اثر 8 هفته تمرين مقاومتي بر تعادل، خستگي و قدرت عضلاني در زنان مبتلا به مالتيپل اسكلروزيس

Effect of 8- Week Resistance Training on Balance, Fatigue, and Muscle Strength in Women with Multiple Sclerosis

ﻣﺎﻟﺘﯿﭙﻞ اﺳﮑﻠﺮوزﯾﺲ )ام اس( ﺑﻪ ﻋﻨﻮان ﯾﮏ ﺑﯿﻤﺎري اﻟﺘﻬﺎﺑﯽ ﻣﺰﻣﻦ ﺳﯿﺴﺘﻢ ﻋﺼﺒﯽ ﻣﺮﮐﺰي ﺗﻌﺮﯾﻒ ﺷﺪه اﺳﺖ ﮐﻪ ﻣﻨﺠﺮ ﺑﻪ ﺿﺎﯾﻌﺎت ﮐﺎﻧﻮﻧﯽ ﺑﺰرگ در ﻣﺎده ﺳﻔﯿﺪ ﻣﻐﺰ و ﻧﺨﺎع ﻣﯽﺷﻮد وﺗﻮﺳﻂ دﻣﯿﻠﯿﻨﻪ ﺷﺪن اوﻟﯿﻪ ﺑﺎ وﺳﻌﺖ ﻣﺘﻐﯿﺮ از دﺳﺖ دادن آﮐﺴﻮن ﻣﺸﺨﺺ ﻣﯽﮔﺮدد. ﻫﺪف از اﯾﻦ ﭘﮋوﻫﺶ ﺑﺮرﺳﯽ اﺛﺮ ﻫﺸﺖ ﻫﻔﺘﻪ ﺗﻤﺮﯾﻦ ﻣﻘﺎوﻣﺘﯽ ﺑﺮ ﺗﻌﺎدل، ﺧﺴﺘﮕﯽ و ﻗﺪرت ﻋﻀﻼﻧﯽ در زﻧﺎن ﻣﺒﺘﻼ ﺑﻪ ام اس ﺑﻮد. روش ﮐﺎر: ﺑﺪﯾﻦ ﻣﻨﻈﻮر، 24 زن ﻣﺒﺘﻼ ﺑﻪ ام اس ﺑﻪ ﺻﻮرت ﻫﺪﻓﻤﻨﺪ و ﺗﺼﺎدﻓﯽ ﺑﻪ دو ﮔﺮوه ﺗﻤﺮﯾﻦ )12 ﻧﻔﺮ ﺑﺎ ﻣﯿﺎﻧﮕﯿﻦ ﺳﻦ 2/75 ± 36/83 ﺳﺎل، ﻣﯿﺎﻧﮕﯿﻦ وزن 5/10 ±42/68 ﮐﯿﻠﻮﮔﺮم و درﺟﻪ ﻧﺎﺗﻮاﻧﯽ 0/80 ± 3/25( و ﮔﺮوه ﮐﻨﺘﺮل )12 ﻧﻔﺮ ﺑﺎ ﻣﯿﺎﻧﮕﯿﻦ ﺳﻦ 5/10 ± 34/91، ﻣﯿﺎﻧﮕﯿﻦ وزن 3/70 ± 64/71 ﮐﯿﻠﻮﮔﺮم و درﺟﻪ ﻧﺎﺗﻮاﻧﯽ 0/90 ±3/00( ﺗﻘﺴﯿﻢ ﺷﺪﻧﺪ. ﮔﺮوه ﺗﻤﺮﯾﻦ ﺑﻪ ﻣﺪت 8 ﻫﻔﺘﻪ، 45 ﺗﺎ 60 دﻗﯿﻘﻪ و ﺳﻪ ﺟﻠﺴﻪ در ﻫﻔﺘﻪ ﺗﻤﺮﯾﻨﺎت ﻣﻘﺎوﻣﺘﯽ را اﻧﺠﺎم دادﻧﺪ. در اﯾﻦ دوران ﮔﺮوه ﮐﻨﺘﺮل ﻫﯿﭻ ﮔﻮﻧﻪ ﻓﻌﺎﻟﯿﺖ ﺑﺪﻧﯽ ﻣﻨﻈﻤﯽ ﻧﺪاﺷﺖ. ﺑﺮاي ارزﯾﺎﺑﯽ ﺗﻌﺎدل از آزﻣﻮن ﺗﻌﺎدﻟﯽ ﺑﺮگ اﺳﺘﻔﺎده ﺷﺪ. ﻋﻼوه ﺑﺮ آن، ﭘﺮﺳﺸﻨﺎﻣﻪ ﺗﺄﺛﯿﺮ ﺧﺴﺘﮕﯽ و ﺷﺎﺧﺺ ﻣﻮﺗﺮﯾﺴﯿﺘﯽ ﺑﺮاي ارزﯾﺎﺑﯽ ﺧﺴﺘﮕﯽ و ﻗﺪرت ﻋﻀﻼﻧﯽ در دو ﮔﺮوه، ﻗﺒﻞ و ﺑﻌﺪ از دوره ﺗﻤﺮﯾﻦ اﺳﺘﻔﺎده ﺷﺪ. ﺗﺤﻠﯿﻞ دادهﻫﺎ ﺗﻮﺳﻂ آزﻣﻮن ﮐﻮوارﯾﺎﻧﺲ در ﺳﻄﺢ ﻣﻌﻨﯽ داري )05 /0> P( ﺑﺎ ﻧﺮم اﻓﺰار SPSS اﻧﺠﺎم ﺷﺪ. ﯾﺎﻓﺘﻪﻫﺎ: ﻧﺘﺎﯾﺞ ﻧﺸﺎن داد ﻫﺸﺖ ﻫﻔﺘﻪ ﺗﻤﺮﯾﻦ ﻣﻘﺎوﻣﺘﯽ ﻣﻮﺟﺐ اﻓﺰاﯾﺶ ﻣﻌﻨﺎدار ﺗﻌﺎدل )0/000 = P(، ﻗﺪرت ﻋﻀﻼﻧﯽ اﻧﺪام ﺑﺎﻻﺗﻨﻪ )0/000 = P( و ﭘﺎﯾﯿﻦ ﺗﻨﻪ )0/000 = P( و ﮐﺎﻫﺶ ﻣﻌﻨﺎدار ﺧﺴﺘﮕﯽ )0/000 = P( ﺑﯿﻤﺎران ﻣﺒﺘﻼ ﺑﻪ ام اس ﻣﯽﺷﻮد. ﻧﺘﯿﺠﻪ ﮔﯿﺮي: ﺑﻪ ﻃﻮر ﮐﻠﯽ ﻣﯽﺗﻮان ﮔﻔﺖ ﮐﻪ اﻧﺠﺎم ﺗﻤﺮﯾﻨﺎت ﻣﻘﺎوﻣﺘﯽ ﺑﺮاي زﻧﺎن ﻣﺒﺘﻼ ﺑﻪ ام اس ﺳﻮدﻣﻨﺪ ﺑﻮده و ﻣﯽﺗﻮاﻧﺪ ﺳﺒﺐ ﺑﻬﺒﻮد ﺑﺮﺧﯽ از ﺷﺎﺧﺺﻫﺎي ﻋﻤﻠﮑﺮدي در اﯾﻦ ﺑﯿﻤﺎران ﮔﺮدد. ﻟﺬا ﭘﯿﺸﻨﻬﺎد ﻣﯽﺷﻮد اﯾﻦ ﺗﻤﺮﯾﻨﺎت ﺑﻪ ﻋﻨﻮان ﺑﺨﺸﯽ از ﻣﺪاﺧﻠﻪ درﻣﺎﻧﯽ در ﺑﺮﻧﺎﻣﻪ ﺗﻮاﻧﺒﺨﺸﯽ و ﺑﻬﺒﻮد ﻣﺒﺘﻼﯾﺎن ﻣﻮرد ﺗﻮﺟﻪ ﻗﺮار ﮔﯿﺮد.

