength & Conditioning Research, 33(5), 1445-1452.
Gebel, C., Gurt, M., & Wagner, U. (2005). Kompetenzförderliche potenziale populärer Computerspiele. Arbeitsgemeinschaft BeTRIEBliche Weiterbildungsforschung, 241-376.
Ghesquiere, S. (2005). File:Anatomy artery.png - Wikimedia Commons. Retrieved 14 August 2019, from https://commons.wikimedia.org/wiki/File:Anatomy_artery.png
Greco, A. V., Mingrone, G., Giancaterini, A., Manco, M., Morroni, M., Cinti, S., ... & Ferrannini, E. (2002). Insulin resistance in morbid obesity: reversal with intramyocellular fat depletion. Diabetes, 51(1), 144-151.
Guo, Z. (2007). Intramyocellular lipid kinetics and insulin resistance. Lipids In Health And Disease, 6(1), 18. doi: 10.1186/1476-511x-6-18
He, J., & Kelley, D. E. (2004). Muscle glycogen content in type 2 diabetes mellitus. American Journal of Physiology-Endocrinology and Metabolism, 287(5), E1002-E1007.
Heo, J., Ryu, J., Yang, H., Kim, A. C. H., & Rhee, Y. (2018). Importance of playing pickleball for older adults’ subjective well-being: A serious leisure perspective. The Journal of Positive Psychology, 13(1), 67-77.
Holten, M. K., Zacho, M., Gaster, M., Juel, C., Wojtaszewski, J. F., & Dela, F. (2004). Strength training increases insulin-mediated glucose uptake, GLUT4 content, and insulin signaling in skeletal muscle in patients with type 2 diabetes. Diabetes, 53(2), 294-305.
Huang, S. (2006). Exercise prescription and curative effect of diabetes patients. Taibei Shi: Hong xin wen hua shi ye you xian gong si, pp.44，50-51，15-18. (in Chinese)
Insull Jr, W. (2009). The pathology of atherosclerosis: plaque development and plaque responses to medical treatment. The American journal of medicine, 122(1), S3-S14.
Interactive Digital Software Association. (2002). Essential facts about the computer and video game industry. Retrieved August, 16, 2006.
Isganaitis, E., & Lustig, R. H. (2005). Fast food, central nervous system insulin resistance, and obesity. Arteriosclerosis, thrombosis, and vascular biology, 25(12), 2451-2462.
Ishii, T., Yamakita, T., Sato, T., Tanaka, S., & Fujii, S. (1998). Resistance training improves insulin sensitivity in NIDDM subjects without altering maximal oxygen uptake. Diabetes care, 21(8), 1353-1355.
Jensen, T. E., Sylow, L., Rose, A. J., Madsen, A. B., Angin, Y., Maarbjerg, S. J., & Richter, E. A. (2014). Contraction-stimulated glucose transport in muscle is controlled by AMPK and mechanical stress but not sarcoplasmatic reticulum Ca2+ release. Molecular metabolism, 3(7), 742-753.
Joslin, E. P. (1930). Arteriosclerosis in diabetes. Annals of Internal Medicine, 4(1), 54-66.
Kinect. (2019). Retrieved 11 August 2019, from https://zh.wikipedia.org/wiki/Kinect
Kisner, C., & Colby, L. (2012). Therapeutic Exercise: Foundations and Techniques (6th ed.). FA Davis Company.
Kovatchev, B. P., Gonder-Frederick, L. A., Cox, D. J., & Clarke, W. L. (2004). Evaluating the accuracy of continuous glucose-monitoring sensors: continuous glucose–error grid analysis illustrated by TheraSense Freestyle Navigator data. Diabetes Care, 27(8), 1922-1928.
Kubota, T., Kubota, N., Kumagai, H., Yamaguchi, S., Kozono, H., Takahashi, T., ... & Kumagai, K. (2011). Impaired insulin signaling in endothelial cells reduces insulin-induced glucose uptake by skeletal muscle. Cell metabolism, 13(3), 294-307.
Laufs, U., Wassmann, S., Czech, T., Münzel, T., Eisenhauer, M., Böhm, M., & Nickenig, G. (2005). Physical inactivity increases oxidative stress, endothelial dysfunction, and atherosclerosis. Arteriosclerosis, thrombosis, and vascular biology, 25(4), 809-814.
Leyva, J. (2013). How Do Muscles Grow? The Science of Muscle Growth. BuiltLean. September, 17.
LI, Y., TANG, F., WANG, X., & YU, C. (2013). School of Electronics and Computer Science and Technology, North University of China; State Key Laboratory of Precision Measurement Technology and Instruments, Department of Precision Instrument, Tsinghua University;; Non-Invasive Glucose Measuring Apparatus of the DSP and Android Software System Design [J]. Chinese Journal of Sensors and Actuators, 10.
Linke, A., Schoene, N., Gielen, S., Hofer, J., Erbs, S., Schuler, G., & Hambrecht, R. (2001). Endothelial dysfunction in patients with chronic heart failure: systemic effects of lower-limb exercise training. Journal of the American college of cardiology, 37(2), 392-397.
Macaluso, A., & De Vito, G. (2004). Muscle strength, power and adaptations to resistance training in older people. European journal of applied physiology, 91(4), 450-472.
McMinn, R., & Last, R. (2009). Last's anatomy. Edinburgh: Churchill Livingstone.
Melmed, S., & Williams, R. (2011). Williams textbook of endocrinology. Philadelphia: Elsevier/Saunders.
National Health Administration, Ministry of Health.. (2018). Retrieved from https://dep.mohw.gov.tw/DOS/lp-1720-113-xCat-2.html
Nitz, J. C., Kuys, S., Isles, R., & Fu, S. (2010). Is the Wii Fit™ a new-generation tool for improving balance, health and well-being? A pilot study. Climacteric, 13(5), 487-491.
