نوع مقاله : مقاله پژوهشی

نویسندگان

1 رفتارحرکتی، دانشکده علوم ورزشی، دانشگاه رازی کرمانشاه، ایران

2 رفتار حرکتی، دانشکده ی علوم ورزشی، دانشگاه رازی، کرمانشاه، ایران

3 فیزیولوژی ورزشی، دانشکده علوم ورزشی، دانشگاه رازی، کرمانشاه، ایران

4 تیم تحقیقاتی علوم اعصاب در حرکات انسان، گروه تربیت بدنی، دانشگاه فدرال ریو گرانده دو نورته، ناتال، برزیل

چکیده

اگرچه امروزه واقعیت مجازی به عنوان جایگزین مناسب و پرهیجان نسبت به سایر روش‌های تمرینی پیشنهاد می-شود، اما همه ابعاد اثرگذاری آن در ترکیب با سایر مداخلات هنوز بخوبی روشن نشده است. بنابراین هدف ما تعیین تأثیر واقعیت مجازی با و بدون تحریک جریان مستقیم فراجمجمه‌ای مغز بر عملکرد تعادلی بود. شرکت‌کنندگان در پژوهش 36 دختران نوجوان کم‌تحرک بودند که بصورت هدفمند انتخاب و داوطلبانه در این مطالعه شرکت کردند. آزمودنی‌ها بصورت تصادفی به سه گروه کنترل (12 نفر)، واقعیت مجازی + تحریک آنودال (12 نفر) و گروه واقعیت مجازی + تحریک شم (12 نفر) تقسیم شدند. ابتدا هر گروه تحریک مغز ( آنودال یا شم) را به مدت 20 دقیقه با شدت 2 میلی‌آمپر دریافت می‌کرد سپس تمرینات واقعیت مجازی را یک ساعت انجام می‌دادند. گروه کنترل هیچ مداخله‌ای دریافت نمی‌کرد. هر گروه، 12 جلسه (3 جلسه در هفته) بصورت یک روز درمیان مداخله را اجرا می‌کرد. برای ارزیابی تعادل، از آزمون Y و STROK استفاده شد. از آزمون آماری تحلیل واریانس دوراهه مرکب در سطح معنا‌داری 05/0 و نرم‌افزار SPSS23 استفاده گردید. مقادیر تعادل ایستا در گروه آنودال بیشتر از گروه شم (004/0p=) و گروه کنترل (001/0p=) بود. همچنین تعادل پویا در گروه آنودال بیشتر از گروه شم ( 013/0p= ) و همچنین گروه کنترل (001/0 p<) بود. الگوی یافته‌ها نشان داد تحریک آنودال می‌تواند اثرگذاری تمرینات مجازی را بیشتر و ماندگارتر کند. و این تفاوت در مرحله پیگیری حفظ شد به گونه‌ای که عملکرد گروه تحریک آنودال نسبت به دو گروه دیگر برتری داشت.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

The effect of virtual reality with and without transcranial direct current stimulation on the balance performance of sedentary adolescent girls

نویسندگان [English]

  • nasrin shahbazi 1
  • Ali Heyrani 2
  • ehsan amiri 3
  • Daniel Gomez Da Silva Machado 4

1 Motor Behavior, Faculty of Sports Sciences, Razi University Kermanshah, Iran

2 Motor Behavior, Sport Science College, Razi University, Kermanshah. Iran

3 Department of Exercise Physiology Faculty of Sport Sciences | Razi University Kermanshah | Iran

4 Research Group in Neuroscience of Human Movement (NeuroMove), Department of Physical Education, Federal University of Rio Grande do Norte, Natal, RN, Brazil

چکیده [English]

