| Summary: | 碩士 === 國立陽明大學 === 物理治療暨輔助科技學系 === 97 === Study Background and Purpose: Aging-related deteriorations of body structure and physical function could lead to decreased ability for maintenance of good posture. Flexed posture commonly seen in older people is characterized by a forward head, rounded shoulders, increased thoracic kyphosis, reduced lumbar lordosis, flexed hips and knees, and decline in height. Although the precise etiology of flexed posture is unknown, there are many underlying musculoskeletal, neuromuscular, and sensory impairments associated with flexed posture. General muscular weakness, neuromuscular deficiencies and biomechanical insufficiency make those sedentary older adults more prone to the flexed posture and its associated physical impairments. This study aimed to investigate the effects of individualized postural correction exercise on posture and physical fitness in a group of community sedentary elderly.
Methods: This prospective study recruited 60 community-dwelling sedentary elderly from an outpatient clinic in Kaohsiung city, and randomly allocated into experimental and control group stratified by sex. The experimental group received an individualized postural correction exercise program of 3 times per week for 6 weeks. Every exercise session lasted for 50 minutes, including 10-minute warming up and range of motion exercise, 30-minute postural correction exercise, and ended up with 10- minute cooling down and stretching exercises. The control group received a health education sheet regarding knowledge for posture maintenance and general postural correction instruction. We used timekeeper, ruler, handheld dynamometer and flexicurve to measure the elder’s body height, degree of forward head, kyphosis, flexibility, cardiovascular fitness, muscular strength, and balance performance. Two-way ANOVA with repeated measures were used to examine the effectiveness of the exercise program in improving the posture and physical fitness in the sedentary community elderly. Pearson product-moment correlation coefficient was used to investigate the relationships between postural indexes and fitness indexes.
Results: Fair to moderate negative relationships （r=-.30~-.54, P<.05） were shown between “usual / erect forward head posture” and flexibility, six minutes walking distance , muscular strength, as well as balance performance. After 6-week exercise intervention, the average muscular strength of the experimental group （N=25） showed only marginal decrease from 134.2 N to 126.4 N （P=0.19）; while the control group （N=17） declined significantly from 148.3 N to 116.4 N （P<0.05）. The time-by-group interaction effect analyzed by the two-way ANOVA with repeated measures was significant （P=0.02）, and demonstrated the exercise intervention efficaciously delayed the deterioration of muscular strength in these sedentary elderly. We performed further analyses divided by sex, and found the average 6-min walk distance of the experimental male group （N=11） increased significantly from 357.0 m to 391.6 m; while the control male group （N=8） declined significantly from 447.4 m to 418.9 m. The time-by-group interaction effect was also significant （P=0.02）, and demonstrated that the exercise intervention effectively improved the 6-min walk distance which appeared to be an overall index reflecting body posture and physical fitness according to our correlational findings.
Conclusions: An individually-prescribed postural correction exercise has been demonstrated to potentially improve the modifiable impairments of muscular strength in the back region, postural alignments and cardio-respiratory fitness associated with flexed posture. Although further studies which recruit larger samples to increase the statistical power and longer intervention period to better demonstrate the exercise effectiveness are warranted, this study provides a promising exercise intervention that my improve posture and physical performance in sedentary elderly. Health policies to encourage the sedentary elderly to exercise regularly and keep up good posture alignments were recommended to delay the deterioration of physical performance and promote the quality of life in the elderly.
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