تاثیر یک دوره برنامه تمرینی پایدارسازی عصبی عضلانی پویا بر تعادل و حس عمقی مچ پا در بیماران مبتلا به مولتیپل اسکلروزیس

نوع مقاله : مقاله پژوهشی

نویسندگان

1 استادیار فیزیولوژی ورزشی، گروه تربیت بدنی و علوم ورزشی، دانشکده علوم انسانی، موسسه آموزش عالی راغب اصفهانی، اصفهان، ایران (نویسنده مسئول)

2 کارشناس ارشد آسیب شناسی و حرکات اصلاحی، گروه تربیت بدنی و علوم ورزشی، دانشکده علوم انسانی، موسسه آموزش عالی راغب اصفهانی، اصفهان، ایران

چکیده

مقدمه
مطالعه حاضر با هدف تاثیر 8 هفته برنامه تمرینی پایدارسازی عصبی عضلانی پویا (DNS) بر تعادل ایستا و پویا، حس عمقی مچ پا در بیماران زن مبتلا به مولتیپل اسکلروزیس ( (MSانجام شد.
روش کار
جهت انجام این مطالعه 24 نفر انتخاب شدند که در دو گروه  کنترل (تعداد: 12 نفر، سن: 06/3 ± 50/45 سال، قد: 27/0 ± 66/1 متر، وزن: 05/3 ± 08/58 کیلوگرم، شاخص توده بدنی: 04/1 ± 99/20 کیلوگرم بر متر مربع، EDSS: 75/0 ± 25/2) و تمرینی (تعداد: 12 نفر، سن: 84/2 ± 91/43 سال، قد: 03/0 ± 65/1 متر، وزن: 73/4 ± 91/56 کیلوگرم، شاخص توده بدنی: 17/1 ± 75/20 کیلوگرم بر متر مربع، EDSS: 51/0 ± 91/1) قرار گرفتند. در این مطالعه تعادل ایستا با آزمون شارپند رومبرگ و تعادل پویا با آزمون زمان برخاستن و رفتن ارزیابی شد. همچنین حس عمقی مچ پا در دو وضعیت دورسی فلکشن و پلانتار فلکشن با گونیامتر ارزیابی شد. پس از پایان ارزیابی ها گروه تمرینی تمرینات را به مدت 8 هفته (3 جلسه در هفته) انجام دادند. گروه کنترل نیز در این دوره به فعالیت های روزمره خود پرداختند. پس از پایان تمرینات مجددا ارزیابی ها انجام شد. در این مطالعه برای بررسی نرمال بودن داده‌ها از آزمون شاپیروویلک استفاده شد. همچنین برای بررسی تأثیر تمرین بر متغیرها و تفاوت های بین گروهی از آزمون تحلیل کوواریانس و تی همبسته، یو من ویتنی و ویلکاکسون برای آنالیز داده‌ها استفاده شد. همچنین برای تحلیل داده‌ها در این پژوهش از نرم‌افزار SPSS 24  استفاده شد.
نتایج
نتایج این مطالعه نشان داد برنامه تمرینی DNS اثر معنی داری در بهبود تعادل ایستا با چشمان باز (001/0=P) و (001/0=P)، تعادل پویا (001/0=P) و حس عمقی مچ پا در وضعیت دورسی فلکشن (01/0=P) و پلانتار فلکشن (001/0=P) دارد. همچنین نتایج مربوط به مقایسه دو گروه نشان دهنده وجود تفاوت معنی دار بین دو گروه بود (05/0≥P).
نتیجه گیری
بر اساس نتایج، استفاده این برنامه تمرینی به درمانگران درگیر با این بیماران پیشنهاد می­شود.

کلیدواژه‌ها

عنوان مقاله [English]

Impact of a course dynamic neuromuscular stabilization (DNS) training program on balance and ankle proprioception in female patients with MS

نویسندگان [English]

  • Saeid Rostami 1
  • Mehrnoush Esmaeilian 2
  • Faeze Asghari Hasori 2
1 Assistant Professor of Sports Physiology, Department of Physical Education and Sports Sciences, Faculty of Humanities, Ragheb Esfahani Institute of Higher Education, Isfahan, Iran (corresponding author)
2 Master of Pathology and Corrective Movements, Department of Physical Education and Sports Sciences, Faculty of Human Sciences, Ragheb Esfahani Institute of Higher Education, Isfahan, Iran
چکیده [English]

Introduction
The aim of this study was to evaluate the impact of a course dynamic neuromuscular stabilization (DNS) training program on balance and ankle proprioception in female patients with MS.
Material and Method
For this study, 24 people were selected who were divided into control (Number: 12 people, Age: 45.50 ± 3.06 years, Height: 1.66 ± 0.02 m, Weight: 58.08 ± 3.05 kg, BMI: 20.99 ± 1.04 Kg/m2, EDSS: 2.05 ± 0.75) and training (Number: 12 people, Age: 43.91 ± 2.84 years, Height: 1.65 ± 0.03 m, Weight: 56.91 ± 4.73 kg, BMI: 20.75 ± 1.17 Kg/m2, EDSS: 1.91 ± 0.51) groups. In this study, static balance was evaluated by Sharpen Romberg test and dynamic balance was evaluated by Timed Up and Go test. Also, ankle proprioception was evaluated in two positions dorsiflexion and plantar-flexion with a goniometer. At the end of the evaluations, the training group performed the exercises for 6 weeks (3 sessions per week). The control group also engaged in their daily activities during this period. Assessments were performed again after the exercises. In this study, Shapiro–Wilk test was used to check the normality of the data. Analysis of covariance and paired t-test, Yu Mann-Whitney and Wilcoxon were also used to analyze the effect of exercise on variables and differences between groups. SPSS24 software was also used to analyze the data in this study.
Results
The results of this study showed that the dynamic neuromuscular stabilization exercise program had a significant effect on improving static balance with open eyes (P=0.001) and (P=0.001), dynamic balance (P=0.001) and proprioception the foot is in dorsiflexion (P=0.01) and plantar flexion position (P=0.001). Also, the results of comparison between the two groups showed a significant difference between the two groups (P≤0.05).
Conclusion
Based on the results of using this exercise program, it is recommended to the therapists involved with these patients.

کلیدواژه‌ها [English]

  • Dynamic Neuromuscular Stabilization
  • Multiple Sclerosis
  • Balance
  • Proprioception

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مجله دانشکده پزشکی دانشگاه علوم پزشکی مشهد
دوره 66، شماره 4
مهر-آبان1402
مهر و آبان 1402

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