Today, although virtual reality is suggested as a suitable and exciting alternative to other training methods, but all aspects of its effectiveness in combination with other interventions have not yet been well clarified. Therefore, our aim was to determine the effect of virtual reality with and without transcranial direct current stimulation on balance performance. The participants in the research were 36 sedentary adolescent girls who were purposefully selected and voluntarily participated in this study. The subjects were randomly divided into three control groups (12 people), VR+a-tDCS (12 people) and VR+sh-tDCS (12 people). First, each group received brain stimulation (anodal or sham) for 20 minutes with an intensity of 2 MA, then they performed virtual reality exercises for one hour. The control group did not receive any intervention. Each group conducted 12 sessions (3 sessions per week) with one day in between. Y and STROK tests were used to evaluate balance. The statistical test of the analysis Two-way Mixed ANOVA was used at the significance level of 0.05 and SPSS23 software. Static balance in the anodal group were higher than the sham group (p=0.004) and control group (p=0.001). Also, the dynamic balance in the anodal group was higher than the sham group (p=0.013) and the control group (p<0.001). The findings showed that anodal stimulation can increase the effectiveness of virtual exercises more and more lastingly. And this difference was maintained in the retention stage so that performance of the VR+a-tDCS group was superior to the other two groups.

کلیدواژه‌ها [English]

