深圳市中轻度残疾人社区康复健身活动及其健康效益研究

Research on community-based rehabilitation exercise and physical activity and its benefits for people with mild and moderate disability in Shenzhen,Guangdong,China

目的 基于WHO 《2018-2030促进身体互动全球行动计划:加强身体活动,造就健康世界》并参照WHO 《身体活动和久坐行为指南》(针对残疾人)《指南》的要求,采用ICF有关残疾与功能的理论架构和方法,对中轻度残疾人参与社区康复健身活动后的身体活动状态、功能状态和生活质量进行分析,探讨在社区环境下,残疾人参与康复健身体育活动的健康效益。方法 根据《指南》和ICF,构建适用于中轻度残疾人社区康复健身活动方案,来自深圳市20个社区230例中轻度残疾人,涉及肢体残疾、语言残疾、智力残疾和精神残疾人参与社区身体活动,由专业康复健身活动指导人员实施和指导。活动类型主要涉及体适能类(有氧运动和抗阻运动)、技能类(平衡运动、协调运动等)以及运动和运动游戏项目类(球类运动、游戏运动等),活动强度为低~中,每次活动30~50 min,每月5次,持续6个月。采用国际身体活动问卷(IPAQ)对中轻度残疾人社区健身活动状况进行调查、运用WHODAS 2.0,对残疾人整体功能进行评定;采用WHOQOL-BREF评估中轻度残疾人的与健康有关的生活质量。结果 中轻度残疾人在参与社区康复健身活动后,IPAQ的工作相关、交通出行相关、家务园艺相关及休闲相关4个领域体育活动的得分显著提高(|t|> 3.391, P <0.001);WHODAS 2.0的认知、活动、自我照护、与他人相处、与生活相关的各项活动、社会参与维度分和总分均显著下降(t> 6.639, P <0.001);WHOQOLBREF的4个维度分显著提高(|t|> 7.486, P <0.001)。结论 参与为期6个月的中轻强度社区康复健身活动后,中轻度残疾人体育活动水平与活动参与度显著提高,整体功能状态和生活质量显著改善。

Objective To investigate the effect of community-based rehabilitation exercise and physical activity on the physical activity levels,functional states,and quality of life for people with mild and moderate disabilities in community settings,to ascertain the health benefits of their engagement in such fitness sports activities,anchoring in the WHO"Global Action Plan on Physical Activity 2018-2030:More Active People for a Healthier World"and the guidelines tailored for people with disabilities,using the theoretical framework and methodology of the International Classification of Functioning,Disability and Health(ICF).Methods Aligning with the WHO guidelines for people with disabilities and the ICF,a community-based rehabilitation exercise and physical activity program was designed for individuals with mild to moderate disabilities,featuring activities like fitness training(aerobic and resistance exercises),skill exercises(such as balance and coordination),as well as sports and recreational games(ball and games,etc.).A total of 230 people with mild and moderate disabilities were recruited from 20 communities in Shenzhen,with types of disabilities including physical,speech,intellectual,and mental.Professional rehabilitation fitness instructors implemented and supervised the program.The activities were of low to moderate intensity,30 to 50 minutes per session,five times a month for six months.The community-based rehabilitation exercise and physical activity progress of these individuals was surveyed using the International Physical Activity Questionnaire(IPAQ),and their overall functioning was evaluated with WHODAS 2.0.The health-related quality of life was measured with WHOQOL-BREF.The health benefits from participation in community-based rehabilitation exercise and physical activity were assessed in terms of functioning,activity involvement,and quality of life.Results After the fitness activities,participation levels significantly increased in IPAQ domains of work-related,transport-related,domestic and gardening activity,and leisure time(|t|>3.391,P<0.001).The scores significantly decreased in the domains of cognition,activity,self-care,getting along,life activities and participation;and overall scores also decreased in WHODAS 2.0(t>6.639,P<0.001).The scores significantly increased in the four dimensions of WHOQOL-BREF(|t|>7.486,P<0.001).Conclusion After participating in a six-month community-based rehabilitation exercise and physical activity program of mild to moderate intensity,individuals with mild to moderate disabilities have improved in physical activity and engagement levels,and the overall functioning and quality of life.