اثر هشت هفته تمرین عملکردی آب و خشکی بر تعادل و حس عمقی مچ پای کودکان فلج مغزی دایپلژ ی

عباسی بافقی, حمید; قاسم شریفی, حسین; عابدین زاده, سعید; شریفاتپور, رضا

doi:10.48308/joeppa.2024.234490.1220

اثر هشت هفته تمرین عملکردی آب و خشکی بر تعادل و حس عمقی مچ پای کودکان فلج مغزی دایپلژ ی

نوع مقاله : علمی - پژوهشی

نویسندگان

گروه علوم ورزشی، دانشگاه یزد، یزد، ایران

10.48308/joeppa.2024.234490.1220

چکیده

زمینه و هدف: کودکان مبتلا به فلج مغزی اسپاستیک از دید حرکتی و تعادل مشکلات فراوانی دارند. ساختار کج قامت کودکان فلج مغزی اسپاستیک، عملکرد آن‌ها در فعالیت‌های روزمره را مختل می‌کند. به‌دلیل تنش دائمی عضلانی در این افراد یک اسپاسم دائمی در عضلات فلکسور آن‌ها دیده می‌شود. این شرایط همراه با دیگر ویژگی‌های بیماری، افراد را در حالت فقر حرکتی قرار می‌دهد. اخیراً تمرین در آب و خشکی در هر دو عرصة ورزش و توانبخشی در میان همگان و به‌ویژه افراد دارای محدودیت حرکتی محبوبیت بسیاری پیدا کرده است. هدف از این تحقیق، بررسی تأثیر روش تمرینی عملکردی در آب و خشکی بر تعادل و حس عمقی اندام تحتانی کودکان فلج مغزی دایپلژی بود.
مواد و روش‌ها: 30 کودک فلج مغزی دایپلژی از طریق نمونه‌گیری در دسترس انتخاب شده و به‌صورت تصادفی به دو گروه 15 نفرة تجربی (سن 63/1±33/9 سال، قد 06/0±32/1 متر، وزن 63/3±88/33 کیلوگرم) و کنترل (سن 30/1±46/9 سال، قد 05/0±30/1 متر، وزن 52/3±04/32 کیلوگرم) تقسیم شدند. به‌منظور ارزیابی تعادل ایستا یا تعادل پویا با استفاده از آزمون رساندن عملکردی (در سه وضعیت)، به‌منظور ارزیابی تعادل پویا از آزمون زمان برخاستن و راه رفتن، و ارزیابی حس عمقی مفصل (دورسی فلکشن) پیش و پس از انجام تمرین استفاده شد. گروه تجربی تمرین روی زمین شامل تمرین قدرتی، تعادلی، عملکردی و تمرین در آب را به مدت هشت هفته و به‌صورت چهار جلسه در هفته انجام دادند. برای بررسی داده‌ها از آزمون‌های تجزیه‌وتحلیل واریانس با اندازه‌گیری مکرر دوراهه در سطح معناداری 05/0≥P استفاده شد.
نتایج: پس از انجام هشت هفته تمرین ترکیبی آب و خشکی، بهبود معناداری در آزمون تعادل رساندن عملکردی (05/0>P) و حس عمقی مفصل مچ پا (001/0=P) و همچنین کاهش معناداری در زمان آزمون برخاستن و راه رفتن مشاهده شد (001/0=P). در هیچ‌یک از متغیرهای گروه کنترل تفاوت معناداری مشاهده نشد (05/0˃ P).
نتیجه‌گیری: نتایج نشان داد که انجام تمرین عملکردی به‌صورت ترکیبی در آب و خشکی، می‌تواند اثر مفیدی بر بهبود تعادل، حس عمقی و در نهایت عملکرد حرکتی و راه رفتن کودکان فلج مغزی داشته باشد. همچنین انجام تمرین ترکیبی آّب و خشکی می‌تواند تعادل و حس عمقی مچ پای کودکان فلج مغزی دایپلژی را بهبود بخشد و به‌وسیلة بهبود تعادل و حس عمقی این کودکان می‌توان مشکلات حرکتی و زمین خوردن این کودکان را کاهش داد و گامی مؤثر در بهبود سلامتی و شیوة زندگی آن‌ها برداشت. بنابراین انجام این تمرین عملکردی ترکیبی به مربیان و درمانگران توصیه می‌شود.

کلیدواژه‌ها

موضوعات

عصب و عضله

عنوان مقاله [English]

The effect of 8 weeks of aquatic and land exercise training on balance and proprioception of the ankle joint in children with diplegia cerebral palsy

نویسندگان [English]

Hamid Abbasi
Hossein Ghasemsharifi
Saeed Abedinzadeh
Reza Sharifatpour

Department of Sports Sciences, University of Yazd, Yazd, Iran

چکیده [English]

Background and Purpose: Children with spastic cerebral palsy have many problems in terms of movement and balance. The crooked structure of children with spastic cerebral palsy disturbs their balance function. Due to the constant muscle tension in these people, a permanent spasm is seen in their flexor muscles. Together with other features of the disease, this leads to limited mobility for those affected. Recently, training in water and on land have become very popular in both sports and rehabilitation, especially for people with limited mobility. The aim of this study was to investigate the effects of a functional training protocol combining water and land exercises on the balance and proprioception of the lower limbs of children with cerebral palsy and diplegia.
Materials and Methods: Thirty children with diplegia cerebral palsy were selected through available sampling and randomly divided into two equal groups of experimental (age, 9.33±1.63 years; height, 1.32±0.06 m; weight, 33.88±3.63 kg) and control group (age, 9.46±1.30 years; height, 1.30±0.05 m; weight, 32.04±3.52 kg). Subjects in the experimental group performed a training protocol on the ground including strength exercises, balance exercises and functional exercises and training protocol in water for 8 weeks and 4 sessions per week. Before and after the training period static balance was evaluated by using the functional reaching test, the dynamic balance by using the time up and go test (TUG), and joint proprioceptive by measuring the angle of dorsiflexion. To statistically analyze the data, two-way repeated measures of ANOVA was used at a significant level of p≤0.05.
Results: After 8 weeks of land and water combined training, there were significant improvements in the functional balance test (p<0.05) and ankle joint proprioception (p=0.001), as well as a significant reduction in time of TUG test(p=0.001). No significant within-group differences were observed in any of the variables in the control group (p˃ 0.05).
Conclusion: The results of the present study showed that performing combined strength, aquatic, functional and balance exercises improve balance, joint proprioception, movement and walking performance in children. In addition, combined water and land exercises can improve the balance and proprioception of children with cerebral palsy and diplegia, and as a result the movement problems and falls of these children could be reduced, which is important for improving the health and lifestyle of these children. Therefore, prescribing this exercise training modality is recommended to trainers and therapists.

کلیدواژه‌ها [English]

Functional Training
Aquatic Exercise
Balance
Proprioception
Diplegia

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