تأثیر هشت هفته برنامه تمرینات اصلاحی سهرمن به‌ صورت حضوری و مجازی بر سندرم متقاطع فوقانی زنان ‏معلم دردوران کرونا

نوع مقاله : مقاله پژوهشی

نویسندگان

1 کارشناسی ارشد آسیب های ورزشی و حرکات اصلاحی، گروه علوم ورزشی، دانشکده ادبیات و علوم انسانی، دانشگاه شهرکرد، ‏شهرکرد، ایران

2 استادیار گروه علوم ورزشی، دانشکده ادبیات و علوم انسانی، دانشگاه شهرکرد، شهرکرد، ایران

چکیده

هدف:
با توجه به شیوع بالای سندرم متقاطع فوقانی (Upper Cross Syndrome) در بین معلمان، لازم است در جهت افزایش بهره‌وری تمرینات اصلاحی (Corrective Exercises) منتخب همواره ارائه گردند. یکی از شیوه های ارائه  تمرینات اصلاحی در شرایط خاص، آموزش مجازی (Virtual Education) است. هدف از پژوهش حاضر مقایسه تأثیر یک دوره تمرینات اصلاحی سهرمن (Sahrmann's) به صورت حضوری و مجازی بر سندرم متقاطع فوقانی زنان معلم بود.
روش بررسی:
پژوهش حاضر از نوع کارآزمایی تصادفی کنترل شده‏‎ با طرح پیش ­آزمون و پس ­آزمون بود. تعداد 60 نفر از معلمین داوطلب که شرایط شرکت در مطالعه را طبق معیارهای ورودی داشتند به صورت تصادفی به سه گروه 20 نفری تمرینات اصلاحی حضوری (با میانگین سنی 3/07±45/90 )، مجازی(با میانگین سنی 4/84±43/30) و کنترل (با میانگین سنی 5/11±42/70) تقسیم شدند. در اندازه ­گیری درد و ناتوانی گردن از پرسشنامه مقیاس (Neck Pain and Disability Scale; NPDS)، درد و ناتوانی شانه از پرسشنامه شاخص (Shoulder Pain and Disability Index; SPADI)، زاویه سر به جلو، شانه به جلو و شانه نابرابر از روش عکسبرداری و نرم افزار اتوکد (AutoCAD) و زاویه کایفوز از کایفومتر (Kyphometer) استفاده شد. در تحلیل آماری پس از تایید نرمال بودن داده­ها، از آزمون­ پارامتریک واریانس یکطرفه (ANOVA) و آزمون تعقیبی بونفرونی (Bonferroni) و در صورت عدم برقراری شرط نرمال بودن داده ­ها، از آزمون­ ناپارامتریک کروسکال- والیس (Kruskal-Wallis) و آزمون یومن-ویتنی (Mann–Whitney U) با تصحیح بونفرونی استفاده شد
یافته ­ها:
نتایج پژوهش بین گروه کنترل با دو گروه تمرینی حضوری و مجازی در تمام متغیر­های ارزیابی: زوایای سر به جلو، شانه به جلو طرف راست و طرف چپ، شانه نابرابر طرف راست و طرف چپ، درد و ناتوانی گردن، زاویه کایفوز و درد و ناتوانی شانه تفاوت معناداری را نشان داد (0/001=p). در مقایسه بین دوگروه تمرینی حضوری و مجازی متغیرهای زاویه کایفوز و درد و ناتوانی شانه تفاوت معناداری وجود داشت (0/001=p)  اما در بقیه متغیرها تفاوت معناداری مشاهده نشد.
نتیجه گیری:
تمرینات اصلاحی مجازی با استفاده از راهکارهای مختلف ارائه شده نتیجه­ای نزدیک به تمرینات حضوری را حاصل کرد. با توجه به اهمیت سلامتی معلمان و اولویت قرار داشتن اهداف توانبخشی در آن ها می ­توان در موارد اضطراری که مانع از آموزش حضوری می­شود استفاده از آموزش مجازی را توصیه کرد.

