پديد آورندگان :
اكبري، مصطفي دانشگاه تهران، تهران، ايران - پرديس البرز , مينونژاد، هومن دانشگاه تهران، تهران، ايران , رجبي، رضا دانشگاه تهران، تهران، ايران , يزدانبخش، كامران دانشگاه رازي، كرمانشاه، ايران
كليدواژه :
كمردرد , تمرينات ثبات عضلاني , نوروفيدبك , تمرينات تركيبي , كاهش درد بيماران
چكيده فارسي :
زمينه و هدف: كمردرد به عنوان يكي از پيامدهاي مشكلات عمدهٔ سلامتي و اجتماعي و اقتصادي و يكي از ضايعات عضلاني-اسكلتي شايع در جوامع است؛ بنابراين هدف از پژوهش حاضر، مقايسهٔ اثربخشي ده هفته تمرينات تركيبي ثبات عضلات مركزي و نوروفيدبك با ثبات مركزي بر درد مبتلايان به كمردرد مزمن غيراختصاصي بود.
روش‌بررسي: پژوهش حاضر از نوع نيمه‌تجربي با طرح پيش‌آزمون-پس‌آزمون با گروه گواه بود. جامعهٔ آماري پژوهش حاضر تمامي بيماران مبتلا به كمردرد مزمن غيراختصاصي بودند. از بين جامعهٔ آماري، تعداد 60 نفر به‌صورت تصادفي در چهار گروه قرار گرفتند. به گروه آزمايش يك پروتكل تركيبي تمرينات ثبات‌دهندهٔ عضلات مركزي و نوروفيدبك و به گروه آزمايش دو پروتكل تمرينات ثبات‌دهندهٔ عضلات مركزي و به گروه آزمايش سه تمرينات نوروفيدبك، تمرين داده شد. گروه گواه مداخله‌اي دريافت نكرد. براي مقايسهٔ دو‌به‌دو گروه‌ها در سطح معناداري 0٫05=α از آزمون يومن‌ويتني و نرم‌افزار SPSS نسخهٔ 23 استفاده شد.
يافته‌ها: يافته‌ها نشان داد كه بين تأثير نوروفيدبك و تمرين كوراستبيليتي بر درد تفاوت معناداري وجود دارد و تمرينات كوراستبيلتي داراي تأثير بيشتري بر كاهش درد است (0٫001>p). همچنين بين تأثير تمرينات نوروفيدبك و تركيبي تفاوت معناداري ديده مي‌شود و تمرينات تركيبي تأثير بيشتري بر كاهش درد دارد (0٫001>p)؛ اما بين تأثير تمرينات كوراستبيليتي و تركيبي بر ميزان درد تفاوت معناداري مشاهده نشد.
نتيجه‌گيري: از يافته‌هاي اين پژوهش مي‌توان نتيجه‌گيري كرد كه تمرينات ثبات عضلاني و نوروفيدبك و تمرينات تركيبي در كاهش درد بيماران مبتلا به كمردرد مزمن تأثير داشته است.
چكيده لاتين :
Background & Objectives: Back pain is among the major health and socioeconomic problems and one of the most frequent musculoskeletal disorders in societies. Therefore, the present study aimed to compare the efficacy of 10 weeks of combined training of central muscle and Central
Nervous System (CNS) stabilization on pain of patients with non–specific chronic Lower Back Pain (LBP).
Methods: This was a quasi–experimental study with a pretest–posttest and a control group design. The statistical population of this study
comprised all patients with non–specific chronic LBP. Among them, 60 subjects were selected as study samples and randomly assigned into 4
groups. The inclusion criteria were the age of 20 to 45 years, being diagnosed with a non–specific chronic LBP, experiencing the acute phase of
LBP (minimum pain; <2weeks), not being a candidate for surgery, and so on. The exclusion criteria included not participating in 2 consecutive
and 3 non–consecutive therapy sessions, dissatisfaction with participation in the training program, and the increased incidence of radicular pain
in the lumbar nerves during treatment. After referring to the clinic, the selected patients were trained to determine the degree of LBP using the
Visual Analogue Scale (VAS) for pain. After a definitive diagnosis, the research methods were described for patients, and their consent for study
participation was obtained. The experimental group 1 was trained by the combination protocols of central muscle stabilization exercises and
neurofeedback. The experimental group 2 practiced by the central muscle stabilization exercises protocol. Three groups of neurofeedback
exercises were tested in the experimental group. The control group received no treatment. To reduce pain, a 2–channel neurofeedback device
was used by the Alpha/Theta (A/T) protocol to reduce chronic pain (Katarina et al.; 2016); it would reduce the frequency from 4 to 7 Hz and
amplify the frequency from 8 to 12 Hz in the O1 and O2 regions. This protocol implements an active electrode to be placed on the O1 or O2 and
reference electrodes on the left ear and electrode on the right ear. First, the protocol instructions were explained to the study samples. Then,
moving animations were presented at the intervention stage. As the brain wanders away from the target (i.e., no increase in A/T), the images
stop moving. For re–routing, the authorities have to change their brain waves in the direction they set.
Results: The obtained data suggested a significant difference between the effects of neurofeedback stabilization exercises on pain. Besides,
blindness exercises had a greater effect on pain relief (p<0.001). There was a significant difference between the effect of neurofeedback and
combined exercises; combined exercises had a greater effect on pain relief (p<0.001). However, there was no significant difference between the
effect of corestabletic and combination exercises on pain.
Conclusion: Patients with chronic non–specific LBP, concerning the positive effects of 10 weeks of central muscle and neurofeedback
stabilization exercises on reducing pain, could be advantageously benefited by the supervision of a specialist physician for pain relief. The obtained results indicated that muscle stability, neurofeedback, and combined exercises significantly reduced pain in patients with chronic LBP.
