مقایسه ی تاثیر دوپروتکل تمرینی بر تعادل و ترس از افتادن زنان مبتلا به استئوآرتریت زانو

نوع مقاله : مقاله پژوهشی

نویسندگان

1 کارشناسی ارشد آسیب شناسی ورزشی و حرکات اصلاحی، دانشکده تربیت بدنی و علوم ورزشی، دانشگاه اصفهان، اصفهان، ایران

2 استاد گروه آسیب شناسی ورزشی و حرکات اصلاحی ، دانشکده تربیت بدنی و علوم ورزشی، دانشگاه اصفهان، اصفهان ایران

چکیده

هدف:
استئوآرتریت زانو از جمله شایع ترین اختلالات عضلانی اسکلتی است که باعث تخریب مفصل و متعاقب آن نقص حس عمقی، کاهش تعادل و زمین خوردن می شود. هدف از این مطالعه بررسی تأثیر تمرینات ثبات مرکزی بر استئوآرتریت زانو بود.  
روش بررسی:
مطالعه حاضر از نوع نیمه تجربی با پیش آزمون و پس آزمون می‌باشد که تعداد 25 زن مبتلا به بیماری استئوآرتریت زانو به صورت هدفمند و در دسترس انتخاب و سپس به صورت تصادفی به دو گروه تجربی تقسیم شدند. بیماران به مدت 8 هفته، هفته‌ای 3 جلسه به انجام تمرینات پرداختند. در ابتدا و انتهای تحقیق، تعادل ایستا، تعادل پویا و ترس از افتادن بیماران، به ترتیب بوسیله‌ی آزمون ایستادن روی یک پا، آزمون تعادل وای (Y) و پرسشنامه ی ترس از افتادن (FES-I) ارزیابی شدند. جهت تجزیه و تحلیل داده‌های آماری از آمار توصیفی، آزمون تحلیل واریانس اندازه‌ گیری مکرر نوع دو در سطح معنی‌داری 5 درصد استفاده شد.
یافته‌ ها:
افزایش معنی‌داری در تعادل ایستا و پویا در گروه تجربی1 و گروه تجربی 2 مشاهده شد (0/001p<). در مجموع در نمره های تعادل ایستا و پویا بین گروه ها تفاوت معنی‌داری مشاهده نشد (0/05p>). در نمره ترس از افتادن در گروه تجربی 1 و گروه تجربی 2 تفاوت معنی‌داری یافت شد (0/001p<). در مجموع در مورد ترس از افتادن بین گروه ها تفاوت معنی‌داری مشاهده نشد (0/05p>).
نتیجه‌گیری:
از یافته‌ ‌های تحقیق حاضر می‌توان نتیجه گرفت که اضافه شدن تمرینات ثبات مرکزی به تمرینات قدرتی و تعادلی که تنها بر مفصل زانو تمرکز داشته است، می‌تواند بر بهبود تعادل و کاهش خطر افتادن بیماران مبتلا به استئوآرتریت موثر باشد.

