背景：衰弱容易造成高齡者不良的健康結果，而規律運動可以維持或增進高齡者的功能性體適能，減少或延緩失能現象。為了增加趣味性，體適能指導員會在運動中增加認知元素，例如記憶或數學成份。本研究目的為探討結合認知元素的運動介入對於衰弱高齡者在衰弱程度、功能性體適能、日常生活活動功能(Activity of daily living, ADL)的成效。
研究方法：從台灣南部安養機構中徵求65 歲以上衰弱高齡者。採取類實驗設計，以單位隨機方式將研究參與者分派至認知運動組(n=25)或單純運動組(n=28)。兩組都接受12 週，每週2 次，每次60 分鐘的運動介入。單純運動組接受整合性運動；認知運動組接受同樣強度的整合性運動，並將認知能力的專注、記憶、數學之元素與運動動作結合，讓研究參與者同時接受認知與運動訓練。以共變數分析(Analysis of covariance, ANCOVA)分析介入的成效，並使用T 檢定比較兩組在基準點的差異以及不同運動後的成效。
研究結果：兩組間僅只有在衰弱程度(F = 8.63, p = 0.005)有顯著的交互作用，單純運動組之改善程度優於認知運動組。而認知運動組在ADL (t = -2.58, p = 0.017)、上肢柔軟度(右側) (t = -3.50, p = 0.002)、上肢柔軟度(左側) (t = -2.48, p = 0.02)、下肢柔軟
度(右側) (t = -4.69, p < 0.001)、下肢柔軟度(左側) (t = -4.24, p < 0.001)有顯著的提升。單純運動組在衰弱程度(t = 5.89, p < 0.001)、ADL(t = -4.08, p < 0.001)、上肢柔軟度(右側) (t = -4.13, p < 0.001)、上肢柔軟度(左側) (t = -4.35, p < 0.001)也有顯著進步。課程滿意度兩組無顯著差異。
結論：認知運動課程有助於改善機構衰弱高齡者的ADL、柔軟度。建議安養機構未來可規劃長期、規律的課程；或推廣至社區，以改善衰弱高齡者的體適能。
關鍵字：認知元素、運動、衰弱、功能性體適能、高齡者

Frailty may lead to poor health outcomes in older adults, and regular exercise can maintain or enhance the functional fitness and avoid disability. Exercise trainer may integrate cognitive components into exercise for increasing fun. The aims of this study were to
investigate the effects of an exercise intervention combining cognitive components on frailty, functional fitness, and activity of daily livings (ADL). Aged 65 and over frail older adults were recruited from nursing homes in Southern Taiwan. Quasi-experimental design was conducted and participants were randomly assigned based on the institution where they stayed to the exercise combining cognitive (EC, n=25) or the exercise group (EX,
n=28). EC group accepted the integrated exercise combining cognitive components. EX group received the same intensity integrated exercise. All participants received 60-minute
exercise training sessions, twice a week for 12 weeks. Frailty, functional fitness, ADL were assessed at baseline and after intervention. Analysis of covariance of variance
(ANCOVA) was used to analyze the effects of intervention, and paired T-test was used to compare the differences between baseline and after intervention in each group.EC group improved ADL, upper flexibility, low flexibility. EX group improved frailty, ADL, upper flexibility. Exercise combining cognitive components may improve ADL and flexibility of older adults in nursing homes. In the future, this style of exercise can be used in the
communities and long-term care institutions to improve the frail older adults’ functional abilities.
Keywords：Cognitive elements, Exercise, Frailty, Functional fitness, Older adults

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