  • Transcranial direct current stimulation of the brain
  • Static balance
  • Dynamic balance
  • Sedentary adolescent girls
  • Virtual reality
  1. Hafsteinsson Östenberg A, Pojskić H, Gilic B, Sekulic D, Alricsson M. Physical fitness, dietary habits and substance misuse: a cross-sectional analysis of the associations in 7,600 swedish adolescents. Physical Activity and Health. 2022;6(1):26-37.
  2. Biddle SJ, Ciaccioni S, Thomas G, Vergeer I. Physical activity and mental health in children and adolescents: An updated review of reviews and an analysis of causality. Psychology of Sport and Exercise. 2019;42:146-55.
  3. Dumith SC, Gigante DP, Domingues MR, Kohl III HW. Physical activity change during adolescence: a systematic review and a pooled analysis. International Journal of Epidemiology. 2011;40(3):685-98.
  4. de Looze M, Elgar FJ, Currie C, Kolip P, Stevens GW. Gender inequality and sex differences in physical fighting, physical activity, and injury among adolescents across 36 countries. Journal of Adolescent Health. 2019;64(5):657-63.
  5. Biddle SJ, Pearson N, Ross GM, Braithwaite R. Tracking of sedentary behaviours of young people: a systematic review. Preventive Medicine. 2010;51(5):345-51.
  6. Jorabian A, Nejad SJ, Jafari F, Latifi N, Shahraki M, Hekmatipour N. The Effect of pilates exercise on the static balance of teenage female students. International Journal of Medical Investigation. 2022;11(4):115-21.
  7. Brodsky JR, Lipson S, Bhattacharyya N. Prevalence of pediatric dizziness and imbalance in the United States. Otolaryngology–Head and Neck Surgery. 2020;162(2):241-7.
  8. Prasertsakul T, Kaimuk P, Chinjenpradit W, Limroongreungrat W, Charoensuk W. The effect of virtual reality-based balance training on motor learning and postural control in healthy adults: a randomized preliminary study. Biomedical Engineering Online. 2018;17(1):1-17.
  9. Skelton DA. Effects of physical activity on postural stability. Age and Ageing. 2001;30(suppl_4):33-9.
  10. Mirakhori F, Pourazar M, Bagherzadeh F. Improvement of static balance through virtual reality practices in children with cerebral palsy. Journal of Sports and Motor Development and Learning. 2021;12(4):413-97.
  11. Morone G, Tramontano M, Iosa M, Shofany J, Iemma A, Musicco M, et al. The efficacy of balance training with video game-based therapy in subacute stroke patients: a randomized controlled trial. BioMed research International. 2014;2014:580861.
  12. Verhoeven K, Abeele VV, Gers B, Seghers J. Energy expenditure during Xbox Kinect play in early adolescents: The relationship with player mode and game enjoyment. Games for Health Journal. 2015;4(6):444-51.
  13. Kim HJ, Lee JW, Choi G, Huh J, Han DH. Differences in Brain Activity and Body Movements Between Virtual Reality and Offline Exercise: Randomized Crossover Trial. JMIR Serious Games. 2023;11:e40421.
  14. Foley L, Maddison R. Use of active video games to increase physical activity in children: a (virtual) reality? Pediatric Exercise Science. 2010;22(1):7-20.
  15. Mao Y, Chen P, Li L, Huang D. Virtual reality training improves balance function. Neural Regeneration Research. 2014;9(17):1628.
  16. Lazzari RD, Politti F, Santos CA, Dumont AJL, Rezende FL, Grecco LAC, et al. Effect of a single session of transcranial direct-current stimulation combined with virtual reality training on the balance of children with cerebral palsy: a randomized, controlled, double-blind trial. Journal of Physical Therapy Science. 2015;27(3):763-8.
  17. Collange Grecco LA, de Almeida Carvalho Duarte N, Mendonça ME, Galli M, Fregni F, Oliveira CS. Effects of anodal transcranial direct current stimulation combined with virtual reality for improving gait in children with spastic diparetic cerebral palsy: a pilot, randomized, controlled, double-blind, clinical trial. Clinical Rehabilitation. 2015;29(12):1212-23.
  18. Kim YJ, Ku J, Cho S, Kim HJ, Cho YK, Lim T, et al. Facilitation of corticospinal excitability by virtual reality exercise following anodal transcranial direct current stimulation in healthy volunteers and subacute stroke subjects. Journal of Neuroengineering and Rehabilitation. 2014;11:1-12.
  19. Etemadi M, Amiri E, Tadibi V, Grospretre S, Valipour V, Machado DGS. Anodal tDCS over the DLPFC but not M1 increases muscle activity and improves psychophysiological responses, cognitive function, and endurance performance in normobaric hypoxia: a randomized controlled trial. BMC Neurosci. 2023.;24(1):25.
  20. Harris DM, Rantalainen T, Muthalib M, Johnson L, Duckham RL, Smith ST, et al. Concurrent exergaming and transcranial direct current stimulation to improve balance in people with Parkinson’s disease: study protocol for a randomised controlled trial. Trials. 2018;19(1):1-13.
  21. Baharlouei H, Saba MA, Yazdi MJS, Jaberzadeh S. The effect of transcranial direct current stimulation on balance in healthy young and older adults: A systematic review of the literature. Neurophysiologie Clinique. 2020;50(2):119-31.
  22. Amini Masouleh M, Chalabianloo G, Abdi R. comparison of cognitive rehabilitation efficacy based on computer-assisted cognitive rehabilitation with and without transcranial direct current stimulation (tDCS) on improving the working memory of stroke patients. Neuropsychology. 2022;8(28):41-53.
  23. Behrangrad S, Zoghi M, Kidgell D, Jaberzadeh S. The effect of a single session of non-invasive brain stimulation on balance in healthy individuals: a systematic review and best evidence synthesis. Brain Connectivity. 2021;11(9):695-716.
