背景：隨著臺灣人口快速老化，高齡者行動力下降、衰弱與失能風險逐漸成為重要公共衛生議題。行動力不僅是維持日常生活功能與獨立生活能力的重要基礎，也與跌倒、住院、失能及生活品質下降等不良健康結果密切相關。世界衛生組織提出之長者整合性照護指引（ICOPE）強調以內在能力為核心，透過早期辨識、後續評估、介入與持續追蹤，延緩長者功能下降與失能風險；其中，行動能力為ICOPE內在能力之重要面向。在臺灣，ICOPE概念已逐漸應用於長者功能評估與預防延緩失能服務，並延伸至原住民族文化健康站等社區場域。然而，現行ICOPE評估多採初篩與異常後複評之分層流程，較偏向整體功能狀態之掌握；若欲觀察規律運動介入期間長者行動力是否產生短期且連續的變化，仍需搭配更聚焦、簡便且可重複施測之功能性指標。因此，本研究以ICOPE架構中的行動能力面向為核心，結合智慧科技輔助五次坐姿起立與四公尺步行檢測，並於文化健康站場域中追蹤規律運動介入期間原鄉高齡者之行動力變化。
研究目的：本研究以屏東原鄉文化健康站高齡者為研究對象，聚焦ICOPE架構中之行動能力面向，運用智慧科技輔助五次坐姿起立與四公尺步行檢測，描述原鄉高齡者之基線行動力表現與行動力判定狀態分布，並評估16週規律下肢功能運動介入期間行動力表現之變化情形，同時比較不同年齡層及不同基線行動力判定狀態者之變化差異。
方法：本研究採單組前後測準實驗設計，於屏東縣禮納里部落園區及長治百合部落園區共六間文化健康站進行。研究對象為符合納入條件且同意參與之高齡者，並於基線（T0）、介入8週後（T2m）及介入16週後（T4m）接受行動力檢測。本研究之運動介入為期16週，每週2次，每次約30至40分鐘，以下肢功能訓練為核心，內容包含踝關節蹠曲與背曲、膝關節伸展及坐站轉換等動作，並搭配族語運動影片，由健康促進老師或文化健康站照顧服務員帶領執行。主要結果指標包含五次坐姿起立時間、四公尺步行時間及行動力分數；其中，行動力分數係參考簡短身體功能量表中五次坐姿起立與四公尺步行兩分項之評分標準加總而成，並依分數區分為無衰弱、衰弱前期及衰弱。統計分析包含描述性統計、配對t檢定、行動力判定狀態轉換分析及線性混合效應模型，以評估介入期間行動力表現之變化，並比較不同年齡層及不同基線行動力判定狀態者之差異。
結果：本研究基線共納入111名高齡者，其中71人完成三個時間點檢測並納入主要分析。完整追蹤者平均年齡為76.45±7.46歲，女性占70.42%；基線行動力判定狀態中，無衰弱者占63.38%，衰弱前期者占21.13%，衰弱者占15.49%。整體而言，介入期間參與者之五次坐姿起立時間與四公尺步行時間皆呈下降，行動力分數則呈上升；與基線相比，介入8週後多數指標即達顯著改善，介入16週後改善幅度更為明顯。依年齡分層觀察，55–74歲組與≥75歲組皆呈現行動力改善趨勢，其中55–74歲組在五次坐姿起立與四公尺步行時間之改善幅度較大，而≥75歲組之四公尺步行時間主要於介入16週後才達顯著改善。行動力判定狀態轉換方面，基線無衰弱者大多維持原有狀態，基線衰弱前期者有較高比例轉為無衰弱，部分基線衰弱者亦轉為較佳之行動力判定狀態。線性混合效應模型結果顯示，追蹤時間與行動力改善具顯著關聯，且年齡分組會影響五次坐姿起立與四公尺步行時間之變化幅度。
結論：本研究結果顯示，屏東原鄉文化健康站高齡者於16週規律運動介入期間，其五次坐姿起立、四公尺步行及整體行動力表現皆呈現正向變化，且介入16週後之改善幅度較介入8週後更為明顯。不同年齡層及不同基線行動力判定狀態者之變化情形有所差異，其中55–74歲組在起站與步行表現之改善較明顯，而基線為衰弱前期及衰弱者較常呈現行動力分數進步或轉為較佳之行動力判定狀態。整體而言，文化健康站結合智慧科技輔助檢測與在地運動介入，具有作為原鄉高齡者功能篩檢、行動力追蹤及健康促進之應用潛力。然而，本研究未設置對照組，未來建議可採具對照組之研究設計，擴大樣本數並延長追蹤時間，以進一步驗證運動介入對原鄉高齡者行動力與衰弱風險之長期影響。

This study examined mobility performance and changes in mobility during a regular exercise intervention among older adults attending Indigenous Cultural Health Stations in Pingtung,Taiwan. Guided by the Integrated Care for Older People (ICOPE) framework, this study focused on the mobility domain and used smart technology-assisted assessment to monitor functional changes during the intervention period.
A one-group pretest–posttest quasi-experimental design was conducted in six Indigenous Cultural Health Stations. Participants received a 16-week lower-limb functional exercise intervention and were assessed at baseline, 8 weeks, and 16 weeks. Mobility outcomes included five-times sit-to-stand time, 4-meter walk time, and a mobility score derived from these two functional tests.
A total of 111 older adults were enrolled at baseline, and 71 completed all three assessments. Overall, five-times sit-to-stand time and 4-meter walk time decreased during the intervention period, while mobility scores increased. Improvements were more pronounced after 16 weeks than after 8 weeks. Age-stratified analyses showed that both age groups improved, with greater improvements in sit-to-stand and walking performance among participants aged 55–74 years. Participants classified as prefrail or frail at baseline were more likely to show improvements in mobility scores or transition to better mobility classification statuses.
These findings suggest that an ICOPE-oriented mobility assessment combined with smart technology-assisted measurement and community-based exercise intervention may have potential for functional screening, mobility monitoring, and health promotion among older adults in Indigenous communities. Future controlled studies with larger sample sizes and longer follow-up periods are needed to further examine its long-term effects on mobility and frailty risk.

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