کلیدواژه‌ها


  1. Erick PN, Smith DR. A systematic review of musculoskeletal disorders among school teachers. BMC Musculoskelet Disord 2011; 12: 260.
  2. Cheng H-YK, Wong M-T, Yu Y-C, Ju Y-Y. Work-related musculoskeletal disorders and ergonomic risk factors in special education teachers and teacher’s aides. BMC Public Health 2016; 16: 137.
  3. Ghasemi S, Naghiloo Z, Soleimani Rad M. Use of e-learning tools, musculoskeletal status and its relationship with physical activity of students during quarantine due to coronavirus outbreak. Studies in Sport Medicine 2021; 13(29): 35-58. [Persian]
  4. Abdulmonem A, Hanan A, Elaf A, Haneen T, Jenan A. The prevalence of musculoskeletal pain & its associated factors among female Saudi school teachers. Pak J Med Sci 2014; 30(6): 1191-1196.
  5. Yue P, Liu F, Li L. Neck/shoulder pain and low back pain among school teachers in China, prevalence and risk factors. BMC Public Health 2012; 12(1): 1-8.
  6. Chiu TT, Lam PK. The prevalence of and risk factors for neck pain and upper limb pain among secondary school teachers in Hong Kong. J Occup Rehabil 2007; 17: 19-32.
  7. Sahrmann S, Azevedo DC, Van Dillen L. Diagnosis and treatment of movement system impairment syndromes. Braz J Phys Ther 2017; 1(6): 391-399.
  8. Lin G, Wang W, Wilkinson T. Changes in deep neck muscle length from the neutral to forward head posture. A cadaveric study using Thiel cadavers. Clin Anat 2022; 35(3): 332-339.
  9. Page P, Frank CC, Lardner R. Assessment and treatment of muscle imbalance. J Can Chiropr Assoc 2012; 56(2):158-165.
  10. Karimian R, Rahnama N, Ghasemi G, Lenjannejadian S. Association between upper-extremity musculoskeletal disorders and upper cross syndrome among teachers, and the effects of NASM corrective exercises along with ergonomic intervention on their upper-extremity musculoskeletal disorders. Studies in Medical Sciences 2020; 31(10): 753-763. [Persian]
  11. Jacob L, Tully MA, Barnett Y, Lopez-Sanchez GF, et al. The relationship between physical activity and mental health in a sample of the UK public: A cross-sectional study during the implementation of COVID-19 social distancing measures. Ment Health Phys Act 2020; 19: 100-345.
  12. Cil A, Yazici M, Uzumcugil A, Kandemir U, et al. The evolution of sagittal segmental alignment of the spine during childhood. Spine 2005; 30(1): 93-100.
  13. Nadler SF, Malanga GA, Bartoli LA, Feinberg JH, et al. Hip muscle imbalance and low back pain in athletes: influence of core strengthening. Med Sci Sports Exerc 2002; 34(1): 9-16.
  14. Tavana Kermani M, Ebrahimi Atri A, Khoshraftar Yazdi N. The effect of eight weeks corrective exercise on the functional kyphosis curvature in the teenager girls. Scientific J Rehabil Med 2017; 6(1): 161-168. [Persian]
  15. Salaffi F, De Angelis R, Stancati A, Grassi W, Pain M. Health-related quality of life in multiple musculoskeletal conditions: a cross-sectional population based epidemiological study. II. The MAPPING study. Clin exp Rheumatol 2005; 23(6): 829-839.
  16. Martarello NdA, Benatti MCC. Qualidade de vida e sintomas osteomusculares em trabalhadores de higiene e limpeza hospitalar. Rev Esc Enferm USP 2009; 43: 422-428.
  17. Khezri D, Abbasi H, Nobari H. Training Loads and Non-Contact Injuries in Soccer: A Full Season Monitoring of a Team in Iranian Premier League. SMJ 2022; 14(31): 45-64. [Persian]
  18. Ghiasinezhad S, Hadadnezhad M, Letafatkar A. The effects of eight weeks of yoga training on motor control, proprioception and forward head angle among girls diagnosed with forward head posture. IJMRHS 2016; 5(11): 40-46. [Persian]
  19. Khezri D, Uosef Pour R, Fayyaz Moghar A. The Establishment of Normative Values for Lower Limbs Strength, Flexibility and Alignment in Runners of Mazandaran Province. SMJ 2019; 10(24): 69-82. [Persian]
  20. Ahmadi H, Yalfani A, Gandomi F. Effect of Eight Weeks of Corrective Exercises Carried Out in Water on Static and Semi Dynamic Balance on Students with Upper Crossed Syndrome) Janda approach. J Rehabil Med 2020; 9(3): 286-296. [Persian]
