فصلنامه علمی- پژوهشی علوم پیراپزشکی وتوانبخشی

فصلنامه علمی- پژوهشی علوم پیراپزشکی وتوانبخشی

تأثیر هشت هفته تمرینات عصبی عضلانی با تکالیف دوگانه شناختی بر حس عمقی و عملکرد بازیکنان فوتسال با ‏نقص ولگوس پویای زانو

نوع مقاله : مقاله پژوهشی

نویسندگان
مجید هامون گرد 1
ملیحه حدادنژاد 2
علی عباسی 2
1 کارشناس ارشد آسیب شناسی ورزشی و حرکات اصلاحی، گروه بیومکانیک و آسیب شناسی ورزشی، دانشکده تربیت بدنی و علوم ‏ورزشی، دانشگاه خوارزمی، تهران، ایران
2 دانشیار گروه بیومکانیک و آسیب شناسی ورزشی، دانشکده تربیت بدنی و علوم ورزشی، دانشگاه خوارزمی، تهران، ایران
10.22038/jpsr.2022.61506.2327
چکیده
هدف:
اکثر آسیب های رباط صلیبی قدامی (Anterior Cruciate Ligament; ACL) در شرایطی اتفاق می ­افتند که توجه ورزشکار همزمان معطوف به انجام تکلیف و محرک­ های شناختی است. اختلال در عملکرد و حس عمقی زانو در شرایط تقسیم توجه، فرد را در معرض آسیب ACL قرار می ­دهد. لذا هدف از پژوهش حاضر بررسی تأثیر هشت هفته تمرینات عصبی عضلانی با تکالیف دوگانه شناختی بر عملکرد و حس عمقی بازیکنان فوتسال با نقص ولگوس پویای زانو است.
روش بررسی:
30 بازیکن فوتسال با نقص ولگوس پویای زانو (میانگین سن: 3/27 ± 21/86 سال، وزن: 9/55 ± 68/91 کیلوگرم، قد: 6/49 ± 175/6 سانتی­ متر) به صورت هدفمند انتخاب و به صورت تصادفی در دو گروه 15 نفری کنترل و تجربی تقسیم شدند. در پیش آزمون عملکرد آزمودنی ­ها بوسیله آزمون پرش تاک (Tuck Jump Test) و سه جهش تک پا (Single Leg Triple Hop Test) و حس عمقی زانو توسط روش گونیامتری تصاویر دیجیتال مورد بررسی قرار گرفت. گروه تجربی به مدت هشت هفته در برنامه تمرینات عصبی عضلانی با تکالیف دوگانه شناختی شرکت کردند. در نهایت پس آزمون در شرایط پیش آزمون و یک تا دو روز پس از جلسه تمرین نهایی برگزار شد. پس از جمع آوری داده ­ها از آزمون­ تحلیل کوواریانس تک متغیری و آزمون تی مستقل جهت بررسی میانگین­ ها و تفاوت­ های بین گروهی در سطح معنی داری (p≤0/05) استفاده شد.
یافته ­ها:
نتایج آزمون های آماری نشان داد که بین میانگین نمرات آزمون پرش تاک (0/001=p) و سه جهش تک پا (0/001=p) بین آزمودنی­ های دو گروه در مرحله پس آزمون تفاوت معنی داری وجود دارد به طوری که گروه تجربی عملکرد بهتری نسبت به گروه کنترل داشتند. در حس عمقی زانو (0/459=p) تفاوت معناداری مشاهده نشد با این حال خطای حس عمقی در گروه تجربی بهبود بیشتری داشت.
نتیجه گیری:
نتایج پژوهش حاضر نشان داد انجام تمرینات عصبی عضلانی با تکالیف دوگانه شناختی موجب بهبود چشمگیر عملکرد و کاهش خطای حس عمقی زانو می­ شود. بنابراین احتمالا انجام تمرینات عصبی عضلانی با تکالیف دوگانه به عنوان یک رویکرد جدید تمرینی در پیشگیری از آسیب ACL می ­تواند موثر باشد.
کلیدواژه‌ها
رباط صلیبی قدامی
حس عمقی
عملکرد
تکلیف دوگانه شناختی
تمرینات عصبی عضلانی
زانو
  1. Junge A, Dvorak J. Injury risk of playing football in Futsal World Cups. Br J Sports Med 2010; 44(15): 1089-1092.
  2. Angoorani H, Haratian Z, Mazaherinezhad A, Younespour S. Injuries in Iran futsal national teams: a comparative study of incidence and characteristics. Asian J Sports Med 2014; 5(3): e23070.
