匹克球介入對思覺失調個案之錐體外徑症候群及功能性體適能之成效:隨機控制組試驗

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題名:	匹克球介入對思覺失調個案之錐體外徑症候群及功能性體適能之成效:隨機控制組試驗
其他題名:	The effectiveness of Pickleball on Extrapyramidal Symptoms and Functional Fitness in people with schizophrenia: Randomized controlled trial
作者:	袁明珠 YUAN, MING-ZHU
貢獻者:	楊鎮嘉;陳朝鍵 YANG, CHENG-CHIA;CHEN, CHAO-CHIEN 健康產業管理學系
關鍵詞:	功能性體適能;錐體外徑症候群;思覺失調症;匹克球 Functional fitness;Extrapyramidal symptoms;Schizophrenia;Picklebal
日期:	2023
上傳時間:	2023-11-22 01:21:12 (UTC+0)
摘要:	研究背景：思覺失調症患者服用抗精神類藥物易導致錐體外徑症候群（Extrapyramidal symptom , EPS）的副作用。錐體外徑症候群( EPS )的出現會造成患者步態不穩、動作僵硬、容易跌倒及運動能力下降，同時影響體適能，造成患者的生活品質出現問題。相關研究發現，匹克球介入會改善身體協調性問題及肢體動作，為此本研究針對存在錐體外徑症候群( EPS )的思覺失調症患者，試圖以匹克球介入思覺失調個案錐體外徑症候群及體適能，改善個案的日常活動能力和體適能。研究方法：本研究為12週匹克球運動介入性試驗研究，於 2022年 10 月 12 日至 2023 年 1 月 6 日在南投縣某康復之家進行收案。本研究共招募受試對象22人，隨機分為試驗組（11人）和控制組（11人）。12週匹克球運動每週三次，每次60分鐘，試驗組進行匹克球運動，控制組依機構一般例行治療，不進行匹克球運動。所有受試對象需進行前測，包括基本資料問卷、藥物錐體外症候群量表（Drug-Induced Extrapyramidal Symptoms Scale, DIEPSS）評估、功能性體適能測試;12週後所有受試對象進行後測，包括評估藥物錐體外症候群量表( DIEPSS )評估、功能性體適能測試。統計方法主要採用魏克生符號檢定（Wilcoxon Signed Ranked Test）分析組內在介入前、後測差異，以曼惠特尼U（Mann-Whitney U）檢定組間指標變化量差異。研究結果：結果顯示，錐體外徑症候群( EPS )指標上，試驗組藥物錐體外症候群量表( DIEPSS )總分（P = 0.005）、整體嚴重度（P = 0.004）、類帕金森氏症總分（P = 0.003）前、後測有顯著性差異。控制組藥物錐體外症候群量表( DIEPSS )總分（P = 0.003）、整體嚴重度（P = 0.006）、類帕金森氏症總分（P = 0.003）、遲發性運動障礙（TD）（P = 0.046）前、後測有顯著性差異。試驗組與控制組組間指標改變量無顯著性差異。體適能測試，試驗組在心肺耐力上兩分鐘抬膝（P = 0.023）前、後測有顯著性差異；平衡能力上坐起繞物（P = 0.013）前、後測有顯著性差異。控制組各指標均無顯著性差異。組間指標改變量，椅子坐起繞物（P = 0.011）有顯著性差異，開眼單足立（P = 0.007）有顯著性差異。研究結論：本研究結果指出，12 週的匹克球運動介入和一般例行治療，均對對存在思覺失調症患者的錐體外症候群( EPS )有顯著性改善，且匹克球對功能性體適能有顯著性改善，特別是心肺耐力和平衡能力方面有顯著性改善，對持續改善住民完成日常活動能力、恢復社交能力、提升其生活品質有重要意義。 Background: Patients with schizophrenia who take antipsychotic drugs may experience extrapyramidal symptoms (EPS) as side effects. The occurrence of EPS can lead to problems such as unstable gait, stiffness in movements, increased risk of falls, and decreased motor abilities, resulting in reduced physical fitness and diminished quality of life. Previous research has shown that Pickleball intervention can improve body coordination and limb movements. Therefore, this study aimed to explore the effectiveness of Pickleball intervention in managing EPS and improving physical fitness in patients with schizophrenia.Methods: This study was a 12-week Pickleball intervention trial conducted from October 12, 2022, to January 6, 2023, at a psychiatric rehabilitation center in Nantou County, Taiwan. A total of 22 participants were recruited and randomly assigned into an experimental group (11 participants) and a control group (11 participants). The experimental group received Pickleball intervention three times a week, 60 minutes each session, while the control group received standard institutional treatments without Pickleball intervention. All participants underwent pre-test assessments, including demographic questionnaires, Drug-Induced Extrapyramidal Symptoms Scale (DIEPSS) evaluations, and functional fitness tests. After 12 weeks, all participants underwent post-test assessments, including evaluations, DIEPSS assessments, and functional fitness tests. Statistical analysis involved Wilcoxon Signed Ranked Test to analyze within-group differences before and after the intervention, and Mann-Whitney U test to compare between-group changes in the outcome measures.Results: The results showed significant improvements in EPS indicators for the experimental group, including DIEPSS total score (P = 0.005), overall severity (P = 0.004), and Parkinsonism total score (P = 0.003) before and after the intervention. The control group also showed significant improvements in DIEPSS total score (P = 0.003), overall severity (P = 0.006), Parkinsonism total score (P = 0.003), and Tardive Dyskinesia (TD) (P = 0.046) before and after the intervention. However, there were no significant between-group differences in the changes of these indicators.Regarding functional fitness tests, the experimental group showed significant improvements in 2-min step (P = 0.023) and sit-to-stand agility (P = 0.013) before and after the intervention. The control group did not show significant differences in the measured indices. Between-group analysis revealed significant differences in the changes of sit-to-stand agility (P = 0.011) and open-eye single-leg standing (P = 0.007). Conclusion: This study's findings indicate that a 12-week Pickleball intervention and standard conventional treatment both significantly improved EPS in patients with schizophrenia. Moreover, Pickleball intervention demonstrated significant improvements in functional fitness, particularly in cardiorespiratory endurance and balance, which is of significant importance in enhancing daily activity performance, restoring social functioning, and improving these patients’ overall quality of life.
顯示於類別:	[健康產業管理學系] 博碩士論文

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