背景: 隨著年齡越大，中老年人的身體機能逐漸下降，行動力變得越來越差。然而，目前僅有少數研究針對身體活動對行動力障礙的變化進行探討，且大多為橫斷性研究，因此身體活動對行動力障礙的影響仍有很大程度為未知。
目的: 了解台灣退休族群行動力障礙之狀況，進一步透過長期追蹤探討從事身體活動對其三年後行動力障礙的分數變化之影響。
方法: 運用台灣「退休規劃與退休歷程對退休後健康狀況之影響調查資料庫」之兩波調查資料(2015-2019)，經排除條件後，共2348位有效問卷。本研究的自變項為不同程度之身體活動(分三組:費力活動達標、僅中度費力活動達標、以及皆未達標)，依變項為行動力障礙分數變化，採連續性分數和切成三組(維持組、改善組、惡化組)呈現，控制變項包括社會人口學變項、健康相關變項、行為相關變項。統計分析方法包括線性迴歸分析(連續性分數)及多類別羅吉斯迴歸分析(分三組)。同時，本研究並進一步進行性別與年齡別之分層分析，以便深入探究不同程度的身體活動對行動力障礙分數變化之關係。
結果: 線性迴歸分析結果顯示，費力活動有達標者相較於皆無達標者，兩波行動力障礙分數變化減少0.14分，未達顯著差異(β = -0.14，p=.12)；僅中度費力活動達標者，兩波行動力障礙分數變化減少0.06分，亦未達顯著差異(β = -0.06，p=.49)。但是經性別分析，發現男性費力活動有達標者相較於皆無達標者，兩波行動力障礙分數變化減少0.27分，達顯著差異(β = -0.27，p=.01)，但僅中度費力活動達標者，兩波行動力障礙分數變化減少0.19分，未達顯著差異(β = -0.19，p=.10)；然而女性皆未達顯著差異。在年齡層部分，僅65至74歲者有從事費力活動有達標者相較於皆無達標者，兩波行動力障礙分數變化減少0.29分，達顯著差異(β = 0.29，p=.05)，僅中度費力活動達標者，兩波行動力障礙分數變化減少0.10分，未達顯著差異(β = 0.10，p=.49)，而50-64歲組未達顯著差異。
其次，若將行動力障礙分數分成3組(分數維持、分數改善、分數惡化)，結果發現，費力活動有達標相較皆無達標者，其分數惡化的勝算比達顯著差異(OR = 0.74，95%C.I.=0.56-0.98)，表示費力活動達標者，可具有保護惡化之效果。經性別分析，發現男性不管是從事費力活動有達標者(OR = 0.61，95%C.I.=0.42-0.87)或是僅有中度費力活動有達標者(OR = 0.67，95% C.I.= 0.46-0.99)相較於皆無達標者，兩者皆可顯著避免行動力障礙惡化，然而女性並沒有同樣的效應。在年齡層部分，僅65至74歲組中，從事費力活動有達標者，可顯著避免後續行動力障礙的惡化(OR = 0.60，95%C.I.=0.40-0.88)，而50-64歲組則無此效應。
結論: 本研究經線性迴歸分析發現不同程度之身體活動皆可以使兩波行動力障礙分數變化減少，然而全體樣本未達顯著差異，但是在男性及年齡層較高的個案，其費力活動有達標者 (費力活動≧75分鐘/週)可以顯著減少兩波行動力障礙分數變化。另外，本研究將兩波行動力障礙分數分組，其中費力活動有達標者相較於皆無達標者，可顯著保護行動力障礙繼續惡化，尤其在男性及年齡層較高的個案。建議未來研究應探討中老年女性和50-64歲組無法從事費力活動或無法達標之因素，也應建議中老年退休族群多從事中度費力活動以上的運動，以維持良好的行動力。

Background: While aging, physical function gradually declines, and mobility becomes worsen among middle-aged and older adults. At present, only a few studies have investigated the changes in physical activity on mobility impairment, most of which are cross-sectional studies. Therefore, the relationship of physical activity to mobility impairment remains largely unknown.
Method: Two waves of data (2015-2019) from the survey of “Retirement Planning and Retirement Process on Post-retirement Health Status” in Taiwan were used, with a total of 2348 valid participants. The independent variable of the study was different levels of physical activity (divided into three groups: strenuous activity, moderate-intensity activity only, and neither meeting the standard), and the dependent variable was the change in the mobility impairment score, using continuous scores and categorical groups (devided into three groups: maintenance, improvement, deterioration). Statistical analysis methods include linear regression analysis and multinomial logistic regression analysis. Also, further stratification analysis was conducted by gender and age .
Results: Linear regression analysis showed that different levels of physical activity could reduce the scores of mobility impairment but were not significant. Further stratification analysis showed that males and 65 to 74 years old who achieved the standard of strenuous activity had a 0.27-point and 0.29-point decrease in the changes in the scores of mobility impairment between the two waves (β = -0.27, p =.01) (β = -0.29, p=.05). There were no significant differences among women and ages between 50-64 years old. Also, if the scores were cut into three groups, the study found that the odds ratio of score deterioration was 0.74 for those who achieved strenuous activity standard (OR=0.74, 95%C.I. = 0.56-0.98), implying a protective effect. Further stratification analysis found that males achieved the standard for strenuous activity (OR = 0.61, 95% C.I.=0.42-0.87) or only moderate-intensity activity (OR = 0.67, 95% C.I. = 0.46-0.99), both activities could significantly prevent the worsening of mobility impairment. In addition, only the age group between 65 and 74 who met the standard for engaging in strenuous activities was found significantly prevent the worsening of subsequent mobility impairment (OR = 0.60, 95% C.I. = 0.40-0.88).
Conclusion: The study found that those who met the standard for engaging in strenuous activities (≥75minutes/week) could prevent subsequent mobility impairment, especially in males and the age groups between 65 and 74 years old.

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