نوع مقاله : مقاله پژوهشی
نویسنده
کارشناس‌ارشد رفتار حرکتی، دانشگاه علامه طباطبایی
چکیده
مولتیپل اسکلروزیس یک بیماری مخرب میلین در قسمت‌های مختلف سیستم عصبی مرکزی از جمله سیستم حسی ـ حرکتی است که باعث اختلال تعادل در بیماران می‌شود. دراین‌راستا، هدف از پژوهش حاضر بررسی اثر بار شناختی تکلیف بر نوسانات قامتی بیماران مولتیپل اسکلروزیس نسبت به افراد سالم بود. بدین‌‌منظور، ۲۰ بیمار مبتلا به مولتیپل اسکلروزیس از انجمن ام.اس ایران (با دامنۀ سنی ۵۹/۱۲±۸۵/۴۱ سال و نمرۀ مقیاس پیشرفت ناتوانی ۵ـ۰) و ۲۰ فرد سالم (با دامنۀ سنی ۶/۸±۵۲/۴۶ سال) به‌صورت داوطلبانه در این پژوهش شرکت نمودند. آزمودنی‌ها سه تکلیف شناختی مختلف را بر روی دستگاه تعادل‌سنج ایستا اجرا کردند ومساحت نوسانات قامتی آزمودنی‌ها با دستگاه تعادل‌سنج ایستا اندازه‌گیری شد. برای تحلیل نتایج نیز از آزمون تحلیل واریانس با اندازه‌گیری‌های مکرر ((P≤0.05استفاده گردید. یافته‌ها نشان می‌دهد که تکلیف شناختی اثر معناداری بر افزایش مساحت نوسانات (P=0.001) در هر دو گروه داشته است و بین میانگین نوسانات قامتی در تمامی سطوح در دو گروه بیماران مبتلا به ام.اس و سالم تفاوت معناداری وجود دارد ((P≤0.05. نتایج بیانگر آن است که نوسانات قامتی در بیماران مولتیپل اسکلروزیس هنگام اجرای تکلیف شناختی نسبت به افراد سالم افزایش بیشتری داشته است.
کلیدواژه‌ها
موضوعات
عنوان مقاله [English]
The Effect of Cognitive Task on Postural Sway in Multiple Sclerosis Patients
نویسنده [English]
- Younes Mosadegh
M.Sc. of Motor Behavior, University of Allameh Tabatabayi
چکیده [English]
Multiple sclerosis is a demyelinating disease that due to the involvement of multiple areas in central nercous system, including sensorimotor system can impair the patients,balance. Purpose of this study was to evaluate the effect of cognitive task on postural sway in multiple sclerosis patients. Twenty volunteer men and women with multiple sclerosis (mean ±SD age: 41.85± 12.59 years old and EDSS score 0-5) from Tehran multiple sclerosis association and twenty healthy adults (mean ±SD age: 46.52± 8/6 years old) were participated in this study and area of postural sway measured in 3 different level by static stabilometer. Repeated measurment test were used for statistical analysis (P<0.005). area under the curve increased by cognitive task in multiple sclerosis and control groups (P=0.000) and there was a significant difference between two groups for area under the curve (P<0.005). The results of this study showed that performance cognitive task increased (%22, %35, %49) of center of pressure sway in multiple sclerosis patients. Also, there was a significant difference between postural sway two groups in all level of cognitive task.
کلیدواژه‌ها [English]
- Multiple Sclerosis
- Postural Sway
- Cognitive Task
- Aryan R, Shaterzadehyazdi M J, Sharafoddinzadeh N, Goharpey Sh, Arastoo A A. Investigation of body balance in people with multiple sclerosis in Khouzestan Province: Use of clinical functional balance tests. Sci Med J. 2010; 9(1): 35-43. (In Persian).
- Cameron M, Lord S. Postural control in multiple sclerosis: Implication for fall prevention. Curr Neurol Neurosci Rep. 2010; 10(1): 407-12.
- Pardo G. Multiple Sclerosis and optic neuritis. Focal Points, Clinical Modules for Ophthalmologists. 2003; 21: 1-13.
- Cameron M H, Horak F B, Herndon R R, Bourdette D. Imbalance in Multiple Sclerosis: A result of slowed spinal somatosensory conduction. Somatosens Mot Res. 2008; 25: 113-22.
- Esmaeeli Abdar M, Zarghami A, Ghotbi Varzaneh A. Differences related to the distance effects of external focus of attention on static balance of the patients with Multiple Sclerosis. Motor Behavior. 2014; 17: 205-18. (In Persian).
- Kalb R, Reitman N. Overview of Multiple Sclerosis. A model of psychosocial support. 5th ed. National Multiple Sclerosis Society. 2012
- Findling O, Sellner J, Meier N, Allum J, Vibert D, Lienert C, et al. Trank sway in mildly disabled Multiple Sclerosis patients with and without balance impairment. Exp Brain Res. 2011; 213: 363-70.
- Rahmani P, Mohammadi F, Abbasi H. The effect of ten-week combined training in stable and unstable surfaces on muscle strength and functional capacity in patients with Multiple Sclerosis. Sport Medicine Studies. 2016; 7(19): 95-116. (In Persian).
- Arocca N G. Impact of walking impairment in Multiple Aclerosis: Perspectives of patients and care partners. Patient-Centered Outcomes Research. 2011; 4: 189–201.
- Chiaravalloti N D, DeLuca J. Cognitive impairment in Multiple Sclerosis. The Lancet Neurology. 2008; 7: 1139–51.