کلیدواژه‌ها

موضوعات


  1. Van Schoor N, Smit J, Twisk J, Lips P. Impact of vertebral deformities, osteoarthritis, and other chronic diseases on quality of life: a population-based study. Osteoporos Int 2005; 16(7):749-756.
  2. Wollheim F. Osteoarthritis. Curr Opin Rheumatol 2002; 14(5): 571-572.
  3. Fransen M, Bridgett L, March L, Hoy D .The epidemiology of osteoarthritis in Asia. Int J Rheum Dis 2011; 14(2):113-121.
  4. Mat S, Tan MP, Kamaruzzaman SB, Ng C T. Physical therapies for improving balance and reducing falls risk in osteoarthritis of the knee: a systematic review.Age Ageing 2014; 112(1): 1-9.  
  5. Ng CT, Tan MP. Osteoarthritis and falls in the older person. Age Ageing 2013; 42: 561-6.
  6. Simao AP, Avelar NC, Tossige-Gomes R Neves CD et al. Functional performance and inflammatory cytokines after squat exercises and whole-body vibration in elderly individuals with knee osteoarthritis. Arch Phys Med Rehabil 2012; 93: 1692-700.   
  7. Gribble P, Hertel J, Denegar C, Buckley W. The effects of fatigue and chronic ankle instability on dynamic postural control. J Athl Train 2004; 39(4): 321-329.
  8. Toulotte C, Thevenon A, Watelain E, Fabre C. Identification of healthy elderly fallers and non-fallers by gait analysis under dual-task conditions. Clin Rehabil. 2006; 20: 269-276.
  9. Brooks P. Impact of osteoarthritis on individuals and society: how much disability? Social consequences and health economic implications. Curr Opin Rheumatol 2002; 14(5): 573-577.
  10. Bennell K, Hinman R. Exercise as a treatment for osteoarthritis. Curr Opin Rheumatol 2005; 17(5): 634 -640.
  11. Mcknight PE, Kacle SH, Going S, Villanueve I. A comparison of strength training self- management, and the combination for early osteoarthritis of the knee Arthritis Care Res (Hoboken) 2010; 62(1): 45-53.
  12. Takacs J, Carpenter MG, Garland SJ, Hunt MA. The role of neuromuscular changes in aging and knee osteoarthritis on dynamic postural control. Aging Dis 2014; 4(2): 84–99.
  13. Song R, Lee EO, Lam P, Bae SC. Effects of tai chi exercise on pain, balance and muscle strength, and perceived difficulties in physical functioning in older woman with osteoarthritis. J Rheomatol. 2003; 30(9): 2039- 44.
  14. Hosseini SS, Hashemi M, Rostamkhani H. Effects of a period core stability and strength training on some physical fitness factors in healthy elderly men. J Sports Sci 2011; 3(8): 81-96. (Persian) 
  15. Clark MA, Fater D, Reuteman P. Core (trunk) stabilization and its importance for closed kinetic chain rehabilitation. Orthop Phys Ther Clin North Am 2000; (9): 119-13.
  16. Barati S, Khayyam bashi KH, Rahnama N, Nayeri M. Effect of core stability training on pain and function of the females with Knee osteoarthritis. J R R S 2012; 8(1): 40- 48. [Persian]
  17. Vilalte C, Nunez M, Segur J, Domingo A et al. Knee osteoarthritis: interpretation variability of radiologic signs. Clin Rheumtol 2004; 23(6): 501-504.
  18. Bennell KL, Hinman RS, Metcalf BR, Buchbinder R et al. Efficacy of physiotherapy management of knee joint osteoarthritis: a randomised, double blind, placebo controlled trial. Ann Rheum Dis 2005; 64(6): 906-912.
  19. Giorgetti MM, Harris BA, Jette A. Reliability of clinical balance outcome measures in the elderly. Physiother Res Int. 1998; 3(4): 274-83, © Whurr Publisher Ltd.
  20. Mokkink LB, Terwee CB, van Lummel RC, de Witte SJ, Wetzels L, Bouter LM, deVet HCW. Construct validity of the dyna port Knee Test. Osteoarthr. Cartil 2005; 13(8): 738-43.
  21. Sasaki R, Urabe Y, Tanaka K. Assessing balance with the star excursion balance test in elderly. J Physiother 2007; 93(1): 443-453.
  22. Yardley  L, Beyer  N, Hauer  K , Kempen  G, Piot-Ziegler  C, Todd C. Development and initial validation of the Falls Efficacy Scale-International (FES-I). Age Ageing 2005; 34(6): 614-619.
  23. Bundy A C, Fisher A G,  Freeman M,  Lieberg G K, et al. Concurrent validity of eEquilibrium tests in boys with learning disabilities with and without vestibular dysfunction. AJOT 1987; 41(1): 28-34.
  24. Page PH, Ellenbecker TS. The scientific and clinical application of elastic resistance. Human Kinetics; 2003: 216-228. Book
  25. Ahmed A F. Effect of sensorimotor training on balance in elderly patients with Knee osteoarthritis.J Advanc Res; 2011; 2(4): 305- 311.
  26. Mattacola CG, Lloyd J W. Effect of 6-week strength and proprioception training program on measures of dynamic balance: A single-case design. J Athl Train 1997; 32(2): 127-135.
  27. Paterno MV,  Myer GD,  Ford KR,  Hewett TE et al. Neuromuscular training improves single- limb stability in young female athletes. J Orthop Sports Phys ther 2004; 34(6): 305- 16.