  3. Myer GD, Ford KR, Hewett T. Preventing ACL injuries in women.  Journal of Musculoskeletal Medicine 2006; 23(1): 12.
  4. Dill KE, Begalle RL, Frank BS, Zinder SM, et al. Altered knee and ankle kinematics during squatting in those with limited weight-bearing–lunge ankle-dorsiflexion range of motion. J Athl Train 2014; 49(6): 723-732.
  5. Fort-Vanmeerhaeghe A, Montalvo AM, Lloyd RS, Read P, et al. Intra-and inter-rater reliability of the modified tuck jump assessment. J Sports Sci Med 2017; 16(1): 117-124.
  6. Myer GD, Ford KR, Hewett TE. Rationale and clinical techniques for anterior cruciate ligament injury prevention among female athletes. Journal of athletic training; 2004; 39(4): 352-364.
  7. Krosshaug T, Nakamae A, Boden BP, Engebretsen L, et al. Mechanisms of anterior cruciate ligament injury in basketball: video analysis of 39 cases. The American Journal of Sports Medicine 2007; 35(3): 359-367.
  8. Myer GD, Paterno MV, Ford KR, Hewett TE. Neuromuscular training techniques to target deficits before return to sport after anterior cruciate ligament reconstruction. The Journal of Strength & Conditioning Research 2008; 22(3): 987-1014.
  9. Liu R, Liu J, Ma X, Li Q, An R, et al. Effect of FIFA 11+ intervention on change of direction performance in soccer and futsal players: A systematic review and meta-analysis. International Journal of Sports Science & Coaching 2021; 16(3): 862-872.
  10. Dai B, Cook RF, Meyer EA, Sciascia Y, et al. The effect of a secondary cognitive task on
    landing  mechanics   and  jump performance. Sports biomechanics 2018; 17(2): 192-205.
  11. Nazary-Moghadam S, Salavati M, Esteki A, Akhbari B, et al. Reliability of kinematic measures in subjects with anterior cruciate ligament deficiency during dual-task walking. Journal of Bodywork and Movement Therapies 2017; 21(4): 852-859.
  12. Almonroeder TG, Kernozek T, Cobb S, Slavens B, et al, Divided attention during cutting influences lower extremity mechanics in female athletes. Sports biomechanics 2019; 18(3): 264-276.
  13. Monfort SM, Pradarelli JJ, Grooms DR, Hutchison KA, et al. Visual-spatial memory deficits are related to increased knee valgus angle during a sport-specific sidestep cut. The American Journal of Sports Medicine 2019; 47(6): 1488-95.
  14. Mandelbaum BR, Silvers HJ, Watanabe DS, Knarr JF, et al. Effectiveness of a neuromuscular and proprioceptive training program in preventing anterior cruciate ligament injuries in female athletes: 2-year follow-up. The American Journal of Sports Medicine 2005; 33(7): 1003-1010.
  15. Nagai T, Schilaty ND, Strauss JD, Crowley EM, et al. Analysis of lower extremity proprioception for anterior cruciate ligament injury prevention: Current opinion. Sports Medicine 2018; 48(6): 1303-1309.
  16. Tegner Y, Lysholm J, Lysholm M, Gillquist J. A performance test to monitor rehabilitation and evaluate anterior cruciate ligament injuries. The American Journal of Sports Medicine 1986; 14(2): 156-159.
  17. D'Isanto T, D'Elia F, Raiola G, Altavilla G. Assessment of sport performance: Theoretical aspects and practical indications. Sport Mont 2019; 17(1): 79-82.
  18. Hamilton RT. Single-Leg Triple Hop Test as a predictor of lower limb strength, power, and balance: The University of North Carolina at Greensboro; 2006.
  19. Pashler H. Dual-task interference in simple tasks: data and theory. Psychological bulletin 1994; 116(2): 220-244.
  20. Ruthruff E, Van Selst M, Johnston JC, Remington R. How does practice reduce dual-task interference: Integration, automatization, or just stage-shortening? Psychological research 2006; 70(2): 125-142.
  21. Abdallat R, Sharouf F, Button K, Al-Amri M. Dual-Task Effects on Performance of Gait and Balance in People with Knee Pain: A Systematic Scoping Review  J. Clin. Med 2020; 9(5): 1554.
  22. Jardim NYV, Bento-Torres NVO, Costa VO, Carvalho JPR, et al. Dual-Task Exercise to Improve Cognition and Functional Capacity of Healthy Older Adults. Frontiers in Aging Neuroscience 2021; 13(33): 589299.
