پديد آورندگان :
مصدق، يونس دانشگاه علامه طباطبايي تهران , نصيري، مهران دانشگاه آزاد اسلامي واحد بندر انزلي , قديمي كلاته، زهرا دانشگاه مازندران , الغوثي، محمد دانشگاه آزاد اسلامي واحد بندر انزلي
كليدواژه :
مولتيپل اسكلروزيس , تكليف شناختي , مرحلۀ استانس , راه رفتن
چكيده فارسي :
هدف: مولتيپل اسكلروزيس از شايع‌ترين بيماري‌هاي عصبي پيش‌رونده در بين بزرگ‌سالان جوان است. هدف از پژوهش حاضر، بررسي اثربار شناختي تكليف بر زمان‌بندي مرحلۀ استانس راه‌رفتن بيماران مولتيپل اسكلروزيس بود.
روش بررسي: روش مطالعۀ حاضر، از نوع نيمه‌تجربي با طرح پيش‌آزمون‌پس‌آزمون بود. بيست بيمار مبتلا به مولتيپل اسكلروزيس از انجمن ام‌اس ايران (با دامنۀ سني 41٫85±12٫59 سال و نمرۀ مقياس پيشرفت ناتواني صفر تا 5) به‌صورت داوطلبانه در اين تحقيق شركت كردند. آزمودني‌ها سه تكليف شناختي مختلف را هم‌زمان با راه‌رفتن بر روي دستگاه فوت مديسنس اجرا كردند و زمان مرحلۀ استانس آزمودني‌ها با دستگاه فوت مديسنس اندازه‌گيري شد. براي تحليل نتايج، از آزمون تحليل واريانس با اندازه‌گيري‌هاي مكرر و آزمون تعقيبي بونفروني در سطح معناداري 0٫05 استفاده شد. داده‌ها با استفاده از نرم‌افزار SPSS نسخۀ 21 تحليل شد.
يافته‌ها: يافته‌هاي به‌دست‌آمده از تحقيق نشان داد تكليف شناختي اثر معناداري بر افزايش زمان استانس راه‌رفتن در هر دو پا داشت (0٫001>p) و بين زمان استانس راه‌رفتن در تمامي مراحل تكليف شناختي، به‌جز مرحلۀ 2 در برابر 3، در پاي چپ تفاوت معناداري وجود داشت (0٫05≤p).
نتيجه‌گيري: نتايج تحقيق نشان داد زمان مرحلۀ استانس گام‌برداري در بيماران مولتيپل اسكلروزيس هنگام اجراي تكليف شناختي افزايش داشته است و بيماران مولتيپل اسكلروزيس هنگام اجراي تكليف شناختي سرعت گام‌برداري كمتري دارند.
چكيده لاتين :
Background & Objective: Multiple sclerosis (MS) disease is one of the common diseases of central nervous system. In the disease white
blood cells attack to the sheath of the central nervous system, which is called myelin. The amount of MS infection in women is two or three
times more men and infecting age range is between 15-50 years old that its peak is in 30 years. Multiple sclerosis can result in variable
neuromuscular deficit including muscle weakness, spasticity, balance impairment and sensory disturbance. Walking difficulties and cognitive
impairments are clinical hallmarks of people with multiple sclerosis. Among symptoms of the disease, growing attention has focused on
cognitive functions. Cognitive deficit have been reported in 45-70% of people affected by this disease. Cognitive impairments can play a
significant role in memory, attention, learning, performance, information processing ability and speed of information processing. One of the
most important problems in MS patients is memory impairment. This memory involves the process of temporary storage of information and
its application in the process of processing information and complex cognitive skills such as reasoning and learning; in other words, working
memory is the result of controlling attention and maintaining concentration in a particular mental activity. In many daily activities, people often
require performing an additional cognitive demanding task while walking. Therefore, purpose of this study was to evaluate the effect of
cognitive task on stance phase timing of walking in multiple sclerosis patients.
Methods: The current study design was a quasi-experimental with pre and posttest. Twenty volunteer men and women with multiple sclerosis
(mean±SD age: 41.85± 12.59 years old and EDSS score 0-5) from Tehran (capital city of Iran) multiple sclerosis association were participated
in this study and stance phase timing of walking measured in 3 different level by foot Medisense. Analysis of variance with repeated measurement
test and Bonferroni post Hoc tests were used for statistical analysis (p<0.05).
Result: Performance cognitive task had a significant effect on increased time of hill strike phase, foot flat phase, mid stance phase, hill off phase
and toe off phase in right leg (p<0.001) and in left leg. In addition, performance of cognitive task had a significant effect on increased time of
hill strike phase, foot flat phase, mid stance phase, hill off phase and toe off phase (p<0.001). Except for stage 2 versus stage 3 in left leg, there
was a significant difference between the time of walking stance phase in all level in the left leg (stage 1 versus stage 2, stage 1 versus stage 3,
stage 1 versus stage 4, stage 2 versus stage 3, stage 2 versus stage 4 and stage 3 versus stage 4) and right leg (stage 1 versus stage 2, stage 1
versus stage 3, stage 1 versus stage 4, stage 2 versus stage 4 and stage 3 versus stage 4).
Conclusion: Stance phase time in multiple sclerosis patients increased during cognitive task and multiple sclerosis patient walk slower during
cognitive task.
