研究背景：老化使高齡者生理機能逐漸衰退，包括認知功能與功能性體適能等。為了促進老年人的健康福祉，近幾年已有許多研究發展出新創運動模式，例如：方塊踏步運動，其主要目的在於可同時促進高齡者認知與功能性體適能的表現。然而，方塊踏步運動最主要的健康促進效益是與認知功能或下肢功能性體適能較為相關，仍有待究進一步釐清。本研究探討此議題將可助於未來實務操作者釐清方塊踏步運動的發展與應用。
研究目的：探討方塊踏步運動測驗表現與下肢功能性體適能及工作記憶的關聯性。
研究方法：本研究經過MMSE低於24分及GDS-SF高於5分的篩選後，符合篩選標準的參與者共112位，年齡範圍落在65-89歲，平均年齡為74.23±6.11歲，在完成篩選過程，再施測工作記憶（記憶廣度順、逆序測驗）表現、下肢功能性體適能（三十秒椅子站立測驗、椅子坐姿體前彎、開眼單足立、2.44公尺椅子坐起繞物）及方塊踏步運動測驗。研究結果以描述性統計、皮爾森相關、淨相關及階層迴歸模型進行資料分析與呈現。
研究結果：本研究主要發現，使用皮爾森相關分析結果顯示方塊踏步測驗分數在人口學變項與年齡、教育程度及MMSE有顯著相關；而在工作記憶的測驗包括記憶廣度-順序及記憶廣度-逆序 亦有顯著相關；而在下肢功能性體適能方面，方塊踏步的表現除了與椅子坐姿體前彎沒有顯著相關之外，其它的測項目包括三十秒椅子站立測驗、開眼單足立、2.44公尺椅子坐起繞物皆有顯著相關；此外，本研究利用淨相關分析控制可能影響實驗結果的人口學變項（包括：年齡、教育程度、MMSE）後，發現方塊踏步運動測驗與下肢功能性體適能的檢測項目皆無顯著相關，僅與工作記憶測驗的記憶廣度-逆序測驗有顯著相關；最後，本研究透過階層迴歸分析發現方塊踏步運動測驗分數只與年齡 (β= -.206, p = .032) 及記憶廣度-逆序 (β= .269, p = .016) 的關係達顯著性，而這亦顯示這兩者與方塊踏步表現的關聯性互為獨立。
研究結論：根據本研究的結果發現，在控制了潛在影響變項之後，方塊踏步運動測驗與工作記憶的表現較為相關，然而與下肢功能性體適能的關聯性則較為無關。因此，未來在使用該新創運動模式時可能須再搭配其它運動型式，以達到促進老年人身體適能及認知功能之目的。

Background: The cognitive abilities and functional fitness of older adults gradually decline over time. In order to promote health and well-being during late adulthood, an increasing number of exercise programs have been developed in recent years. Among these recently-developed exercise programs, square-stepping exercise (SSE) was designed to improve cognitive function and functional fitness in older adults. However, it is unclear whether the health-related components of SSE are more related to cognitive abilities or functional fitness, especially working memory and lower extremity functional fitness, which have been shown to benefit from SSE training.
Purpose: The purpose of this study was to investigate the different associations of working memory and lower-extremity functional fitness with SSE performance. Our findings may help refine the utilities and applications of SSE in older adults.
Methods: After screening out the participants who scored below 24 points on the Mini-Mental State Examination (MMSE) as well as those who scored over 5 points on the Geriatric Depression Scale Short Form (GDS-SF), a total of 112 eligible participants aged between 65 and 89 years (mean age 74.23±6.11) completed the working memory tests (i.e., WMS-III forward and backward digit span tests), lower-extremity functional fitness assessments (i.e., the chair stand test, the chair sit-and-reach test, the 2.44m up-and-go test, and the single leg stand with eyes open), as well as the SSE program. The data were analyzed using descriptive statistics, Pearson’s r, partial correlation, and a hierarchical regression model.
Results: It was found that SSE performance was positively correlated with working memory and lower-extremity functional fitness. The partial correlation analysis controlling for demographic factors (e.g., age, education level, and MMSE score) showed that improved SSE performance was correlated with better performance during the backward digit span task. Finally, the hierarchical regression analysis showed that the SSE performance was associated with age (β= -.206, p = .032) and forward digit span task performance (β= .269, p = .016).
Conclusion: After controlling for confounding variables, it was found in this study that SSE performance is selectively correlated with increased working memory performance but not lower-extremity functional fitness. Therefore, the current findings suggest that SSE is a potential means by which to improve working memory and can be combined with other exercise programs to improve physical health in the elderly.

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