背景與目的：衰弱是一種臨床症候群，多個器官系統的生理儲備和功能下降導致的。衰弱會導致長者的肌力、有氧能力和獨立性下降，應儘早於衰弱前期進行介入。過去研究顯示中強度有氧運動可有效提升健康長者的有氧能力和功能性活動表現。然而先前的研究顯示由於衰弱長者的肌肉質量下降，衰弱長者對有氧運動的適應性降低，因此要獲得更好的有氧訓練效果可能需要更高強度的有氧運動。對於衰弱前期的長者來說，達成更高強度的訓練是有困難的。最近研究發現，在運動期間使用血流阻斷可能會產生代謝壓力，並進一步增加健康成年人的肌肉肥大和通氣量，因此低強度有氧運動就足以增加健康長者的肌肉質量。然而，有氧運動結合血流阻斷對衰弱前期長者的效果尚不清楚。因此本研究探討中強度有氧運動對於衰弱前期長者的效益，並比較中強度有氧運動結合血流阻斷對於衰弱前期高齡長者之有氧能力及功能性活動的效益。
研究方法：34位衰弱前期（Fried衰弱表現型符合1或2個標準）長者（≥ 65歲）隨機分為兩組，分別接受有氧運動結合血流阻斷（實驗組）和僅接受有氧運動（控制組）。兩組皆接受6週、每週3次，共18次中等強度（50-70%心率儲備）有氧運動。實驗組在運動過程中在慣用側的大腿施加額外 50% 的血流阻斷壓力。在訓練前（前測）、訓練三週（三週測）、訓練後（後測），以及訓練結束後一個月和兩個月（一個月和兩個月追蹤），評估六分鐘行走測試、兩分鐘踏步測試、計時起走測試、日常習慣行走和最快行走速度下的行走表現、軀幹和四肢肌肉質量、下肢肌力、肺部功能、和衰弱狀態。採用二因子重複測量變異數分析進行統計分析，比較兩組在五次測試時間的差異。顯著差異訂定為p值小於0.05。
研究結果：研究結果發現，六分鐘行走測試 (p<0.01)、兩分鐘踏步測試 (p<0.01)、計時起走測試 (p<0.01)、日常習慣行走速度 (p<0.01)，和握力 (p=0.03)，在後測、一個月和兩個月追蹤時的測試結果與前測相比皆顯著進步。實驗組在最快行走速度下，最快行走速度 (p=0.01) 與步頻 (p<0.01)，在後測、一個月和兩個月追蹤與前測相比皆顯著增加，而控制組並沒有因為訓練而顯著進步。四肢肌肉質量、下肢肌力、及肺部功能在介入後皆無顯著差異。在衰弱狀態部分，實驗組有兩位長者，控制組有四位長者在介入後，從衰弱前期逆轉到無衰弱。
討論與結論：中強度有氧運動可以改善衰弱前期長者的有氧能力、功能性活動表現、行走表現，和握力，且此效果可維持到兩個月追蹤。中強度有氧運動結合血流阻斷相比於單純中強度有氧運動，在最快行走速度及步頻有更好的介入效益。然而，中強度有氧運動結合血流阻斷未顯著提升下肢肌肉質量與力量。因此對於衰弱前期長者進行有氧運動結合血流阻斷還需要更多研究的探討，找出更有效發揮血流阻斷訓練的機制的訓練方式。

Frailty reduces aerobic capacity and independence in older adults. Moderate-intensity aerobic exercise improves these outcomes in healthy older adults. Additionally, when combined with blood flow restriction (BFR), low-intensity aerobic exercise was sufficient to increase muscle mass in healthy older adults. However, the effect of moderate-intensity aerobic exercise with BFR on pre-frail older adults is unclear. This study examined its impact on aerobic capacity and physical function in pre-frail older adults. Thirty-four pre-frail older adults were randomized to aerobic exercise with BFR (BFR group) or without BFR (CON group). Both groups received moderate-intensity aerobic exercise three times/week for six weeks, with the BFR group applying 50% limb occlusion pressure to the dominant thigh. Assessments were conducted before training (pre-test), after three weeks, after six weeks (post-test), and one and two months after training. Measurements included aerobic capacity, physical function, walking performance, muscle mass, muscle strength, and pulmonary function. The results showed that both groups significantly improved in aerobic capacity, physical function, grip strength and walking performance after training. The BFR group significantly increased maximum walking speed and cadence at post-test, while the CON group did not. No significant differences were found in lower limb muscle mass and strength, or pulmonary function between the two groups after training. These findings support that moderate-intensity aerobic exercise effectively improves aerobic capacity, physical function, walking performance, and grip strength in pre-frail older adults. Moreover, combining moderate-intensity aerobic exercise with BFR enhances maximum walking speed.

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