  28. Islam MM, Nasu E, Rogers ME, Koizumi D. et al. Effects of combined sensory and muscular training on balance in Japanese older adults.Adv Prev Med 2004; 39(6): 1148-1155.
  29. Judge JO, Whipple RH, Wolfson LI. Effect of resistive and balance exercise on isokinetic strength in older person. J Am Geriatr Soc 1994; 42: 937-946.
  30. Khajeh Ne`mat K, Sadeghi H, Sahebazzamani M. The effects of eight weeks of strength training on static and dynamic balance in healthy men .J Sport Med 2014; 6(1):45-55. [Persian] 
  31. Haywood K, Getchell N. Life Span Motor Development. Namazi zadeh M, Aslankhani MR. Fourth edition. Tehran: Samt; 2014: 342-348. [Persian translator]
  32. Trudelle–Jackson EJ, Jackson AW, Morrow JR. Muscle strength and postural stability in healthy, older women. Implications for fall prevention. J of phys act and hlth. 2006; 3(3): 292- 303.
  33. Cynthia AT. The effects of strength and plyometric training on joint position, joint moments and joint stiffness at the knee. Dissertation. Faculty of Brigham young university (Canada) 2004; 4(2):265-273.
  34. Schlicht J, Camaione DN, Owen SV. Effect of intense strength training on standing balance, walking speed and sit to stand performance in older adults. J Geront Series A 2001; 56(5): 281-286.
  35. Petrofsky JS, Cuneo M, Dial R, Pawley AK, et al. Core Strengthening and Balance in the Geriatric Population. The J of App Res 2005; 5(3): 423-433.
  36. Carpes FP, Reinehr FB, Mota CB. Effects of a program for trunk strength and stability on pain, low back and pelvis kinematics, and body balance.J Bodyw Mov Ther 2008; 12(1): 22-30.
  37. Kimberli SM, Sandrey MA. A core stabilization training program for tennis athletes. J of Athlet Thrap Today 2005; 46(3): 41-46.
  38. Piegaro AB. The comparative effects of four – week core stabilization and balance – training programs in semidynamic and dynamic balance". Master's thesis. Morgantown WV: West Virginia University. 2003.
  39. Lewarchik TM, Bechtel ME, Bradley DM, Hughes CJ, and Smith TD. The effects of a seven week core stabilization program on athletic performance in collegiate football players. J Athl Train 2003; 38: 80-81.
  40. Swaney MR, Hess RA. The effects of core stabilization on balance and posture in female collegiate swimmers. J Athl Train 2003; 38S: 90-95.
  41. Gribble PA, Hertel J, Plisky P. Using the star excursion balance test to assess dynamic postural-control deficits and outcomes in lower extremity injury: a literature and systematic Review. J Athl Train 2012; 47(3): 339-57.
  42. Kahle NL, Gribble PA. Core stability training in dynamic balance testing among young, healthy adults. Athl Train Sports Health Care 2009; 1(2): 65-73.
  43. Panjabi, MM. The stabilizing system of the spine. Part I: function, dysfunction, adaptation and enhancement. J spinal disord 1992; 5(4): 383-389.
  44. Hodges PW, Richardson CA. Contraction of the abdominal muscles associated with movement of the lower limb. Phys Ther. 1997; 77(2): 132-142.
  45. Song R, Roberts BL, Lee EO, Lam P, et al. A randomized study of the effects of t’ai chi on muscle strength, bone mineral density, and fear of falling in women with osteoarthritis. J Altern Complement Med 2010; 16(3): 227-33.
  46. Lund H, Weile U, Christensen R, Rostock B, et al. A randomized controlled trial of aquatic and land-based exercise in patients with knee osteoarthritis. J Rehabil Med 2008; 40(2): 137-44.
  47. Hale LA, Waters D, Herbison P. A randomized controlled trial to investigate the effects of water-based exercise to improve falls risk and physical function in older adults with lower-extremity osteoarthritis. Arch Phys Med Rehabil 2012; 93: 27-34.  
  48. Hsieh RL, Lo MT, Liao WC, Lee WC. Short-term effects of 890-nanometer radiation on pain, physical activity, and postural stability in patients with knee osteoarthritis: a doubleblind, randomized, placebo-controlled study. Arch Phys Med Rehabil 2012; 93: 757-64.
  49. Ganz DA, Higashi T, Rubenstein LZ. Monitoring falls in cohort studies of community-dwelling older people: effect of the recall interval. J Am Geriatr Soc 2005; 53(12): 2190-4.
  50. Aslankhani MA, Poordehkordi  P. Comparison of mental practice, physical or a combination training on static and dynamic balance in healthy elderly. J Ageing 2008; 3(9): 22-29. 
  51. Mahdavi S, Golpaygani M, Shavandi N, Farzaneh Hesari A, et al. The effect of 6 weeks of core stability training on the rate of falling in older women. J Ageing 2000; 5(17): 30-35.
  52. Crisco J J, Panjabi M M, Yamamoto I, Oxland T R. Stability of the human ligamentous lumbar spine. Part II: experiment. Clin Biomech 1992; 7(1): 27-32.
  53. Lange AK, Vanwanseele B, Fiatarone Singh MA. Strength training for treatment of osteoarthritis of the knee: a systematic review. Arthritis Rheum 2008; 59(10): 1488-94.