背景：普瑞德-威利氏症候群 (Prader-Willi Syndrome, PWS，俗稱小胖威利，簡稱小胖)為先天性第十五對染色體異常之罕見疾病，發生率約 1/10,000~1/30,000，症狀包括輕度到中度智能障礙、情緒與學習障礙、過度進食以及肌肉張力低下，以致小胖傾向靜態生活，並缺少自主運動的能力。
目的：本研究欲探討社區日間作業設施(俗稱小作所)是否能促使小胖增加身體活動、減少靜態行為，以達到健康生活 的目的。
方法：我們利用三軸加速規測量十八名成年小胖連續八天之身體活動時間與強度、靜態行為的時間與型態;其中十名於週間日間參與小作所課程，八名未參與小作所課程。以獨立樣本 t 檢定比較兩組一週期間、週間日間、週間夜間、週末週日的身體活動量及靜態行為時間。
結果：結果顯示參與小作所課程的小胖於週間日間有較多的身體活動總量、中高強度身體活動量、步數，以及較少的靜態行為。於一週期間也有較多的中高強度身體活動量和步數，且在週末有較少的久坐次數。在週間夜間，兩組的身體活動量及靜態行為則無差異。
結論：本研究顯示，因為小作所的課程內容安排和時間規劃妥當，參與小作所課程的成年小胖比未參與小作所課程的成年小胖有較多的身體活動以及較少的靜態行為，尤其是週間日間。此項研究結論可作為健康促進政策之制定參考，若能廣設社區日間作業設施;或指導成年小胖之照顧者以此原則規劃作息和活動，可使更多成年小胖達到多動少坐的健康生活型態。

Background: It remains unclear whether adults with Prader-Willi syndrome (PWS) attending structured programs or courses in the community can engage in higher levels of physical activity and lower levels of sedentary behavior. Therefore, the purpose of this study was to compare the accelerometer-assessed physical activity and sedentary behavior of adults with PWS attending or not attending a small-scale community workshop (SSCW).
Methods: A total of 18 adults with PWS were recruited in this study. Of these participants, 10 regularly attended an SSCW and 8 did not. All of the participants were asked to wear GT3X+ accelerometers (Actigraph) for eight continuous days. Intensity-specific physical activity, total sedentary time, and sedentary bouts were measured. Anthropometric and personal demographic data were also gathered. The independent t-test was used to compare the differences in PA and sedentary behavior for the SSCW attending and non-attending groups.
Results: The results showed that over the 7-day period, the adults with PWS who attended the SSCW engaged in more moderate-to-vigorous PA and took more daily steps than those who did not. By stratifying between daytime/nighttime on weekdays, we further found that the participants who attended the SSCW had higher levels of total PA, moderate- to-vigorous PA, and steps, as well as lower total sedentary time, during the daytime on weekdays than those who did not. At nighttime of weekdays and weekends, however, no significant differences between the groups in terms of PA and sedentary time were found, except for the number of sedentary bouts on weekends.
Conclusions: The results showed that the adults with PWS who regularly attended the SSCW regularly had more PA and less sedentary time than those who did not, especially during the daytime on weekdays. Policies or programs promoting PA among adults with PWS should thus consider providing structured programs or courses in a community center.

Bames, J., Behrens, T. K., Benden, M. E., Biddle, S., Bond, D., Brassard, P., et al. (2012). Letter to the Editor: Standardized use of the terms" sedentary" and" sedentary behaviours". Applied Physiology Nutrition and Metabolism-Physiologie Appliquee Nutrition Et Metabolisme, 37, 540-542.
Butler, M. G. (1990). Prader‐Willi syndrome: Current understanding of cause and diagnosis. American journal of medical genetics, 35(3), 319-332.
Butler, M. G., Manzardo, A. M., Heinemann, J., Loker, C., & Loker, J. (2017). Causes of death in Prader-Willi syndrome: Prader-Willi Syndrome Association (USA) 40-year mortality survey. Genetics in Medicine, 19(6), 635-642.
Butler, M. G., Theodoro, M. F., Bittel, D. C., & Donnelly, J. E. (2007). Energy expenditure and physical activity in Prader–Willi syndrome: comparison with obese subjects. American journal of medical genetics Part A, 143(5), 449-459.
Cassidy, S. B. (1984). Prader-Willi syndrome. Current problems in pediatrics, 14(1), 5-55.
