تأثیر هشت هفته تمرین ترکیبی بر قدرت عضلانی، تعادل و ظرفیت عملکردی بیماران مبتلا به مولتیپل اسکلروزیس

نویسندگان
ابراهیم عطارسیاح
سید علیرضا حسینی کاخک
محمدرضا حامدی نیا
بهاره پیرایش
مؤسسه فیزیوتراپی توان، سبزوار
چکیده
زمینه و هدف

مولتیپل اسکلروزیس یک بیماری مزمن در سیستم اعصاب مرکزی است که مسیرهای حرکتی را تحت تأثیر قرار می دهد و به ضعف و خستگی عضلانی منجر می شود. هدف از این پژوهش بررسی تأثیر هشت هفته تمرین ترکیبی (مقاومتی و تسهیل عصبی-عضلانی گیرنده های عمقی) بر قدرت عضلانی، تعادل و ظرفیت عملکردی این بیماران بود.

مواد و روش ها

بدین منظور، 37 زن و مرد مبتلا به مولتیپل اسکلروزیس بصورت هدفمند و تصادفی به دو گروه هدف ( 19 نفر با میانگین سن 51 /6 ± 53 /34 سال، میانگین وزن 4/ 13 ± 02 /67 کیلوگرم و درجه ناتوانی 21 /1 ± 55 /2) و گروه کنترل ( 18 نفر با میانگین سن 93 /4± 78 /36 سال، میانگین وزن 13 /10 ± 92 /66 کیلوگرم و درجه ناتوانی 97 /0 ± 88 /2) تقسیم شدند. گروه هدف در یک برنامه تمرین ترکیبی (تمرین قدرتی و تمرین تسهیل عصبی-عضلانی گیرنده های عمقی) به مدت هشت هفته شرکت کردند. قبل و بعد از پروتکل تمرینی، قدرت عضلانی، تعادل و ظرفیت عملکردی بیماران ارزیابی گردید. برای تحلیل داده ها از آزمون t وابسته در سطح معنی داری ( 05/P< 0 ) استفاده شد.

یافته ها

نتایج نشان داد هشت هفته تمرین ترکیبی موجب افزایش معنی دار قدرت عمومی ( 001/P= 0 )، قدرت بالاتنه ( 001/P= 0 )، تعادل پای برتر ( 003/P= 0 )، تعادل پای غیربرتر ( 001/P= 0 ) و استقامت راه رفتن ( 001/P= 0 ) شد. همچنین هیچ تفاوت معنی داری در فاکتور سرعت راه رفتن ( 12/P= 0 ) مشاهده نشده است.

نتیجه گیری

یک دوره تمرین ترکیبی، منجر به افزایش قدرت، تعادل و استقامت راه رفتن در بیماران مبتلا به مولتیپل اسکلروزیس می گردد. لذا پیشنهاد می شود این نوع تمرینات نیز به عنوان بخشی از مداخله درمانی در برنامه توانبخشی و بهبود مبتلایان مورد توجه قرار گیرد.



* نویسنده مسئول: دانشگاه حکیم سبزواری، دانشکده تربیت بدنی و علوم ورزشی.

پست الکترونیک: E.attarsayyah68@gmail.com
کلیدواژه‌ها
مولتیپل اسکلروزیس
تمرین مقاومتی
تمرینات کششی

عنوان مقاله English

Effect of 8-week Combined Training on Muscle Strength, Balance and Functional Capacity of Multiple Sclerosis Patients

نویسندگان English

Ebrahim Attar Sayyah
Seyyed Alireza Hosseini Kakhk
Mohammadreza Hamedinia
Bahare Pirayesh
چکیده English

Introduction and Aims

Multiple Sclerosis (MS) is a chronic disease of the central nervous system that affects motor pathways, leading to muscle weakness and muscle fatigue. The purpose of the present study was to investigate the influence of 8 weeks of combined (resistance and proprioceptive neuromuscular facilitation) training on the muscle strength, the balance and functional capacity in patients with MS.

