規律運動訓練對僧帽瓣脫垂女性患者症狀困擾與生活品質成效之探討
僧帽瓣脫垂為臨床常見的瓣膜性心臟疾病，盛行率為 5 － 15% ，好發於年輕女性。僧帽瓣脫垂患 者常被胸痛、手臂痛、心悸、呼吸短促、疲憊、頭痛、焦慮、情緒不穩、頭暈、意識短暫喪失及肌 肉震顫等症狀所困擾並影響其生活品質。因此改善僧帽瓣脫垂患者的症狀困擾程度並提升生活品質 是非常重要的。
本研究旨在探討規律運動訓練對僧帽瓣脫垂女性患者症狀困擾與生活品質之成效。本研究採前後測 實驗法，以立意取樣法選取 20 － 50 歲僧帽瓣脫垂之女性患者，再隨機分為運動組與對照組，運動 組 17 位及對照組 18 位共 35 位婦女。運動組個案進行每週 3 次，每次 30 分鐘，共為期 12 週之規 律跑步機運動訓練，對照組個案保持原來生活型態。於研究計畫前後收集個案的人口學特性基本資 料表、僧帽瓣脫垂症狀量表、 SF-36 生活品質量表及跑步機運動測試等資料，並以統計軟體 SPSS 1 1.0 for Windows 進行分析，如百分比、平均值與標準差、卡方檢定（ Chi-Square test ）、曼－惠特 尼檢定（ Mann-Whitney U test ）、斯皮爾曼等級相關性（ Spearman Correlation ）及魏克森訊號
（ Wilcoxon Sign Rank test ）等檢定法。
研究結果發現：（ 1 ）所有個案平均年齡 36.0 ± 8.1 歲，平均身體質量指數為 20.2 ± 2.1kg /m2 ，平 均運動耐力則為 8.5 ± 2.3 METs 。（ 2 ）個案於計畫前之症狀困擾以疲憊平均得分最高，而肌肉震 顫之得分最低。（ 3 ）個案於計畫前生活品質 8 項次概念中，以身體生理功能平均得分最高，而活 力平均得分最低。（ 4 ）個案的症狀困擾與生活品質之「身體生理功能」、「一般健康」及「社會 功能」等次概念呈負相關（ p < .05 ）。（ 5 ）運動組個案經 12 週運動訓練計畫後，其整體症狀困 擾、胸痛、疲憊、頭痛、情緒不穩及頭暈等症狀困擾具顯著改善。（ 6 ）在生活品質方面，經運動 組經規律運動訓練計畫後，其身體疼痛、一般健康、活力及心理健康等生活品質次概念等得分具顯 著提升。
本研究結果顯示，僧帽瓣脫垂女性患者經 12 週跑步機規律運動訓練後，可協助改善其症狀困擾並 提升生活品質。
The Effects of Regular Exercise Training on Symptom Distress and Quality of Life in Female Patients With Mitral Valve Prolapse.
Title of Thesis: The Effects of Regular Exercise Training on Symptom Distress and Quality of Life in Female Patients With Mitral Valve Prolapse.
Institution: Graduate Institute of Nursing, Taipei Medical University
Author: Yu-Shuang Lin
Thesis directed by: Jen-Chen Tsai, Professor
The Mitral Valve Prolapse is the most common valvular disorder. It affects 5-15 adults, with a frequency in women approxi ﹪ mately twice that of men. Mitral Valve Prolapse is associate with symptoms of chest pain, arm pain, palpation, shortness of br eath, fatigue, headache, anxiety, mood swing, dizziness, passing out spells , muscle cramp and more. As a result, it is very im portant to increase the life quality for mitral valve prolapse patients by controlling the symptoms.
The purpose of the study were to evaluate the effects of regular exercise training on symptom distress and quality of life in fe male patients with mitral valve prolapse. A experimental design were used in this study. The subjects are female with mitral v alve prolapse and symptoms, aged between 20-50. They were randomized assigned into either exercise or control groups, 17 i n the exercise and 18 in the control, the exercise group participated in a 12-weeks treadmill exercise program, three times a we ek, 30 minutes each time. The control group were remained their living pattern. Date on the personal data chart, MVP sympto m check list, SF-36 (Short-Form 36 Health Survey), treadmill exercise testing of each subject were collected prior to the study , and the 12th week of the study. The date were analyzed by using percentage, mean, standard deviation, Chi-Square test, Man n-Whitney U test, Spearman Correlation and Wilcoxon Sign Rank test.
Results: (1) The average age of the subjects are thirthty-six years, average body mass index is 20.2 ± 2.1kg /m2 ， average ex ercise tolerance is 8.5 ± 2.3 METs. (2)Fatigue is the most frequently symptom, and the less is muscle cramp. (3)The total scor e of symptom distress and the subscores of life quality “physical functioning”, “general health” and “social functioning” are n egative related. (4)Patients who attended the regular exercise training program had significant improvement in the subscores o f chest pain, fatigue, headache, mood swing, dizziness and total symptom scores on the MVP symptom check list after the pro gram. (5)The exercise group had significant improvement in the subscores of “body pain”, “general health”, “vitality” and “m ental health” on the SF-36 compared with control group.
