اثربخشی یک برنامه‌ی تمرین راه رفتن با نشانه حسی بر مدت‌زمان فعالیت عضلانی اندام تحتانی در بیماران مبتلا به ام‌ اس

نوع مقاله : مقاله پژوهشی

نویسندگان

1 دکتری تخصصی، استادیار، دانشکده ادبیات و علوم انسانی، دانشگاه زابل، زابل، ایران (نویسنده مسئول)

2 دانشجوی پزشکی، دانشگاه علوم پزشکی اصفهان، ایران

چکیده

مقدمه: بیماری ام اس به دلیل از بین رفتن میلین سیستم عصبی مرکزی قادر است که توانایی راه رفتن و کیفیت زندگی افراد را تحت تأثیر قرار دهد؛ بنابراین، هدف از این مطالعه، بررسی اثربخشی یک برنامه­ی تمرین راه رفتن با نشانه حسی بر مدت‌زمان فعالیت عضلانی اندام تحتانی در بیماران مبتلا به ام‌ اس بود.
روش کار: مطالعه حاضر نیمه تجربی و جامعه آماری شامل تمامی بیماران عضو انجمن ام‌ اس زاهدان بودند که از میان آن­ها تعداد 28 بیمار داوطلب (9 مرد و 19 زن) با دامنه سنی 25 تا 45 سال انتخاب شدند. تمرینات گروه تجربی شامل؛ راه رفتن با نشانه موزن شنیداری و برای گروه کنترل شامل؛ راه رفتن ساده بود. تمرینات به مدت شش هفته، سه جلسه در هفته و هر جلسه 30 دقیقه انجام شدند. قبل و بعد از تمرینات، مدت‌زمان فعالیت عضلات؛ همسترینگ و دوقلو توسط دستگاه الکترومایوگرافی سطحی اندازه­گیری شد. تحلیل داده­ها با استفاده از مدل آنالیز کوواریانس و روش ناپارامتری بوت استرپ در مدل آنالیز کوواریانس انجام شد.
نتایج: یافته‌ها نشان داد؛ نشانه موزون حسی بر مدت‌زمان فعالیت عضلات همسترینگ و دوقلو در فاز استقرار تأثیر معنی­داری داشته است (05/0>p). همچنین؛ علی­رغم عدم وجود تفاوت معنی­دار در مدت‌زمان فعالیت عضلات همسترینگ و دوقلو بین دو گروه تجربی و کنترل در فاز نوسان (05/0p>)، بهبودی در مدت‌زمان فعالیت عضله همسترینگ در فاز نوسان مشاهده گردید.
نتیجه‌گیری: می‌توان بیان نمود که تمرین راه رفتن با نشانه موزون شنیداری را می­توان به‌عنوان یک روش درمان مکمل برای بهبود مدت‌زمان فعالیت عضلانی اندام تحناتی و درنتیجه عملکرد راه رفتن در بیماران مبتلا به ام اس پیشنهاد کرد.

کلیدواژه‌ها

عنوان مقاله [English]

The effectiveness of a walking exercise program with sensory cues on the duration of lower limb muscle activity in patients with MS

نویسندگان [English]

  • Mansoureh Shahraki 1
  • Mohammad Sadegh Sahebzadeh 2
1 Faculty of Literature and Humanities, University of Zabol, Zabol, Iran. (Corresponding Author)
2 Medical Student, Isfahan Medical University, Iran
چکیده [English]

Introduction: MS is due to the loss of inflammatory myelin of the central nervous system that is able to walk, affect the quality of life; Thus, The aim of this study was to evaluate the effectiveness of a walking exercise program with sensory cues on the duration of lower limb muscle activity in patients with MS.
Methods: The present study was a quasi-experimental and the statistical population included all patients who were members of Zahedan MS Association, from which 28 volunteer patients (9 males and 19 females) with an age range of 25 to 45 years were selected. Experimental group exercises include; Walking with auditory weight signals and for the control group including; Walking was easy. Exercises were performed for six weeks, three sessions per week and each session lasted 30 minutes. Before and after exercise, duration of muscle activity; Hamsters and twins were measured by surface electromyography. Data analysis was performed using covariance analysis model and non-parametric bootstrap method in covariance analysis model.
Results: The findings showed; Rhythmic sensory cues had a significant effect on the duration of hamstring and Gastrocnemius muscle activity in the stance phase (p <0.05). also; Despite the lack of significant differences in the duration of hamstring and Gastrocnemius muscle activity between the experimental and control groups in the swing phase (p> 0.05), improvement in the duration of hamstring muscle activity in the swing phase was observed.
Conclusion: It can be said that walking exercise with auditory rhythmic cue can be suggested as a complementary treatment method to improve the duration of muscular activity and thus gait performance in patients with MS.

