اثر 8 هفته تمرین پله بر تعادل ایستا و پویا زنان سالمند با درد مزمن غیراختصاصی زانو.

نوع مقاله : مقاله پژوهشی

نویسندگان

1 استادیار، دانشکده علوم ورزشی، دانشگاه صنعتی اصفهان، اصفهان، ایران

2 دانشجوی کارشناسی ارشد آسیب شناسی ورزشی و حرکات اصلاحی، دانشگاه ازاد خوراسگان اصفهان، اصفهان، ایران

3 دانشجوی دکترای آسیب شناسی ورزشی و حرکات اصلاحی(امدادگر ورزشی)، دانشکده پردیس علوم ورزشی، دانشگاه تهران، تهران، ایران

چکیده

زمینه و هدف: سالمندی با کاهش قابلیت های فیزیکی و شناختی همراه است اما فعالیت بدنی تاثیرات مثبتی بر زندگی این افراد دارد. هدف تحقیق حاضر تعیین اثربخشی هشت هفته تمرینات پله بر تعادل ایستا و پویا زنان سالمند با درد مزمن غیراختصاصی زانو بود.
روش بررسی: در مطالعه نیمه تجربی حاضر 30 زن سالمند شهرستان شهرکرد به صورت در دسترس انتخاب و به صورت تصادفی در دو گروه تمرینی (سن: 45/4±64/65 سال، قد: 34/3±64/165 سانتی­متر، وزن: 62/4± 45/78 کیلوگرم) و کنترل (سن: 45/3±14/62 سال، قد: 32/3±91/162 سانتی­متر، وزن: 66/3±26/76 کیلوگرم) قرار گرفتند. گروه تجربی هشت هفته تمرین پله (3 جلسه 30 دقیقه ای در هفته) را انجام دادند. در این دوره آزمودنی­های گروه کنترل فعالیت روزمره خود را داشتند. قبل و بعد از دوره تمرینی تعادل ایستا و پویا با آزمون­های امتیازدهی خطای تعادل  و برخاستن و رفتن ارزیابی شد. تحلیل داده ها با آزمون آنالیز واریانس ترکیبی مکرر و آزمون تعقیبی بونفرونی SPSS نسخه 20 در سطح 05/0 انجام شد.
یافته ها: نتایج نشان داد هشت هفته تمرین پله بر تعادل ایستا (01/0=P ) و تعادل پویا (001/0=P) تاثیر معناداری داشت.
نتیجه گیری: تمرینات پله بر بهبود تعادل ایستا و پویا تاثیر داشت و بر اساس نتایج، این تمرینات در زنان سالمند با ایجاد سازگاری های فیزیولوژیکی موثر، سیستم عصبی و روانی را تحت تاثیر قرار داده و از این طریق می تواند تعادل سالمندان زن را بهبود بخشد. بر همین اساس توصیه می شود، زنان سالمند با درد مزمن اختصاصی زانو به انجام تمرینات پله بپردازند.

