اثربخشي آموزش كاركرد اجرايي مبتني بر فعاليت حركتي بر حافطه كاري و توجه پايدار كودكان مبتلا به اختلال نقص توجه/بيش‌فعالي

Effectiveness of motor activity-based executive function training on working memory and sustained attention of children with attention-deficit/hyperactivity disorder

مقدمه: اختلال نقص توجه/بيش­ فعالي يك اختلال عصبي رشدي است كه با نشانه ­هاي كاهش توجه، افزايش تكانش ­گري و بيش ­فعالي همراه است. ورزش به عنوان يك درمان كمكي ايمن و كم هزينه براي كودكان داراي اختلال نقص توجه/بيش­ فعالي پيشنهاد شده است. هدف پژوهش حاضر بررسي اثربخشي آموزش كاركرد اجرايي مبتني بر فعاليت حركتي بر حافطه كاري و توجه پايدار اين كودكان بود. روش كار: پژوهش حاضر از نوع نيمه آزمايشي با طرح پيش­آزمون_پس­آزمون بود. جامعه آماري شامل تمامي كودكان 9 تا 12 ساله مبتلا به اختلال نقص توجه/بيش ­فعالي شهر كرمانشاه تشكيل بود كه از ميان آنان 20 كودك به صورت در دسترس انتخاب و در دو گروه 10 نفره كنترل و آزمايش جايگزين شدند. ابزار پژوهش آزمون بهره هوشي وكسلر كودكان، پرسشنامهConners والدين، آزمون حافظه كاري و آزمون عملكرد پيوسته بود. برنامه آموزش كاركرد اجرايي مبتني بر فعاليت حركتي طي 12 هفته متوالي و دو بار در هفته به مدت 70 دقيقه در سالن ورزشي براي گروه آزمايش برگزار شد. تحليل داده ­ها با استفاده از آزمون تحليل كوواريانس تك متغيره و چند متغيره در نرم ­افزار SPSS-23 استفاده شد. يافته­ ها: نتايج حاكي از پيشرفت معنادار در حافظه كاري و توجه پايدار كودكان داراي اختلال نقص توجه/بيش­ فعالي به دنبال 12 هفته تمرينات كاركردهاي اجرايي بود (001/0P≤). نتيجه­ گيري: بر اساس نتايج پژوهش حاضر مي­توان گفت از آنجا كه آموزش كاركرد اجرايي مبتني بر فعاليت حركتي تاثير مثبت و معناداري بر حافطه كاري و توجه پايدار كودكان مبتلا به اختلال نقص توجه/بيش ­فعالي دارد، روش مداخله ­اي مناسبي جهت درمان اين كودكان است.

Introduction: Attention-Deficit/Hyperactivity Disorder (ADHD) is a developmental neurological disorder associated with decreased attention symptoms, increased impulsivity and hyperactivity. Working memory and sustained attention are the essential aspects of executive functions. Working memory is an abstract structure that refers to the primary mechanism or system for storing and processing information related to tasks while performing a cognitive task. Sustained attention refers to maintaining attention during continuous activity. Sustained attention helps individuals to control the interference of stimuli and respond only to the appropriate stimulus. Exercise has been suggested as a safe and low-cost Conventional therapy for children with ADHD. The present study aimed to investigate the effectiveness of executive function training based on motor activity on working memory and sustained attention of children with ADHD. Methods: The present study was a quasi-experimental study with a pre-test-post-test design. The Ethics Committee of the Islamic Azad University of Kermanshah approved the present study's proposal at the time of approval. Besides, all participants participated in this study with full consent, and written consent was obtained from their parents in this regard. In addition, participants were assured that their information would remain confidential. The present study’s statistical population included all children aged 9 to 12 years with ADHD in Kermanshah city. Participants in this study were 20 children selected by convenience sampling and randomly assigned into two control and experimental groups. The experimental group participants participated in a physical activity protocol held in the gym for 12 weeks and twice a week for 70 minutes. The research instruments were the Wechsler intelligence quotient test for children, Connors Parent Questionnaire, working memory, and continuous performance test. Prior to implementing the training protocol, all participants’ sustained attention and working memory scores were recorded as a pre-test with N-back and a continuous performance test. At the end of the training protocol, all subjects’ working memory and sustained attention scores were recorded as post-test. Shapiro-Wilk test was used to check the data's normality, and the Levin test was used to check the homogeneity of variances. Finally, an analysis of covariance in SPSS-23 software was used to test the research hypothesis. The significance was considered 0.05 at all stages. Results: The results revealed that after 12 weeks of executive function training based on motor activity, there was a significant difference in working memory and sustained attention scores in the post-test of two groups (P≤0.001). According to ETA squares, 92% of the changes in working memory and 89% of the sustained attention changes were due to the effect of exercises. Conclusion: According to the results of this study, it can be said that since executive function training based on motor activity has a positive and significant effect on working memory and sustained attention in children with ADHD, it is a suitable intervention method to treat these children.