  24. Kaski D, Dominguez RO, Allum JH, Bronstein AM. Improving gait and balance in patients with leukoaraiosis using transcranial direct current stimulation and physical training: an exploratory study. Neurorehabilitation and Neural Repair. 2013;27(9):864-71.
  25. Viana R, Laurentino G, Souza R, Fonseca J, Silva Filho E, Dias S, et al. Effects of the addition of transcranial direct current stimulation to virtual reality therapy after stroke: a pilot randomized controlled trial. NeuroRehabilitation. 2014;34(3):437-46.
  26. Clark VP, Coffman BA, Mayer AR, Weisend MP, Lane TD, Calhoun VD, et al. TDCS guided using fMRI significantly accelerates learning to identify concealed objects. Neuroimage. 2012;59(1):117-28.
  27. Soler MD, Kumru H, Pelayo R, Vidal J, Tormos JM, Fregni F, et al. Effectiveness of transcranial direct current stimulation and visual illusion on neuropathic pain in spinal cord injury. Brain. 2010;133(9):2565-77.
  28. Baumert A, Buchholz N, Zinkernagel A, Clarke P, MacLeod C, Osinsky R, et al. Causal underpinnings of working memory and Stroop interference control: testing the effects of anodal and cathodal tDCS over the left DLPFC. Cognitive, Affective, & Behavioral Neuroscience. 2020;20(1):34-48.
  29. Tajik N. The effect of Concurrent cerebral transcranial direct current stimulation and neuromuscular coordination exercises on balance elderly people. Journal of Gerontology. 2019;4(3):53-44.
  30. Bahrami S, Mousavi Sadati SK, Daneshjoo A. Effect of transcranial direct current stimulation and selected exercises on balance in children with developmental coordination disorder. The Scientific Journal of Rehabilitation Medicine. 2020;9(1):259-69.
  31. Saenz-de-Urturi Z, Garcia-Zapirain Soto B. Kinect-based virtual game for the elderly that detects incorrect body postures in real time. 2016;16(5):704.
  32. Arastoo AA, Zahednejad S, Parsaei S, Alboghebish S, Ataei N, Ameriasl H. The effect of direct current stimulation in left dorsolateral prefrontal cortex on working memory in veterans and disabled athletes. Daneshvar Medicine. 2020;26(6):25-32.
  33. Stagg CJ, Nitsche MA. Physiological basis of transcranial direct current stimulation. The Neuroscientist. 2011;17(1):37-53.
  34. Reiman MP, Manske RC. Functional testing in human performance. Champaign: Human Kinetics; 2009.
  35. Shaffer SW, Teyhen DS, Lorenson CL, Warren RL, Koreerat CM, Straseske CA, et al. Y-balance test: a reliability study involving multiple raters. Military medicine. 2013;178(11):1264-70.
  36. BashiriMoosavi F, Farmanbar R, Taghdisi M, AtrkarRoshan Z. Level of physical activity among girl high school students in Tarom county and relevant factors. Iranian Journal of Health Education and Health Promotion. 2015;3(2):133-40.
  37. Yosephi MH, Ehsani F, Zoghi M, Jaberzadeh S. Multi-session anodal tDCS enhances the effects of postural training on balance and postural stability in older adults with high fall risk: primary motor cortex versus cerebellar stimulation. Brain Stimulation. 2018;11(6):1239-50.
  38. Takai H, Tsubaki A, Sugawara K, Miyaguchi S, Oyanagi K, Matsumoto T, et al. Effect of transcranial direct current stimulation over the primary motor cortex on cerebral blood flow: a time course study using near-infrared spectroscopy. In Oxygen Transport to Tissue XXXVII; 2016: Cham: Springer.
  39. Ruohonen J, Karhu J. tDCS possibly stimulates glial cells. Clinical Neurophysiology. 2012;123(10):2006-9.
  40. Teo WP, Goodwill AM, Hendy AM, Muthalib M, Macpherson H. Sensory manipulation results in increased dorsolateral prefrontal cortex activation during static postural balance in sedentary older adults: An fNIRS study. Brain and behavior. 2018;8(10):e01109.
  41. Craig CE, Doumas M. Anodal transcranial direct current stimulation shows minimal, measure-specific effects on dynamic postural control in young and older adults: a double blind, sham-controlled study. PloS One. 2017;12(1):e0170331.
  42. Chen T-Y, Hwang I-S, Chang G-C. Effects of transcranial direct current stimulation on balance in healthy adults. Physiotherapy. 2015;101:e229.
  43. Sohn MK, Jee SJ, Kim YW. Effect of transcranial direct current stimulation on postural stability and lower extremity strength in hemiplegic stroke patients. Annals of Rehabilitation Medicine. 2013;37(6):759.
  44. Vaseghi B, Zoghi M, Jaberzadeh S. The effects of anodal-tDCS on corticospinal excitability enhancement and its after-effects: conventional vs. unihemispheric concurrent dual-site stimulation. Frontiers in Human Neuroscience. 2015;9:533.
  45. Jarrahi S, Abedanzadeh R, Doustan MR. The effect of eight-week interactive video games on the static and dynamic balance of male students. Neuropsychology. 2020;6(1):31-46.
  46. Tarakci D, Ersoz Huseyinsinoglu B, Tarakci E, Razak Ozdincler A. Effects of Nintendo Wii‐Fit® video games on balance in children with mild cerebral palsy. Pediatrics International. 2016;58(10):1042-50.
  47. Farič N, Smith L, Hon A, Potts HW, Newby K, Steptoe A, et al. A virtual reality exergame to engage adolescents in physical activity: Mixed methods study describing the formative intervention development process. Journal of Medical Internet Research. 2021;23(2):e18161.
  48. Adamovich SV, Fluet GG, Tunik E, Merians AS. Sensorimotor training in virtual reality: a review. NeuroRehabilitation. 2009;25(1):29-44.