- Fasoli S E, Trombly C A, tickle L, Verfaellie M H. Effect of instruction of functional reach in person with and without cererovascoular accident. AM J Occup. 2002; 56(4): 380-90.
- Konradsen L. Sensori motor control of the uninjured and injured human ankle. J Electromyogr Kinesiol. 2002; 12: 199-203.
- Woollacott M, Shumway-Cook A. Attention and the control of posture and gait: A review of an emerging area of research. Gait & Posture. 2002; 16: 1-14.
- Al-Yahya, E, Dawes E, Smith L, Dennis A, Howells K, Cockburn J. Cognitive motor interference while walking: A systematic review and meta-analysis. Neuroscience Biobehavioral Reviews. 2011; 35: 715-28.
- Foley J A, Cantagallo A, Della Sala S, Logie R H. Dual task performance and post traumatic brain injury. Brain Injury. 2010; 24: 851-8.
- Hamilton F, Rochester L, Paul L, Rafferty D, Leary C P, Evans J J. Walking and talking: An investigation of cognitivemotor dual tasking in Multiple Sclerosis. Multiple Sclerosis. 2009; 15: 1215–27.
- Pirayeh N, Talebian S, Hadian M R, Olyaei G R, Jalaei S. Assessment of effect of cognitive task on postural control in female patients with knee osteoarthritis. Modern rehabilitation. 2012; 7(2): 35-41. (In Persian).
- Hasher L, Zacks S. Automatic and effortful processes in memory. Journal of Experimental Psychology. 1979; 108: 356-88.
- Kalron A, Dvir Z, Achiron A. Effect of a cognitive task on postural control in patients with a clinically isolated syndrome suggestive of multiple sclerosis. Eur J Phys Rehabil Med. 2011; 47: 579-86.
- Negahban H, Mofateh R, Arastoo A A, Mazaheri M, Yazdi M J, Salavati M, et al. The effects of cognitive loading on balance control in patients with Multiple Sclerosis. Gait & Posture. 2011; 34: 479-84. (In Persian).
- Jacobs J V, Kasser S L. Effects of dual task on postural performance of people with and without Multiple Sclerosis. Journal of Neurology. 2012; 259: 1166-76.
- Soyuer F, Mirza M, Erkorkmaz U. Balance performance in three forms of Multiple Sclerosis. Neurol Res. 2006; 28: 555-62.
- Sosnoff J J, Shin S, Motl R W. Multiple Sclerosis and postural control: The role of spasticity. Arch Phys Med Rehabil. 2010; 91: 93-9.
- Attar Sayyah E, Hoseini Kakhk A R, Hamedinia M R, Abbasi Farmanabadi I. The effect of eight-week combined training (resistance and PNF) on muscular performance and functional and degree of disability in Multiple Sclerosis patients. Sport Physiology. 2016; 8(29): 103-18. (In Persian).
- Jalali Sh, Minoodukht M, Tabatabaighomsheh F, Jafarpisheh A. Effect of predictable anxiety on body sway in athlettes and non athletes. Motor Behavior and Sport Psychology Journal. 2010; 5: 365-73. (In Persian).
- Cattaneo D, Jonsdottir J, Zocchi M, Regola A. Effects of balance exercises on people with Multiple Sclerosis: A pilot study. Clin Rehabil. 2007; 21: 771-81.
- Horak F B, Diener H C. Cerebellar control of postural scaling and central set in stance. J Neurophysiol. 1994; 72: 479–93.
- Nashner L M. Practical biomechanics and physiology of balance. In G. Jacobson, C. Newman & J. Kartush (Eds.), Handbook of balance function and testing. Mosby Year Book; St Louis, MO; 1993. P. 261–79.
- Bendict R H, Fisher J S, Archibald C J, Amett P A, Beatty W W, Bobholz J, et al. Minimal neuropsychological assessment of MS patient: A consensus approach. Clin Neuropsychol. 2002; 16(3): 381-97.
- Porosinska A, Pierzchala K, Mentel M, Karpe J. Evaluation of postural balance control in patients with multiple sclerosis effect of different sensory conditions and arithmetic task execution: A pilot study. Neurochirurgia Polska. 2010; 44: 35–42.
- Plummer P, Eskes G, Wallace S. Cognitive-motor interference during functional mobility after stroke. Archives of Physical Medicine and Rehabilitation. 2013; 94: 2565-74.
- Wajda D, Sandroff B, Pula J, Motl R, Sosnoff J. Effects of walking direction and cognitive challenges on gait in persons with Multiple Sclerosis. Mult Scler Int. 2013; 2013(859323): 1-6.
- Enferadi Doug Abadi A, Taheri Torbati H R, Saberi Kakhki A R, Nikkhah K. The effect of a period balance training and cognitive combination on postural sway women with Multiple Sclerosis. Motor Behavior. 2016; 8(23): 143-56. (In Persian).
- Learmonth Y, Pilutti L, Motl R. Generalized cognitive motor interference in Multiple Sclerosis. Gait Posture. 2015; 42: 96-100.
- Yogev-Seligmann G, Giladi N, Brozgol M, Hausdorff J M. A training program to improve gait while dual- tasking in patients with Parkinson’s disease: A pilot study. Arch Phys Med Rehabil. 2012; 93: 176-81.
- Silsupadol P, Shumway-Cook A, Lugade V, vonDonkelaar P, Chou L S, Mayr U, et al. Effects of single-task versus dual-task training on balance performance in older adults: A double-blind, randomized controlled trial. Arch Phys Med Rehabil. 2009; 90: 381-7.
)