  21. Jabbar KM, Gandomi F. The comparison of two corrective exercise approaches for hyperkyphosis and forward head posture: A quasi-experimental study. J Back Musculoskelet Rehabil 2021; 34(4): 677-687. [Persian]
  22. Sahrmann S. Movement system impairment syndromes of the extremities, cervical and thoracic spines: Elsevier Health Sciences; 2010; 130-178.
  23. Sarvari S, Mokari Saei S, Rahimzadeh M, Salehian MH. The Effect of an Online Corrective Training intervention on the Upper Cross Syndrome and Feelings of Fatigue and Pain in Adolescents. International Journal of Pediatrics 2022; 10(4): 15813-15822. [Persian]
  24. Yaghoubitajani Z, Gheitasi M, Bayattork M, Andersen LL. Online supervised versus workplace corrective exercises for upper crossed syndrome: a protocol for a randomized controlled trial. Trials 2021; 22(1): 1-12. [Persian]
  25. Oproescu M, Iana G, Jianu E, Anghel M-R, editors. E-learning in Computer-Assisted Training, Advantages, Disadvantages and Future Trends. 2019 11th International Conference on Electronics, ECAI 2019; 1-6.
  26. Azari R. Farhangian University E-learning System (LMS): examining pros and cons Based on Professor-user personal experiences, 2015-2020. J Pouyesh in Education and Consultation (JPEC) 2021; 1399(13): 68-90. [Persian]
  27. Alvandi F, Letafatkar A. The effect of respiratory exercises on pain, disability, proprioception and forward head angle in female patients with chronic neck pain. J Anesth Pain 2018; 8(3): 44-54. [Persian]
  28. Davari N, Rabiei M, Qasemi B, Shafi Zade A. The Effect of Eight-Week Selected Corrective Exercises on Reduction of Disability and Neck & Shoulder Pain and Forward Head Angle of Carpet Weavers. Sport Medicine Studies 2022; 14(32): 77-102. [Persian]
  29. Doosti M, Seidi F, Akouchkian M. Prevalence of pain and musculoskeletal disorders in diving coaches (Recreational Diving) and their relationship with musculoskeletal disorders Armaghane Danesh. 2020; 25(6): 805-824. [Persian]
  30. Javazi F, Sedaghati P, Daneshmandi H. The effect of selected corrective exercises with physioball on the posture of female computer users with upper crossed syndrome. J Sport Biomech 2019; 5(2): 23-112. [Persian]
  31. Khosrojerdi B, Karimizadeh Ardakani M, Khalaghi BirakOlia K. Comparison of the Effect of the Eight-week Corrective Exercises Program, Postural Reeducation, and Combined Training on Women with Upper Cross Syndrome: With Emphasis On Physical Distance Conditions. The Scientific Journal of Rehabilitation Medicine 2022; 11(5): 810-821. [Persian]
  32. Alyarnezhad C, Daneshmandi H, Samami N. Evaluation and Comparison of the Upper Limb Musculoskeletal Structure and the Static Balance in Children with Visual and Hearing Impairment. Journal of Exceptional Children (JOEC) 2021; 21 (1): 52-41. [Persian]
  33. Sawyer QL. Effects of forward head rounded shoulder posture on shoulder girdle flexibility, range of motion, and strength: The University of North Carolina at Chapel Hill; 2006; 20(10): 59-69.
  34. Rajabi R, Latifi S, Minoonejad H, Rajabi F. The effect of soft tissues in measurement of thoracic kyphosis by Iranian kyphometer. J Practical Studies of Biosciences Sport 2018; 5(10): 67-76. [Persian]
  35. Asheghan M, Hashemi SE, Sobhani V, Shakibaee A, et al. The relationship between forward head position and dorsal kyphosis with non-specific chronic low back pain in military mans. Journal of Military Medicine. 2021; 23(2): 186-193. [Persian]
  36. Yousefpour K, Shojaedin SS, Hadadnegha M. Comparison of the Effect of Therapeutic Exercise Protocol with and Without Kinesiotype and Manual Therapy on Pain and Disability and Muscle Function of Men with Cervicogenic Headache. Scientific Journal of Rehabilitation Medicine 2022; 11(4): 560-575. [Persian]
  37. Miri M, Hashemizade H, Mohammadpour A, Zaheri H. Effect of one period of exercise-therapy and an engonomic intervention on the rate of chronic neck pain and disability in computer users. Intern Med Today 2015; 21(3): 197-203. [Persian]