  23. Ghaderi M, Letafatkar A, Thomas AC, Keyhani S. Effects of a neuromuscular training program using external focus attention cues in male athletes with anterior cruciate ligament reconstruction: a randomized clinical trial. BMC Sports Science, Medicine and Rehabilitation 2021; 13(1): 1-11.
  24. Herrington L. The effects of 4 weeks of jump training on landing knee valgus and crossover hop performance in female basketball players. The Journal of Strength & Conditioning Research 2010; 24(12): 3427-32.
  25. Myer GD, Ford KR, PALUMBO OP, Hewett TE. Neuromuscular training improves performance and lower-extremity biomechanics in female athletes. The Journal of Strength & Conditioning Research 2005; 19(1): 51-60.
  26. Monfort SM, Comstock RD, Collins CL, Onate JA, et al. Association between ball-handling versus defending actions and acute noncontact lower extremity injuries in high school basketball and soccer. The American Journal of Sports Medicine 2015; 43(4): 802-807.
  27. Ghanati HA, Letafatkar A, Almonroeder TG, Rabiei P. Examining the Influence of Attentional Focus on the Effects of a Neuromuscular Training Program in Male Athletes. Journal of strength and conditioning research 2022; 36(6); 1568-1575.
  28. Saito A, Okada K, Sasaki M, Wakasa M. Influence of the trunk position on knee kinematics during the single-leg landing: Implications for injury prevention. Sports Biomechanics 2022: 21(7): 810-823.
  29. Ghaderi M, Letafatkar A, Almonroeder TG, Keyhani S. Neuromuscular training improves knee proprioception in athletes with a history of anterior cruciate ligament reconstruction: A randomized controlled trial. Clinical Biomechanics 2020; 80: 105157.
  30. Ness BM, Zimney K, Kernozek T, Schweinle WE, et al. Incorporating a Dual-Task Assessment Protocol with Functional Hop Testing. Int J Sports Phys Ther 2020; 15(3): 407-420.
  31. Numata H, Nakase J, Kitaoka K, Shima Y, et al. Two-dimensional motion analysis of dynamic knee valgus identifies female high school athletes at risk of non-contact anterior cruciate ligament injury. Knee Surgery, Sports Traumatology, Arthroscopy 2018; 26(2): 442-447.
  32. Kajiwara M, Kanamori A, Kadone H, Endo Y, et al. Knee biomechanics changes under dual task during single-leg drop landing. Journal of experimental orthopaedics 2019; 6(1): 1-6.
  33. Dingenen B, Barton C, Janssen T, Benoit A, et al. Test-retest reliability of two-dimensional video analysis during running. Physical Therapy in Sport 2018; 33: 40-47.
  34. Williams M, Squillante A, Dawes J. The Single Leg Triple Hop for Distance Test. Strength & Conditioning Journal 2017; 39(3): 94-98.
  35. Mir S, Hadian M, Talebian S, Nasseri N. Functional assessment of knee joint position sense following anterior cruciate ligament reconstruction. Br J Sports Med 2008; 42(4): 300-303.
  36. Stillman BC, McMeeken JM. The role of weightbearing in the clinical assessment of knee joint position sense. Australian Journal of Physiotherapy 2001; 47(4): 247-253.
  37. Rezola-Pardo C, Arrieta H, Gil SM, Yanguas JJ, et al. A randomized controlled trial protocol to test the efficacy of a dual-task multicomponent exercise program in the attenuation of frailty in long-term nursing home residents: Aging-ON DUAL-TASK study. BMC geriatrics 2019; 19(1): 1-9.
  38. Schnittjer A, Simon JE, Yom J, Grooms DR. The Effects of a Cognitive Dual Task on Jump-landing Movement Quality. Int J Sports Med. 2021 42(01); 90-95.
  39. Williams GN, Chmielewski T, Rudolph KS, Buchanan TS, et al. Dynamic knee stability: current theory and implications for clinicians and scientists. Journal of orthopaedic & sports physical therapy: JOSPT 2001; 31(10): 546-566.
  40. Hewett TE, Ford KR, Hoogenboom BJ, Myer GD. Understanding and preventing acl injuries: current biomechanical and epidemiologic considerations-update 2010. N Am J Sports Phys Ther: NAJSPT 2010; 5(4) 234-251.
  41. Riemann BL, Lephart SM. The sensorimotor system, part II: the role of proprioception in motor control and functional joint stability. J Athl Train 2002; 37(1): 80-84.
  42.  Hamoongard M, Hadadnezhad M, Abbasi A. Effect of combining eight weeks of neuromuscular training with dual cognitive tasks on landing mechanics in futsal players with knee ligament dominance defect: a randomized controlled trial. BMC Sports Science, Medicine and Rehabilitation 2022: 14(1): 1-12.