کلیدواژه‌ها


Abdulla, A., Adams, N., Bone, M., Elliott, A. M., Gaffin, J., Jones, D., Knaggs, R., Martin, D., Sampson, L., & Schofield, P. (2013). Guidance on the management of pain in older people. Age and ageing, 42, i1-57.
Amaral-Carvalho, V., & Caramelli, P. (2012). Normative data for healthy middle-aged and elderly performance on the Addenbrooke Cognitive Examination-Revised. Cognitive and Behavioral Neurology, 25(2), 72-76.
Arden, N. K., Crozier, S., Smith, H., Anderson, F., Edwards, C., Raphael, H., & Cooper, C. (2006). Knee pain, knee osteoarthritis, and the risk of fracture. Arthritis Care & Research: Official Journal of the American College of Rheumatology, 55(4), 610-615.
Aslankhani, M. A., Farsi, A., Fathirezaie, Z., Zamani Sani, S. H., & Aghdasi, M. T. (2015). Validity and Reliability of the Timed Up and Go and the Anterior Functional Reach Tests in Evaluating Fall Risk in the Elderly [Research]. Salmand: Iranian Journal of Ageing, 10(1), 16-25. http://salmandj.uswr.ac.ir/article-1-720-fa.html
Bennell, K., & Hinman, R. (2005). Effect of experimentally induced knee pain on standing balance in healthy older individuals. Rheumatology, 44(3), 378-381.
Blackburn, T., Guskiewicz, K. M., Petschauer, M. A., & Prentice, W. E. (2000). Balance and joint stability: the relative contributions of proprioception and muscular strength. Journal of sport rehabilitation, 9(4), 315-328.
Buckley, T. A., Munkasy, B. A., & Clouse, B. P. (2018). Sensitivity and specificity of the modified balance error scoring system in concussed collegiate student athletes. Clinical journal of sport medicine, 28(2), 174-176.
Chen, L.-Y., Su, F.-C., & Chiang, P.-Y. (2000). Kinematic and EMG analysis of backward walking on treadmill. Proceedings of the 22nd Annual International Conference of the IEEE Engineering in Medicine and Biology Society (Cat. No. 00CH37143),
Christopher, A., Kraft, E., Olenick, H., Kiesling, R., & Doty, A. (2019). The reliability and validity of the timed Up and Go as a clinical tool in individuals with and without disabilities across a lifespan: a systematic review: psychometric properties of the Timed Up and Go. Disability and rehabilitation, 1-15. Dashti, P., Shabani, M., & Moazami, M. (2015). Comparison of the effects of two selected exercises of Theraband and Pilates on the balance and strength of lower limb in elderly women. The Iranian Journal of Obstetrics, Gynecology and Infertility, 18(153), 1-9. https://doi.org/10.22038/ijogi.2015.4698
Deandrea, S., Lucenteforte, E., Bravi, F., Foschi, R., La Vecchia, C., & Negri, E. (2010). Risk factors for falls in community-dwelling older people:" a systematic review and meta-analysis". Epidemiology, 658-668.
Garber, C. E., Blissmer, B., Deschenes, M. R., Franklin, B. A., Lamonte, M. J., Lee, I.-M., Nieman, D. C., & Swain, D. P. (2011). Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise.
Giné-Garriga, M., Roqué-Fíguls, M., Coll-Planas, L., Sitja-Rabert, M., & Salvà, A. (2014). Physical exercise interventions for improving performance-based measures of physical function in community-dwelling, frail older adults: a systematic review and meta-analysis. Archives of physical medicine and rehabilitation95(4), 753-769.‏
Hall, S. E., & Hendrie, D. V. (2003). A prospective study of the costs of falls in older adults living in the community. Australian and New Zealand journal of public health, 27(3), 343-351.
Hochberg, M. C., Altman, R. D., April, K. T., Benkhalti, M., Guyatt, G., McGowan, J., Towheed, T., Welch, V., Wells, G., & Tugwell, P. (2012). American College of Rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee. Arthritis care & research, 64(4), 465-474.
Hopewell, S., Clarke, M., Moher, D., Wager, E., Middleton, P., Altman, D. G., & Schulz, K. F. (2008). CONSORT for reporting randomised trials in journal and conference abstracts. The Lancet, 371(9609), 281-283.
Hurley, M., Dickson, K., Hallett, R., Grant, R., Hauari, H., Walsh, N., Stansfield, C., & Oliver, S. (2018). Exercise interventions and patient beliefs for people with hip, knee or hip and knee osteoarthritis: a mixed methods review. Cochrane Database of Systematic Reviews(4).
Jonathan Bean, M. D., Seth Herman, B. A., Mph, D. K. K., Damien Callahan, B. S., Kelly Mizer, B. S., Md, W. R. F., & Fielding, R. A. (2002). Weighted stair climbing in mobility‐limited older people: a pilot study. Journal of the American Geriatrics Society50(4), 663-670.‏
Jönsson, T., Hansson, E. E., Thorstensson, C. A., Eek, F., Bergman, P., & Dahlberg, L. E. (2018). The effect of education and supervised exercise on physical activity, pain, quality of life and self-efficacy-an intervention study with a reference group. BMC musculoskeletal disorders, 19(1), 1-11.
Khanmohamadi, R., Khalaji, H., & Yousefi, R. (2016). The Effect of PETTLEP Imagery and Balance Practice on Dynamic Balance of the Elderly. Journal of Motor Learning and Movement, 8(1), 79-98. https://doi.org/10.22059/jmlm.2016.58497
Lajoie, Y., & Gallagher, S. (2004). Predicting falls within the elderly community: comparison of postural sway, reaction time, the Berg balance scale and the Activities-specific Balance Confidence (ABC) scale for comparing fallers and non-fallers. Archives of gerontology and geriatrics, 38(1), 11-26.