کلیدواژه‌ها [English]

  • Gait
  • Sensory Cues
  • MS
  • Muscle Activity

مراجع

  1. Heesen C, Bohm J, Reich C, Kasper J, Goebel M, Gold SM. Patient perception of bodily functions in multiple
    sclerosis: gait and visual function are the most valuable. Mult Scler. 2008;14(7):988–91.
    2. Larocca NG. Impact of walking impairment in multiple sclerosis: perspectives of patients and care partners. Patient.
    2011;4(3):189-201.
    3. Noseworthy JH, Lucchinetti C, Rodriguez M, Weinshenker BG. Multiple Sclerosis. N Engl J Med. 2000;343(13):938-
    52.
    4. Cameron MH, Wagner JM. Gait Abnormalities in Multiple Sclerosis: Pathogenesis, Evaluation, and Advances in
    Treatment. Curr Neorol Neurosci. 2011;11(5):507-15.
    5. Huisinga JM, Filipi ML, Schmid KK, Stergiou N. IS there a relationship between fatigue questionnaires and gait
    mechanics in persons with multiple sclerosis?. Arch Phys Med Rehabil. 2011;92(10):1594–601.
    6. Sacco R, Bussman R, Oesch P, Kesselring J, Beer S. Assessment of gait parameters and fatigue in MS patients during
    inpatient rehabilitation: a pilot trial. J Neurol. 2011;258(5):889-94
    7. Thoumie P, Lamotte D, Cantalloube S, Faucher M, Amarenco G. Motor determinants of gait in 100 ambulatory
    patients with multiple sclerosis. Mult Scler. 2005;11(4):485-91.
    8. Yahia A, Ghroubi S, Mhiri C, Elleuch MH. Relationship between muscular strength, gait and postural parameters in
    multiple sclerosis. Ann Phys Rehabil Med. 2011;54(3):144-55. doi: 10.1016/j.rehab.2011.02.004.
    9. Sosnoff JJ, Gappmaier E, Frame A, Motl RW. Influence of spasticity on mobility and balance in persons with multiple
    sclerosis. J Neurol Phys Ther. 2011;35(3):129-32. doi: 10.1097/NPT.0b013e31822a8c40.
    10. Pearson OR, Busse ME, Van Deursen RW, Wiles CM. Quantification of walking mobility in neurological disorders.
    QJM 2004;97(8):463–75.
    11. Vitkovich M. Stroop interference and negative priming in patients with multiple sclerosis. Neuropsychologia.
    2002;40(9):1570-6.
    12.Conklyn D, Stough D, Novak E, Paczak S, Chemali K, Bethoux F. A home-based walking program using rhythmic
    auditory stimulation improves gait performance in patients with multiple sclerosis: a pilot study. Neurorehabil Neural
    Repair. 2010;24(9):835-42.
    13. Ghai S, Ghai I. Effects of rhythmic auditory cueing in gait rehabilitation for multiple sclerosis: a mini systematic
    review and meta-analysis. Frontiers in neurology. 2018 Jun 11;9:386.
    14. Shahraki M, Sohrabi M, Torbati HT, Nikkhah K, NaeimiKia M. Effect of rhythmic auditory stimulation on gait
    kinematic parameters of patients with multiple sclerosis. Journal of medicine and life. 2017 Jan;10(1):33.
    15. Shahraki M, Sohrabi M, Torbati HT, Nikkhah K, NaeimiKia M. The Effect of Rhythmic Visual
    Stimulation on Kinematics Parameters of Gait in Patients with Multiple Sclerosis. Motor Behavior.
    2019 Spring;11(35):17-34. (In Persian).
    16. Memar Moghaddam M, Shahraki M. The Effect of Rhythmic Auditory Stimulation During Gait Training on
    Kinematic Parameters of Gait in Patients with Multiple Sclerosis. Motor Behavior. 2018; 10(33):149-64. (In Persian).
    17. Thaut MH. Neural basis of rhythmic timing networks in the human brain. Ann N Y Acad Sci. 2003;999:364-73.
    18.Bengtsson SL, Ullen F, Ehrsson HH, Hashimoto T, Kito T, Naito E, Forssberg H, Sadato N. Listening to rhythms
    activates motor and premotor cortices. cortex. 2009 Jan 1;45(1):62-71.
    19.Chen JL, Penhune VB, Zatorre RJ. Listening to musical rhythms recruits motor regions of the brain. Cerebral cortex.