  38. Ylinen J, Nikander R, Nykänen M, Kautiainen H, Häkkinen A. Effect of neck exercises on cervicogenic headache: a randomized controlled trial. J Rehabil Med 2010; 42(4): 344-349.
  39. Aghaei B, Norouzadeh R, Heidari MR. Shoulder pain and disability index: validation of Iranian version. IJBD 2014; 7(2): 16-22. [Persian]
  40. Roach KE, Budiman-Mak E, Songsiridej N, Lertratanakul Y. Development of a shoulder pain and disability index. Arthritis Care Res 1991; 4(4): 143-149
  41. Akbari A, Naroei S, Mogharnasi M. Comparing the effect of a simulated action potential simulation and vibration in reducing neck and shoulder pain and disability in patients with trigger points in trapezius and levator scapulae muscles. KAUMS Journal (FEYZ). 2013; 16(6): 507-514. [Persian]
  42. Kim T-W, An D-I, Lee H-Y, Jeong H-Y, Kim D-H, Sung Y-H. Effects of elastic band exercise on subjects with rounded shoulder posture and forward head posture. J Phys Ther Sci 2016; 28(6): 1733-1737.
  43. Sikka I, Chawla C, Seth S, Alghadir AH, Khan M. Effects of deep cervical flexor training on forward head posture, neck pain, and functional status in adolescents using computer regularly. Biomed Res Int 2020; 15-21.
  44. Beneka A, Malliou P, Gioftsidou A. Neck pain and office workers: An exercise program for the workplace. ACSM's Health & Fitness Journal 2014; 18(3): 18-24.
  45. Abdollahi Z, Ghanizadehhesar N, Roshani S, Mohammad Ali Nasab Firouzjah E. The effect of functional corrective, central stability exercises and combination on the shoulder girdle posture of adolescent girls. IJRN 2022; 8(2): 42-51. [Persian]
  46. Idan Almasoodi MC, Mahdavinejad R, Ghasmi G. The Effect of 8 Weeks National Academy of Sports Medicine Exercises Training on Posture, Shoulder Pain, and Functional Disability in Male with Upper Cross Syndrome. Psychology and Education 2021; 58(2): 6741-6752.
  47. Najafi M, Behpoor N. The effects of a selective corrective program on the scapula and shoulder joint posture in girls with rounded shoulder. Sport Sciences and Health Research 2013; 4(2): 31-47. [Persian]
  48. Esmailondi R, Shokri B, Babadi M, Khodadadi M. The effect of 10 weeks of American National Academy of Sports Medicine (NASM) exercises on upper quadrant syndrome (kyphosis, forward slouching, uneven shoulder) in female students aged 15 to 18 years. Applied Research Journal of Sports Science Without Borders 2017; 2(7): 61-77. [Persian]
  49. Moradporian M, Rahmati M, Fouladvand M. Study of abnormality frequency and its related factors in Khorramabad Azad university students. Yafteh 2012; 14(4): 113-120. [Persian]
  50. Godarzi Salkhori A, Daei R, Faridnia H, Bigtashkhani R. The effect of 8 weeks of Pilates exercises on pain change and kyphosis angle in women's health in Tehran's second district. Sociology and Lifestyle 2022; 7(18): 190-210. [Persian]
  51. Divya, Parveen A, Nuhmani S, Ejaz Hussain M, Hussain Khan M. Effect of lumbar stabilization exercises and thoracic mobilization with strengthening exercises on pain level, thoracic kyphosis, and functional disability in chronic low back pain. J Complement Integr Med 2020; 18(2): 419-424.
  52. Roshani S, Mahdavinejad R. The effect of a NASM-based training protocol on upper cross syndrome in paraplegia spinalcord injury patients. Journal of Ilam University of Medical Sciences 2018; 25(6): 73-85. [Persian]
  53. Atılgan E, Aytar A, Çağlar A, Tığlı AA, Arın G, Yapalı G, et al. The effects of Clinical Pilates exercises on patients with shoulder pain: A randomised clinical trial. J Bodyw Mov Ther 2017; 21(4): 847-851.
  54. Santello G, Rossi DM, Martins J, Libardoni TdC, de Oliveira AS. Effects on shoulder pain and disability of teaching patients with shoulder pain a home-based exercise program: a randomized controlled trial. Clin Rehabil 2020; 34(10): 1245-1255.
  55. Clark M, Lucett S. NASM essentials of corrective exercise training: Lippincott Williams & Wilkins. 2010; 180-280.