Macaluso, A., Nimmo, M. A., Foster, J. E., Cockburn, M., McMillan, N. C., & De Vito, G. (2002). Contractile muscle volume and agonist‐antagonist coactivation account for differences in torque between young and older women. Muscle & nerve25(6), 858-863.‏
Mair, J. L., De Vito, G., & Boreham, C. A. (2019). Low volume, home-based weighted step exercise training can improve lower limb muscle power and functional ability in community-dwelling older women. Journal of Clinical Medicine8(1), 41.‏
McAlindon, T. E., Bannuru, R. R., Sullivan, M., Arden, N., Berenbaum, F., Bierma-Zeinstra, S., Hawker, G., Henrotin, Y., Hunter, D., & Kawaguchi, H. (2014). OARSI guidelines for the non-surgical management of knee osteoarthritis. Osteoarthritis and cartilage, 22(3), 363-388.
Menz, H. B., Lord, S. R., & Fitzpatrick, R. C. (2003). Age‐related differences in walking stability. Age and ageing, 32(2), 137-142.
Muraki, S., Akune, T., Oka, H., En‐yo, Y., Yoshida, M., Nakamura, K., Kawaguchi, H., & Yoshimura, N. (2011). Prevalence of falls and the association with knee osteoarthritis and lumbar spondylosis as well as knee and lower back pain in Japanese men and women. Arthritis care & research, 63(10), 1425-1431.
Nashner, L. M. (2014). Practical biomechanics and physiology of balance. Balance function assessment and management, 431.
Ojoawo, A. O., Olaogun, M. O., & Hassan, M. A. (2016). Comparative effects of proprioceptive and isometric exercises on pain intensity and difficulty in patients with knee osteoarthritis: a randomised control study. Technology and Health Care, 24(6), 853-863.
Orssatto, L. d. R., Moura, B. d., Bezerra, E. d. S., Andersen, L. L., Oliveira, S. d., & Diefenthaeler, F. (2018). Influence of strength training intensity on subsequent recovery in elderly. Experimental gerontology, 106, 232-239.
Pahlevanian, A. A., Najarian, R., Adabi, S., & Mirshoja, M. S. (2020). The Prevalence of Fall and Related Factors in Iranian Elderly: A Systematic Review [Review]. Archives of Rehabilitation, 21(3), 286-303. https://doi.org/10.32598/rj.21.3.2084.6
Patel, K. V., Phelan, E. A., Leveille, S. G., Lamb, S. E., Missikpode, C., Wallace, R. B., Guralnik, J. M., & Turk, D. C. (2014). High prevalence of falls, fear of falling, and impaired balance in older adults with pain in the United States: findings from the 2011 National Health and Aging Trends Study. Journal of the American Geriatrics Society, 62(10), 1844-1852.
Penzer, F., Duchateau, J., & Baudry, S. (2015). Effects of short-term training combining strength and balance exercises on maximal strength and upright standing steadiness in elderly adults. Experimental gerontology, 61, 38-46.
Punakallio, A. (2005). Balance abilities of workers in physically demanding jobs: With special reference to firefighters of different ages. Journal of Sports Science and Medicine, 4(8), 1-47.
Rozzi, S. L., Lephart, S. M., Sterner, R., & Kuligowski, L. (1999). Balance training for persons with functionally unstable ankles. Journal of Orthopaedic & Sports Physical Therapy, 29(8), 478-486.
Seyedjafari, E., Sahebozamani, M., & Ebrahimipour, E. (2017). Effect of eight weeks of water exercises on deep part of the pool on the static balance of the elderly man. Iranian Journal of Ageing, 12(3), 384-393.
Shumway-Cook, A., & Woollacott, M. (2001). Aging and postural control. motor control: theory and practical applications, 2nd. In: Baltimore, Williams & Wilkins.
Skelton, D. A., Greig, C. A., Davies, J. M., & Young, A. (1994). Strength, power and related functional ability of healthy people aged 65–89 years. Age and ageing23(5), 371-377.‏
Stubbs, B., Binnekade, T., Eggermont, L., Sepehry, A. A., Patchay, S., & Schofield, P. (2014). Pain and the risk for falls in community-dwelling older adults: systematic review and meta-analysis. Archives of physical medicine and rehabilitation, 95(1), 175-187. e179.
Svensson, P., Miles, T. S., Graven-Nielsen, T., & Arendt-Nielsen, L. (2000). Modulation of stretch-evoked reflexes in single motor units in human masseter muscle by experimental pain. Experimental brain research, 132(1), 65-71.
Takacs, J., Krowchuk, N. M., Garland, S. J., Carpenter, M. G., & Hunt, M. A. (2017). Dynamic balance training improves physical function in individuals with knee osteoarthritis: a pilot randomized controlled trial. Archives of physical medicine and rehabilitation, 98(8), 1586-1593.
Toda, H., Nagano, A., & Luo, Z. (2015). Age and gender differences in the control of vertical ground reaction force by the hip, knee and ankle joints. Journal of physical therapy science27(6), 1833-1838.‏
Van der Esch, M., Knoop, J., Van der Leeden, M., Roorda, L., Lems, W., Knol, D., & Dekker, J. (2015). Clinical phenotypes in patients with knee osteoarthritis: a study in the Amsterdam osteoarthritis cohort. Osteoarthritis and cartilage, 23(4), 544-549.
(Chamachaei et al., 2022)
Chamachaei, A., Mohammed, & sdaghati.   (2022). Comparison of static, dynamic balance and postural control in the elderly with different foot structure. Research in exercise rehabilitation, 9(18).