تاثير شش هفته تمرينات اصلاحي بر كينماتيك كتف مردان داراي نقص چرخش پاييني كتف: يك كارآزمايي باليني تصادفي

The Effect of Six Weeks of Corrective Exercises on the Kinematics of the Scapula in Males with Scapular Downward Rotation Defect: A Randomized Clinical Trial

زﻣﯿﻨﻪ و ﻫﺪف: ﯾﮑﯽ از ﻓﺮمﻫﺎي ﻏﯿﺮ ﻃﺒﯿﻌﯽ راﺳﺘﺎي ﮐﺘﻒ، ﻧﻘﺺ ﭼﺮﺧﺶ ﭘﺎﯾﯿﻨﯽ ﮐﺘﻒ ﻣﯽﺑﺎﺷﺪ ﮐﻪ ﺷﺎﻣﻞ ﭘﺎﯾﯿﻦ آﻣﺪن، اﺑﺪاﮐﺸﻦ و ﺗﯿﻠﺖ ﻗﺪاﻣﯽ اﺳﮑﺎﭘﻮﻻ ﻣﯽﺑﺎﺷﺪ ﮐﻪ ﺑﻪ ﻃﻮر ﺑﺎﻟﻘﻮه ﺑﺎﻋﺚ ﮐﺎﻫﺶ ﭼﺮﺧﺶ ﺑﺎﻻﯾﯽ و ﺗﯿﻠﺖ ﺧﻠﻔﯽ ﮐﺘﻒ ﻣﯽﺷﻮد. ﻟﺬا ﻫﺪف از ﻣﻄﺎﻟﻌﻪ ﺣﺎﺿﺮ ﺗﻌﯿﯿﻦ ﺗﺄﺛﯿﺮ ﺷﺶ ﻫﻔﺘﻪ ﺗﻤﺮﯾﻨﺎت اﺻﻼﺣﯽ ﺑﺮ ﮐﯿﻨﻤﺎﺗﯿﮏ ﮐﺘﻒ ﻣﺮدان داراي ﻧﻘﺺ ﭼﺮﺧﺶ ﭘﺎﯾﯿﻨﯽ ﮐﺘﻒ ﺑﻮد. ﻣﻮاد و روشﻫﺎ: اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﮐﺎرآزﻣﺎﯾﯽ ﺑﺎﻟﯿﻨﯽ در داﻧﺸﮑﺪه ﺗﺮﺑﯿﺖ ﺑﺪﻧﯽ داﻧﺸﮕﺎه ﺧﻮارزﻣﯽ در ﺳﺎل 1398 اﻧﺠﺎم ﮔﺮﻓﺖ. ﺗﻌﺪاد 24 ﻓﺮد واﺟﺪ ﺷﺮاﯾﻂ ﺑﻪ ﺻﻮرت در دﺳﺘﺮس اﻧﺘﺨﺎب و ﺑﻪﻃﻮر ﺗﺼﺎدﻓﯽ ﺑﻪ دو ﮔﺮوه ﻣﺴﺎوي 12 ﻧﻔﺮه )ﮔﺮوه ﺗﻤﺮﯾﻨﺎت اﺻﻼﺣﯽ ﮐﺘﻒ و ﮔﺮوه ﮐﻨﺘﺮل(، ﺗﻘﺴﯿﻢ ﺷﺪﻧﺪ. ﮔﺮوه ﮐﻨﺘﺮل در ﻃﯽ ﻣﻄﺎﻟﻌﻪ درﻣﺎن ﺧﺎﺻﯽ را درﯾﺎﻓﺖ ﻧﮑﺮدﻧﺪ. ﻣﯿﺰان زاوﯾﻪ ﭼﺮﺧﺶ ﻓﻮﻗﺎﻧﯽ و ﺗﯿﻠﺖ ﺧﻠﻔﯽ ﮐﺘﻒ ﻗﺒﻞ و ﺑﻌﺪ از اﻋﻤﺎل ﺗﻤﺮﯾﻨﺎت اﺻﻼﺣﯽ در ﮔﺮوه ﻣﺪاﺧﻠﻪ، ﺑﺎ روﯾﻪ ﯾﮏﺳﺎن، ﺗﻮﺳﻂ دﺳﺘﮕﺎهMyoMotion 3D ﺷﺮﮐﺖ ﻧﻮراﮐﺴﻮن اﻧﺪازهﮔﯿﺮي ﺷﺪﻧﺪ. دادهﻫﺎ ﺑﺎ اﺳﺘﻔﺎده از آﻧﺎﻟﯿﺰ وارﯾﺎﻧﺲ دوﻃﺮﻓﻪ ﺑﺎ اﻧﺪازهﮔﯿﺮيﻫﺎي ﻣﮑﺮر و آزﻣﻮن t زوﺟﯽ ﻣﻮرد ﺗﺠﺰﯾﻪ و ﺗﺤﻠﯿﻞ ﻗﺮار ﮔﺮﻓﺘﻨﺪ. ﯾﺎﻓﺘﻪﻫﺎ: اﻓﺰاﯾﺶ ﻣﻌﻨﯽداري در ﻣﯿﺰان زاوﯾﻪ ﭼﺮﺧﺶ ﻓﻮﻗﺎﻧﯽ در زواﯾﺎي p<0/001) 90º ،(p<0/001) 60º ،(P=0/038) 30º ( و p<0/001) 120º( و ﺗﯿﻠﺖ ﺧﻠﻔﯽ در زواﯾﺎي p<0/001) 90º ،(p<0/001) 60º ،(p<0/001) 30º( و p<0/001) 120º( اﺑﺪاﮐﺸﻦ ﺷﺎﻧﻪ ﭘﺲ از اﻋﻤﺎل ﻣﺪاﺧﻠﻪ ﺗﻤﺮﯾﻨﯽ در ﮔﺮوه ﻣﺪاﺧﻠﻪ ﻧﺴﺒﺖ ﺑﻪ ﮔﺮوه ﮐﻨﺘﺮل ﻣﺸﺎﻫﺪه ﺷﺪ. ﻧﺘﯿﺠﻪﮔﯿﺮي: ﻧﺘﺎﯾﺞ ﻧﺸﺎن داد ﮐﻪ ﻣﺪاﺧﻠﻪ ﺗﻤﺮﯾﻨﺎت اﺻﻼﺣﯽ ﮐﺘﻒ ﺑﺎﻋﺚ ﺑﻬﺒﻮد زاوﯾﻪ ﺗﯿﻠﺖ ﺧﻠﻔﯽ و ﭼﺮﺧﺶ ﻓﻮﻗﺎﻧﯽ ﮐﺘﻒ در اﻓﺮاد داراي ﻧﻘﺺ ﭼﺮﺧﺶ ﭘﺎﯾﯿﻨﯽ ﮐﺘﻒ ﻣﯽﺷﻮد.