Obici, S., & Rossetti, L. (2003). Minireview: nutrient sensing and the regulation of insulin action and energy balance. Endocrinology, 144(12), 5172-5178.
Ohara, B. (2019). File:Posterior Hip Muscles 3.PNG - Wikimedia Commons. Retrieved 13 August 2019, from https://commons.wikimedia.org/wiki/File:Posterior_Hip_Muscles_3.PNG
Reeves, N. D., Narici, M. V., & Maganaris, C. N. (2006). Musculoskeletal adaptations to resistance training in old age. Manual therapy, 11(3), 192-196.
Reid, K. F., Callahan, D. M., Carabello, R. J., Phillips, E. M., Frontera, W. R., & Fielding, R. A. (2008). Lower extremity power training in elderly subjects with mobility limitations: a randomized controlled trial. Aging clinical and experimental research, 20(4), 337-343.
Sawada, N., Jiang, A., Takizawa, F., Safdar, A., Manika, A., Tesmenitsky, Y., ... & Kamei, Y. (2014). Endothelial PGC-1α mediates vascular dysfunction in diabetes. Cell metabolism, 19(2), 246-258.
Schinner, S., Scherbaum, W. A., Bornstein, S. R., & Barthel, A. (2005). Molecular mechanisms of insulin resistance. Diabetic Medicine, 22(6), 674-682.
Schrauwen-Hinderling, V. B., Van Loon, L. J. C., Koopman, R., Nicolay, K., Saris, W. H. M., & Kooi, M. E. (2003). Intramyocellular lipid content is increased after exercise in nonexercising human skeletal muscle. Journal of applied physiology, 95(6), 2328-2332.
Shepherd, P. R., Gnudi, L., Tozzo, E., Yang, H., Leach, F., & Kahn, B. B. (1993). Adipose cell hyperplasia and enhanced glucose disposal in transgenic mice overexpressing GLUT4 selectively in adipose tissue. Journal of Biological Chemistry, 268(30), 22243-22246.
Shi, Y., & Hu, F. B. (2014). The global implications of diabetes and cancer. The lancet, 383(9933), 1947-1948.
Skjæret, N., Nawaz, A., Morat, T., Schoene, D., Helbostad, J. L., & Vereijken, B. (2016). Exercise and rehabilitation delivered through exergames in older adults: An integrative review of technologies, safety and efficacy. International journal of medical informatics, 85(1), 1-16.
Smith, A. C., Mullen, K. L., Junkin, K. A., Nickerson, J., Chabowski, A., Bonen, A., & Dyck, D. J. (2007). Metformin and exercise reduce muscle FAT/CD36 and lipid accumulation and blunt the progression of high-fat diet-induced hyperglycemia. American Journal of Physiology-Endocrinology and Metabolism, 293(1), E172-E181.
Statistics Department, Ministry of Health and Welfare. (2018). Retrieved from https://www.hpa.gov.tw/Pages/Detail.aspx?nodeid=641&pid=1231
Strayer, D., Rubin, E., Saffitz, J. and Schiller, A. (2011). Rubin's pathology.
Stuart, C. A., Howell, M. E., Baker, J. D., Dykes, R. J., Duffourc, M. M., Ramsey, M. W., & Stone, M. H. (2010). Cycle training increased GLUT4 and activation of mTOR in fast twitch muscle fibers. Medicine and science in sports and exercise, 42(1), 96.
The elderly population broke through 14%. The Ministry of the Interior: Taiwan officially entered the advanced society. (2018). Retrieved from https://www.moi.gov.tw/chi/chi_news/news_detail.aspx?type_code=02&sn=13723
Tiedemann, A., O’Rourke, S., & Sherington, C. (2014). How is a yoga-based fall prevention program perceived by older people?. Journal of Science and Medicine in Sport, 18, e94.
Tipton, K., & Wolfe, R. R. (2001). Exercise, protein metabolism, and muscle growth. International journal of sport nutrition and exercise metabolism, 11(1), 109-132.
Vaisy, M., Szlufcik, K., De Bock, K., Eijnde, B. O., Van Proeyen, K., Verbeke, K., ... & Hespel, P. (2011). Exercise-induced, but not creatine-induced, decrease in intramyocellular lipid content improves insulin sensitivity in rats. The Journal of nutritional biochemistry, 22(12), 1178-1185.
Watson, R. T., Kanzaki, M., & Pessin, J. E. (2004). Regulated membrane trafficking of the insulin-responsive glucose transporter 4 in adipocytes. Endocrine reviews, 25(2), 177-204.
WHO | Diabetes. (2013). from https://web.archive.org/web/20130826174444/http://www.who.int/mediacentre/factsheets/fs312/e
Wiemeyer, J., & Kliem, A. (2012). Serious games in prevention and rehabilitation—a new panacea for elderly people?. European Review of Aging and Physical Activity, 9(1), 41.
Wii. (2019). Retrieved 11 August 2019, from https://zh.wikipedia.org/wiki/Wii
Wilson, S. H., Celermajer, D. S., Nakagomi, A., Wyndham, R. N., Janu, M. R., & Ben, S. F. (1999). Vascular risk factors correlate to the extent as well as the severity of coronary atherosclerosis. Coronary artery disease, 10(7), 449-453.
World Health Organization. (2017). Diabetes. Available at: http://www.who.int/mediacentre/factsheets/fs312/en/
World Health Organization. (2018). The top 10 causes of death. Retrieved 15 August 2019, from https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death
Yamaguchi, M., Mitsumori, M., & Kano, Y. (1998). Noninvasively measuring blood glucose using saliva. IEEE Engineering in Medicine and Biology Magazine, 17(3), 59-63.