    2008 Dec 1;18(12):2844-54.
    20. Grahn JA, Brett M. Rhythm and beat perception in motor areas of the brain. Journal of cognitive neuroscience. 2007
    May 1;19(5):893-906.
    21. Thaut MH, McIntosh GC, Rice RR. Rhythmic facilitation of gait training in hemiparetic stroke rehabilitation. J Neurol
    Sci. 1997;151(2):207-12.
    22. Thaut MH, McIntosh GC, Prassas SG, Rice RR. Effect of Rhythmic Auditory Cuing on Temporal Stride Parameters
    and EMG Patterns in Normal Gait. J Neruo Rehab. 1992;6:185-90.
    23. Thaut MH, Leins AK, Rice RR, Argstatter H, Kenyon GP, McIntosh GC, et al. Rhythmic auditory stimulation
    improves gait more than NDT/Bobath training in near-ambulatory patient early poststroke:a single-blind,
    randomizedtrial .Neurorehabil Neural Repair. 2007;21(5):455-9.
    24. Paltsev YI, Elner AM. Change in the functional state of the segmental apparatus of the spinal cord under the influence
    of sound stimuli and its role in voluntary movement. Biophysics. 1967;12:1219-26.
    25.Rossignol S, Jones GM. Audio-spinal influences in man studied by the H-reflex and its possible role in rhythmic
    movement synchronized to sound. Electroencephaloger Clin Neurophysiol. 1976;41(1):83-92.
    26.Rossignol S. Reaction of spinal motoneurons to musical sounds.Proc XXV Int Phys Congr 1971;IX:abs.480.
    27. Safranek M, Koshland G, Raymond G. Effect of auditory rhythm on muscle activity. Phys Ther. 1982;62(2):161-8.
  2. 28. Thaut MH, Schleiffers S, Davis WB. Analysis of EMG activity in biceps and triceps muscle in an upper extremity
    gross motor task under the influence of auditory rhythm. J Music Ther. 1991;28(2):64-88.
    29. Hashiguchi Y, Ohata K, Kitatani R, Sakuma K,Watanabe A, Yamakami N, eat al. Efeect of rhythmic auditory
    stimulation on gait parameters and gait emg in patients with hemiplegia after strok. Gait Posture. 2014;39(1):S139.
    30.Rochester L, Nieuwboer A, Baker K, Hetherington V, Willems AM, Chavret F, et al. The attentional cost of external
    rhythmical cues and their impact on gait in Parkinson's disease: effect of cue modality and task complexity. J Neural
    Transm. 2007;114(10):1243–48.
    31.Rochester L, Baker K, Hetherington V, Jones D, Willems AM, Kwakkel G, et al. Evidence for motor learning in
    Parkinson's disease: acquisition, automaticity and retention of cued gait performance after training with external
    rhythmical cues. Brain Res. 2010;1319:103–11.
    32. Newell KM, Carlton LG, Carlton MJ. Velocity as a Factor in Movement Timing Accuracy. J Motor Behav
    1980;12(1):47-56.
    33. Haas F, Distenfeld S, Axen K. Effects of perceived musical rhythm on respiratory patterns. J Appl Physiol.
    1986;61(3):1185-91.
    34. Wulf G, Dufek JS, Lozano L, Pettigrew C. Increased jump height and reduced EMG activity with an external focus.
    Hum Mov Sci. 2010;29(3):440-8.
    35. Ploutz LL, Tesch PA, Biro RL, Dudley GA. Effect of resistance training on muscle use during exercise. J Appl Physiol.
    1994;76(4):1675-81.
    36.Conley MS, Stone MH, Nimmons M, Dudley GA. Resistance training and human cervical muscle recruitment
    plasticity. J Appl Physiol. 1997;83(6): 2105-11.
    37. Green RAR, Wilson DJ. A pilot study using magnetic resonance imaging to determine the pattern of muscle group
    recruitment by rowers with different levels of experience. Skeletal Radiol. 2000;29(4):196-203.
    38. Wulf G. Attentional focus effects in balance acrobats. Res Q Exerc Sport. 2008;79(3):319-25
مجله دانشکده پزشکی دانشگاه علوم پزشکی مشهد
دوره 63، شماره 1
فروردین و اردیبهشت 1399
صفحه 2312-2321

فایل ها

هم رسانی

ارجاع به این مقاله

آمار