研究目的：本研究探討高齡者下肢肌力與動作準備能力及跌倒風險的可能關聯性，以事件相關電位之腦電波成份其解釋動作準備歷程的神經機制。研究方法：本研究招募40位無身體與認知障礙的高齡者，排除條件是中文版蒙特利爾智能測驗≦26，無腦部與心臟問題以及髖關節、膝關節、踝關節手術以及過去一週內有服用影響認知相關藥物。並藉由徒手肌力測試 (manual muscle test, MMT)、三十秒椅子坐立與起身行走測試 (time up and go, TUG) 測量高齡者下肢肌力與跌倒風險，及使用前時距作業 (foreperiod paradigm) 來測量高齡者的動作準備歷程能力，再進一步使用腦電波之動作準備電位（即關聯性負變異; contingent negative variation, CNV）來探討其背後的神經機制。研究結果：雖然本研究從相關的結果發現高齡者的MMT表現與前時距500毫秒與前時距1500毫秒的反應時間表現皆有相關，且TUG亦與前時距500毫秒與前時距1500毫秒的反應時間有相關，然而在控制了身高與體重的影響後，於淨相關的結果僅發現MMT與前時距500毫秒的反應時間的相關達顯著效果。最後，本研究從腦電波結果發現下肢肌力較佳的老年人，其在額中葉電極的動作準備電位CNV振幅皆顯著較肌力較差者大。結論：本研究結果發現高齡者下肢肌力與跌倒風險皆可能會反映在動作準備的認知作業表現上，而透過腦電波的結果顯示其可能與動作反應的準備過程中可招募的注意力資源多寡有關。因此，未來或許可設計強化老年人下肢肌力的運動處方，以促進動作準備過程中神經資源招募，進而降低跌倒的可能性。

Purpose. This study explored the possible correlations among the muscle strength of the lower limbs, motor preparation, and the risk of falling in the elderly. Participants performed a foreperiod (FP) paradigm while the behavioral performance and contingent negative (CNV) were collected in order to investigate the cognitive and neural mechanisms underly motor preparation.
Method. Forty healthy elderly people without cognitive impairments were recruited. The exclusion criteria included participants scored less than or equal to 26 points on Montreal Cognitive Assessment (MoCA), those who had brain and cardiovascular problems, hip, knee and ankle surgery, and those who had taken cognition-related drugs regularly in the last week. The participants’ lower limb muscle strength and the risk of falling were examined by means of the manual muscle test (Manual Muscle Test, MMT) and the 30 second chair stand test time up and go test (TUG). A foreperiod paradigm with variable FP (i.e., 500ms and 1500ms) was used to measure the ability to prepare for a response. Further, this study adopted CNV to explore the underlying neural mechanism. Results. Although this study found that MMT and TUG performances were correlated with the response time for both FP500ms and FP1500ms, it was found that only the correlation between MMT and response time for FP500ms survived after controlling for the influences of height and weight. Further, the neural data revealed that elderly adults with better muscle strength of the lower limbs had significantly larger CNV amplitudes at the frontal middle lobe electrodes than those with weaker muscle strength.
Conclusions. This study showed that both the muscle strength of the lower limbs of the elderly and the risk of falling may be reflected in the performance of cognitive tasks involving the processing of motor preparation. The neurophysiological data showed that it may be related to the amount of attention resources that can be recruited during the preparation of a response. Therefore, it may be feasible for future research to design exercise prescriptions to strengthen the muscle strength of the lower limbs in the elderly in order to improve their physical and cognitive health, thereby reducing the risk of falling.

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