Materials and Methods

To this end, thirty-seven male and female subjects with Multiple Sclerosis were randomly-purposefully assigned to the experimental (N=19, Age=34.53±6.51, Weight=67.02±13.14, EDSS=2.55±1.21) and control (N=18, Age=36.78±4.93, Weight=66.92±10.13, EDSS=2.88±0.97) groups. The experimental group received a combined (resistance and proprioceptive neuromuscular facilitation) training program for 8 weeks. In the experimental group, the muscular strength, balance and functional capacity of the subjects were measured before and after the training protocol. The collected data were analyzed using paired sample T-test at α = 0.05 level of significance.

Results

The results of the study showed that there was a significant increase in general strength (P=0.001), upper strength (P=0.001), dominant leg balance (P=0.003), non-dominant leg balance (P=0.001) and gait endurance (P=0.001) factors, while there was observed no increase in the gait speed factor (P=0.12).

Conclusion

Based on the findings of the present study, a period of combined training produced a significant increase of strength, balance and distance of walking. Therefore, it is suggested that this type of training be considered as a part of the intervention in the rehabilitation program to improve the physical condition of the patients.



* Corresponding Author: Hakim Sabzevary University of Sabzevar, Faculty of Physical Education and Sport Sciences.

Email: E.attarsayyah68@gmail.com

کلیدواژه‌ها English

multiple sclerosis
resistance training
muscle stretching exercises
Mayr N, Baumgartner C, Zeitlhofer J, Deecke L. The sensitivity of transcranial cortical magnetic stimulation in detecting pyramidal tract lesions in clinically definite multiple sclerosis. Neurology, 1991;41(4):566-9.

Dalgas U, Stenager E, Ingemann-Hansen T. Multiple sclerosis and physical exercise: recommendations for the application of resistance- endurance and combined training. Mult Scler. 2008;14(1):35-53

Eftekhari A, Nikbakht H, Etemadifar M, RAbiee K. The effect of endurance training on aerobic capacity and quality of life in women Multiple Sclerosis. Olympic, 2008;16(1):37-46. [Persian]

Kishiyama S, Oken BS.(2002). Yoga as an experimental intervention for cognition in Multiple Sclerosis. Int J Yoga Therap. 2002;12(1):57-62.

Romberg A, Virtanen A, Ruutiainen J, Aunola S, Karppi SL, Vaara M, et al. Effects of a 6 month exercise program on patients with multiple sclerosis: a randomized study. Neurology, 2004;63(11);2034-8.

White LJ, McCoy SC, Castellano V, Gutierrez G, Stevens JE, Walter GA, et al. Resistance training improves strength and functional capacity in person with multiple sclerosis. Mult Scler. 2004;10(6):668-74.

Carroll CC, Gallagher PM, Seidle ME, Trappe SW. Skeletal muscle characteristics of people with multiple sclerosis. Arch Phys Med Rehabil. 2005;86(2):224-9.

Ng AV, Miller R, Gelinas D, Kent-Braun JA. Functional relationships of central and peripheral muscle alterations in multiple sclerosis. Muscle Nerve, 2004;29(6):843-52.

Schulz KH, Gold SM, Witte J, Bartsch K, Lang UE, Hellweg PR, et al. Impact of aerobic training on immuneendocrine rametrers, neurotophic factors, quality of life and coordinative function in multiple sclerosis. J Neurol Sci. 2004;225(1-2):11-8.

Kurdi M, Anoosheh L, Khodadadh S, Khosravi N, Sangelaji B. The effect of selected combined training on strength, balance and life quality of Multiple Sclerosis patients. J Sports Med. 2011;2(2):51-64. [Persian]

DeBolt LS, McCubbin JA. The effects of home-based resistance exercise on balance, power, and mobility in adults with Multiple Sclerosis. Arch Phys Med Rehabil. 2004;85(2):290-7.

Cattaneo D, Jonsdittor J, Zocchi,M, Regola A. Effects of balance exercises on people with Mulitple Sclerosis: A pilot study. Clin Rehabil. 2007;21(9):771-81.

Taylor NF, Dodd KJ, Prasad D, Denisenko S. Progressive resistance exercise for people with multiple sclerosis. Disabil Rehabil. 2006;28(18):1119-26.