Multiple Sclerosis (MS) is a chronic inflammatory disease of the central nerve system (CNS), which leads to large focal lesions in the white matter of the brain and spinal cord, characterized by primary demyelination with a variable extent of axonal loss. The purpose of this study was to evaluate the effect of 8- week resistance training on balance, fatigue, and muscle strength in women with multiple sclerosis. Methods: To this end, 24 women with MS were randomly- purposefuly assigned to the exercise( N = 12, Age = 36,83 ± 2,75,Weight = 68,42 ± 5,10 Kg, EDSS = 3,25 ± 0,80) and control(N = 12, Age = 34,91 ± 5,10, Weight = 64,71 ± 3,70 Kg, EDSS = 3,00 ± 0,90) groups. Exercise group carried out an 8- week resistance exercise program for 45 to 60 min 3 times/week, but Control group did not have any regular physical activity. Berg Balance Scale was used to assess the balance. In addition, Fatigue Impact Scale questionnaire and Motricity Index were used to evaluate fatigue and muscle strength of the two groups before and after training. Data were analayzed by covariance test with SPSS software at (P < 0.05). Results: According to the results, performing eight weeks of resistance training was associated with a significant increase in balance (P = 0.000), upper body muscle strength (P = 0.000), lower body muscle strength (P = 0.000), and a significant decrease in fatigue (P = 0.000). Conclusions: In general, performing resistance training is beneficial for women with MS and can improve functional indices (balance, muscle strength, and fatigue) in these patients. Therefore, these exercises are recommended as a part of the rehabilitation program to improve these patients.