特別養護老人ホーム入所者の生活時間構造および24時間心拍数変動

Heart Rate Response During 24 Hours of Daily Life in Elderly Disabled Persons

要旨

　特別養護老人ホーム入所者の身体活動水準を知るために，入所者30名(年齢66～92歳，男性11名，女性19名)を移動能力別に3群(A群：独歩，B群：車椅子，C群：寝たきり)に分類し，1．日常生活時間調査および2．胸部双極誘導心電図による24時間連続心拍数を指標として各群を比較した．

　その結果，1)日常生活時間の使い方は，3群ともに休養・くつろぎの時間が約7時間30分～12時間30分で睡眠時間を除く一日の大半を占めていた．身体運動は0～4分であり顕著にすくなかった．2)24時間における平均心拍数は，男性が63～69拍/分，女性が66～73拍/分であり，男性・女性の各群間では有意差が認められず，独歩群の活動量の不足が指摘された．また，睡眠時の平均心拍数に対する覚醒時の平均心拍数の増加率は，約11～18.3％であり，活動時間帯の身体活動が全体的に低いことが明らかになった．心拍数を増加させた日常生活行動は，体位変換，食事動作などであった．

　以上のことから，特別養護老人ホーム入所者の活動水準は全体的に低く，特に，ADLの自立している独歩群(A群)にたいして，活動性を高めるための援助の必要性が示唆された．

Abstract

　The physical activity level of elderly disabled persons was meaured through variations of their heart rate in daily life for a period of 24 hours.

　Thirty elderly disabled persons were investigated. They were living in the geriatric nursing home for disabled elderly persons. There were 11 males and 19 females of ages ranging from 66 to 92. The subjects were divided into three groups according to their degree of mobility, including an independent ambulated group (A), a wheel-chair group (B), and a bed-ridden group (C).

　The results were summerized as follows : Concerning the point of daily life spent in the nursing home, they spent less time for social activities-more time for resting or idleness, and physical exercise was extremely reduced. There were no significant differences in use of daily time among the groups. The mean heart rate per day varied from 63 beats/min to 73 beats/min, and no differences were noted in respect to sex. Neither were differences noted among the groups. The maximum, minimum and mean heart rates were increased during waking more than sleeping, as a whole. Major daily activities that increased the heart rate were changing position, taking meals, etc.

　The physical activity level of the elderly disabled persons was found to be very low, especially for the independent ambulated group. It is necessary to set up a program for general conditioning exercises for all groups.