Korkmaz NC, Kirdi N, Temucin CM, Armutlu K, Yakut Y, Karabudak R . Improvement of muscle strength and fatigue with high voltage pulsed galvanic stimulation in multiple sclerosis patients- a non-randomized controlled trial. J Pak Med Assoc. 2011;61(8):736-43.

Korkmaz NC, Kirdi N, Temucin CM, Armutlu K, Yakut Y, Karabudak R. Improvement of muscle strength and fatigue with high voltage pulsed galvanic stimulation in multiple sclerosis patients--a non-randomized controlled trial. J Pak Med Assoc. 2011;61(8):736-43.

Phillips WT, Ziuraitis JR. Energy cost of the ACSM single set resistance training protocol. J Strength Cond Res. 2003;17(2):350-5.

Welsch MA, Pollock ML, Brechue WF, Graves JE. Using the exercise test to develop the exercise prescription in health and disease. Prim Care. 1994;21(3):589-609.

Motl RW, Goldman MD, Benedict RH. Walking impairment in patients with multiple sclerosis: exercise training as a treatment option. Neuropsychiatr Dis Treat. 2010;6:767-74.

Rahnama N, Namazizadeh M, Etemadifar M, Bambaechi E, Arbabzadeh S, Nazarian A. Effects of yoga training on elected physical fitness factors in MS patients. Olampic, 2011;19(3):95-106. [Persian]

Armutlu K, Karabudak R, Nurlu G. Physiotherapy approaches in the treatment of ataxic multiple sclerosis. A pilot study Neurorehabil. 2001;15(3):203-11.

Adler S, Beckers D, Buck M. PNF in Practice. 3rd ed. Springer; 2008.

Aimet M, Lampichler J, Musil U, Spiesberger R, Pelikan J, Schmid J, et al. High and moderate intensities in strength training in multiple sclerosis. Isokin Exerc Sci. 2006;14(2):153.

Ayán Pérez C, Martín Sánchez V, De Souza Teixeira F, De Paz Fernández JA. Effects of a resistance training program in multiple sclerosis Spanish patients: a pilot study. J Sport Rehabil. 2007;16(2):143-53.

Gutierrez GM, Chow JW, Tillman MD, McCoy SC, Castellano V, White LJ. Resistance training improves gait kinematics in persons with multiple sclerosis. Arch Phys Med Rehabil. 2005;86(9):1824-9.

Mirek E, Chawala W, Longawa K, Rudzinska M, Adamkiewicz P, Szczudlik A. Proprioceptive neuromuscular facilitation method of therapeutic rehabilitation in the treatment of patients with Parkinson disease. Neurol Neurochir Pol. 2003;37:89-102.

Thoumie P, Mevellec E. Relation between walking speed and muscle strength is affected by somatosensory loss in multiple sclerosis. J Neurol Neurosurg Psychiatry. 2002;73(3):313-5.

Dalgas U, Stenager E, Jakobsen J, Petersen T, Hansen HJ, Knudsen C, et al. Resistance training improves muscle strength and functional capacity in multiple sclerosis. Neurology, 2009;73(18):1478-84.

Broekmans T, Roelants M, Feys P, Alders G, Gijbels D, Hanssen I, et al. Effects of long-term resistance training and simultaneous electro-stimulation on muscle strength and functional mobility in multiple sclerosis. Mult Scler. 2011;17(4):468-77.

Sadeghi H, Naghinejad F, Rajabi H. The effect of a strength training period on some walking kinematic parameters of healthy elderly women]. Salmand Iran J Ageing. 2008;3(3-4):30-6. [Persian]

Etemadifar M, Chitsaz A. Multiple Sclerosis. Esfahan: Mashaal; 2005. [Persian]

de Souza-Teixeira F, Costilla S, Ayán C, García-López D, González-Gallego J, de Paz JA. Effects of resistance training in multiple sclerosis. Int J Sports Med. 2009;30(4):245-50.

Mary LF, Leuschen MP, Huisinga J, Schmaderer L, Vogel J, Kucera D, et al. Impact of resistance training on balance and gait in Multiple Sclerosis. Int J MS Care. 2010;12(1):6-12.