Cassidy, S. B., Schwartz, S., Miller, J. L., & Driscoll, D. J. (2012). Prader-Willi syndrome. Genet Med, 14(1), 10-26.
Castner, D. M., Tucker, J. M., Wilson, K. S., & Rubin, D. A. (2014). Patterns of habitual physical activity in youth with and without Prader-Willi syndrome. Research in Developmental Disabilities, 35(11), 3081-3088.
Crinò, A., Fintini, D., Bocchini, S., & Grugni, G. (2018). Obesity management in Prader–Willi syndrome: current perspectives. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 11, 579-593.
de Rezende, L. F. M., Lopes, M. R., Rey-Lopez, J. P., Matsudo, V. K. R., & do Carmo Luiz, O. (2014). Sedentary behavior and health outcomes: an overview of systematic reviews. PloS one, 9(8).
Faghri, P., Stratton, K., & Momeni, K. (2015). Sedentary lifestyle, obesity and aging: Implication for prevention. J. Nutr. Disorders and Therapy, 5(1).
Goldstone, A., Holland, A., Hauffa, B., Hokken-Koelega, A., Tauber, M., & PWS, S. C. a. t. S. E. M. o. t. C. C. o. P. W. (2008). Recommendations for the diagnosis and management of Prader-Willi syndrome. The Journal of Clinical Endocrinology & Metabolism, 93(11), 4183-4197.
Holm, V. A., Cassidy, S. B., Butler, M. G., Hanchett, J. M., Greenswag, L. R., Whitman, B. Y., & Greenberg, F. (1993). Prader-Willi syndrome: consensus diagnostic criteria. Pediatrics, 91(2), 398-402.
Martínez-González, M. Á., Martinez, J. A., Hu, F., Gibney, M., & Kearney, J. (1999). Physical inactivity, sedentary lifestyle and obesity in the European Union. International journal of obesity, 23(11), 1192-1201.
Migueles, J. H., Cadenas-Sanchez, C., Ekelund, U., Delisle Nyström, C., Mora-Gonzalez, J., Löf, M., et al. (2017). Accelerometer Data Collection and Processing Criteria to Assess Physical Activity and Other Outcomes: A Systematic Review and Practical Considerations. Sports Med, 47(9), 1821-1845.
Morales, J. S., Valenzuela, P. L., Pareja‐Galeano, H., Rincón‐Castanedo, C., Rubin, D. A., & Lucia, A. (2019). Physical exercise and Prader‐Willi syndrome: A systematic review. Clinical endocrinology, 90(5), 649-661.
Nordstrøm, M., Hansen, B. H., Paus, B., & Kolset, S. O. (2013). Accelerometer-determined physical activity and walking capacity in persons with Down syndrome, Williams syndrome and Prader–Willi syndrome. Research in Developmental Disabilities, 34(12), 4395-4403.
Prader, A. (1956). Ein syndrom von adipositas, kleinwuchs, kryptorchismus und oligophrenie nach myatonieartigem zustand im neugeborenenalter. Schweiz Med Wochenschr, 86, 1260-1261.
Russell, H., & Oliver, C. (2003). The assessment of food‐related problems in individuals with Prader‐Willi syndrome. British Journal of Clinical Psychology, 42(4), 379-392.
Schlumpf, M., Eiholzer, U., Gygax, M., Schmid, S., van der Sluis, I., & l'Allemand, D. (2006). A daily comprehensive muscle training programme increases lean mass and spontaneous activity in children with Prader-Willi syndrome after 6 months. Journal of Pediatric Endocrinology and Metabolism, 19(1), 65-74.
Troiano, R. P. (2007). Large-scale applications of accelerometers: new frontiers and new questions. Med Sci Sports Exerc, 39(9), 1501.
Vismara, L., Cimolin, V., Grugni, G., Galli, M., Parisio, C., Sibilia, O., & Capodaglio, P. (2010). Effectiveness of a 6-month home-based training program in Prader-Willi patients. Research in Developmental Disabilities, 31(6), 1373-1379.
Woods, S. G., Knehans, A., Arnold, S., Dionne, C., Hoffman, L., Turner, P., & Baldwin, J. (2018). The associations between diet and physical activity with body composition and walking a timed distance in adults with Prader–Willi syndrome. Food & nutrition research, 62.
Zipf, W. B. (2004). Prader-Willi syndrome: the care and treatment of infants, children, and adults. Adv Pediatr, 51, 409-434.