  43. Balba AE-DA, Alaa IE-K, Ahmed H, Mohammad MM. Effect of Core Stability Training on Knee Proprioception after Anterior Cruciate Ligament Reconstruction. The Medical Journal of Cairo University 2018; 86: 231-240.
  44. Ribeiro F, Oliveira J. Effect of physical exercise and age on knee joint position sense. Archives of gerontology and geriatrics 2010; 51(1): 64-67.
  45. Bouët V, Gahéry Y. Muscular exercise improves knee position sense in humans. Neuroscience letters 2000; 289(2): 143-146.
  46. Pohl T, Brauner T, Wearing S, Stamer K, et al. Effects of sensorimotor training volume on recovery of sensorimotor function in patients following lower limb arthroplasty. BMC musculoskeletal disorders 2015; 16(1): 1-9.
  47. Kaya D, Guney-Deniz H, Sayaca C, Calik M, et al. Effects on lower extremity neuromuscular control exercises on knee proprioception, muscle strength, and functional level in patients with ACL reconstruction. BioMed research international 2019; Article ID 1694695, 1-7.
  48. Paul J, Nagaraj M, Solomon J. Effectiveness of coordination exercise on proprioception of knee injured male professional footballers. Drug Invention Today 2018; 10(10): 1887-1891.
  49. Lee SJ, Ren Y, Chang AH, Geiger F, et al. Effects of pivoting neuromuscular training on pivoting control and proprioception. Med Sci Sports Exerc 2014; 46 (7): 1400-1409.
  50. Millikan N, Grooms DR, Hoffman B, Simon JE. The development and reliability of 4 clinical neurocognitive single-leg hop tests: implications for return to activity decision-making. Journal of sport rehabilitation 2019; 28(5): 536-544.
  51. Hewett TE, Myer GD, Ford KR, Heidt Jr RS, et al. Biomechanical measures of neuromuscular control and valgus loading of the knee predict anterior cruciate ligament injury risk in female athletes: a prospective study. The American journal of sports medicine. 2005; 33(4): 492-501.
  52. Grooms DR, Onate JA. Neuroscience application to noncontact anterior cruciate ligament injury prevention. Sports Health 2016; 8(2): 149-152.
  53. Kasmi S, Zouhal H, Hammami R, Clark CC, et al. The effects of eccentric and plyometric training programs and their combination on stability and the functional performance in the post-ACL-surgical rehabilitation period of elite female athletes. Frontiers in Physiology 2021; 12(688385).
  54. Ohji S, Aizawa J, Hirohata K, Ohmi T, et al. Single-leg hop distance normalized to body height is associated with the return to sports after anterior cruciate ligament reconstruction. Journal of Experimental Orthopaedics 2021; 8(1): 1-7.
  55. Gokeler A, Benjaminse A, Welling W, Alferink M, et al. The effects of attentional focus on jump performance and knee joint kinematics in patients after ACL reconstruction. Physical therapy in sport 2015; 16(2): 114-120.
  56. Holm I, Fosdahl MA, Friis A, Risberg MA, et al. Effect of neuromuscular training on proprioception, balance, muscle strength, and lower limb function in female team handball players. Clinical Journal of Sport Medicine 2004; 14(2): 88-94.
  57. Read PJ, Oliver JL, Dobbs IJ, Wong MA, et al. The Effects of a Four-Week Neuromuscular Training Program on Landing Kinematics in Pre-and Post-Peak Height Velocity Male Athletes. Journal of Science in Sport and Exercise. 2021;3(1):37-46.
  58. Oliver G, Roling K, Dittmore S, Moiseichik M. The Effects of a Lumbopelvic-Hip Strengthening Intervention Program on Functional Testing in Collegiate Female Tennis Players. Clinical Kinesiology (Online Edition) 2012; 66(1): 13-18.
  59. Sue D, Barber-Western S, Hermato A, Noyes F. Six Week Neuromuscular Performance Training Program Improve Speed agility, Dynamic Balance and Core Endurance in Junior Tennis Player. J Athl Enhancement 2015; 4(1): 1-8.
  60. Noyes FR, Barber-Westin SD, Fleckenstein C, Walsh C, et al. The drop-jump screening test: difference in lower limb control by gender and effect of neuromuscular training in female athletes. The American journal of sports medicine 2005; 33(2): 197-207.
فصلنامه علمی- پژوهشی علوم پیراپزشکی وتوانبخشی
دوره 11، شماره 3
پاییز 1401
صفحه 50-66