One of the abnormal forms of scapular malalignment is the scapular downward rotation defect, which includes depression, protraction, and anterior scapula tilt, which potentially reduces the upper rotation and posterior tilting of the scapula. Therefore, the aim of this study was to determine the effect of six weeks of corrective exercises on the kinematics of the scapula in males with scapular downward rotation defect. Materials and Methods: This randomized clinical trial was performed in the Faculty of Physical Education of Kharazmi University in 2019, Iran. Twenty-four eligible patients were selected and randomly divided into two equal groups of 12, corrective exercises and control group. The control group did not receive any specific treatment during the study. The scapular upward rotation and scapular posterior tilt were measured in the same way before and after the corrective exercises in the intervention group by Noraaxon's MyoMotion 3D device. Data were analyzed using twoway repeated measures ANOVA and paired t-test. Results: A significant increase was observed in scapular upward rotation in the angles of 30º (p=0.038), 60º (p<0.001), 90º (p<0.001) and 120º (p<0.001), and in scapular posterior tilt in the angles of 30º (p<0.001), 60º (p< 0.001), 90º (p<0.001) and 120º (p<0.001) after applying the exercise intervention in the intervention group compared to the control group. Conclusion: The results showed that the intervention of scapular correction exercises improves the angles of scapular upward rotation and scapular posterior tilt in people with scapular downward rotation defect.