رفتار حرکتی

کاربرد چارچوب نقطۀ چالش در بهبود توانایی حرکتی بیماران مبتلا به مولتیپل اسکلروزیس

نوع مقاله : مقاله پژوهشی

نویسندگان

1 دانشجوی دکتری رفتار حرکتی، دانشگاه تهران

2 دانشیار ‌رفتار حرکتی، دانشگاه تهران

3 استادیار‌ مغز و اعصاب، دانشگاه علوم پزشکی جندی‌شاپور اهواز

چکیده
اگرچه تمرین به‌عنوان یکی از مهم‌ترین عوامل اثرگذار بر یادگیری در چارچوب نقطۀ چالش مطرح می‌باشد؛ اما عوامل دیگری نظیر موقعیت تمرینی، دشواری تکلیف و سطح مهارت آزمودنی می‌تواند بر یادگیری اثرگذار باشد؛ ازاین‌رو، هدف از پژوهش حاضر، بررسی اثربخشی چارچوب نقطۀ چالش در بهبود توانایی حرکتی بیماران مبتلا به مولتیپل اسکلروزیس (ام.‌‌‌اس) بود. در این پژوهش نیمه‌تجربی‏، 22 فرد مبتلا به مولتیپل اسکلروزیس (‌با میانگین سنی 5/4±‌32 سال) از میان بیماران انجمن مبتلایان به ام.‌‌اس شهر اهواز به‌صورت تصادفیانتخاب شدند و به دو گروه تجربی و کنترل تقسیم گردیدند. جهت انجام پژوهش، ابتدا، پیش‌آزمون 10 متر راه‌رفتن ‌‌به‌عمل آمد. سپس، آزمودنی‌هایگروهتجربیبه‌مدت12جلسه (هفته‌ایسهجلسۀ45دقیقه‌ای)بهانجامتمرینات پرداختند؛ اماگروهکنترلتحت مداخله قرار نگرفت‌. شایان‌ذکر است کهداده‌ها با استفاده از روش تحلیل واریانس مرکب وتحلیلواریانسبا اندازه‌گیری تکراری با سطح معنا‌داری (05/0) تحلیل گردیدند. یافته‌ها نشان می‌دهند که توانایی حرکتی گروه تجربی در اثر مداخلۀ مبتنی بر چارچوب نقطۀ چالش بهبود یافته است و آن‌ها نسبت به گروه کنترل از توانایی حرکتی بالاتری برخوردار بوده‌اند (0.001≥P)؛ بنابراین،می‌توان گفت که انجام چهار هفته تمرینات واکنش گام‌برداری با استفاده از چارچوب نقطۀ چالش باعث بهبود معنادار سرعت راه‌رفتن در بیماران مبتلا به مولتیپل اسکلروزیس می‌شود.

کلیدواژه‌ها

موضوعات

عنوان مقاله English

Application of challenge point framework to improve the mobility in patients with Multiple Sclerosis

نویسندگان English

  • Masoud Zahiri 1
  • Shahzad Tahmasebi Boroujeni 2
  • Nastran Majdi Nasab 3
1 Ph.D. Student of Motor Behavior, University of Tehran
2 Associate Professor of Motor behavior, University of Tehran
3 Assistant Professor, Jundishapur University of Ahvaz
چکیده English

In the challenge point framework, although practice has been known as one of the most important factors affecting learning, but other factors such as practice conditions, task difficulty and skill level of participants, could effect on the incidence of learning. The purpose of present study was to examine the effectiveness of challenge point framework to improve the mobility in patients with Multiple Sclerosis(MS).In this semi experimental study, 22 patients with multiple sclerosis (M= 32 ± 4.5 years) among MS Society of Ahvaz were selected randomly and were divided into two experimental and control groups. Outset, 10-Meters Walking Test was performed as per-test. Then, experimental group’s subjects did the intervention for 12 sessions (three sessions of a week for 45 minutes) and control groups were not exercised. Data was analyses by multiple variance analysis and repeated measures variance and in p≤0.05 significant levels. Results revealed that the experimental group mobility was improved as a result of intervention based on thechallenge point framework and mobility was higher in comparison to control group (p≤0.001).Significantly improved in as a result of four week protocol (p≥0.05). Therefore the results indicate that four weeks of training stepping reaction using challenge point framework had significant improvement on walking speed in patients with multiple sclerosis.
Key words: challenge point framework, mobility, speed walking, multiple sclerosis

کلیدواژه‌ها English

  • challenge point framework
  • mobility
  • speed walking
  • Multiple Sclerosis
  1. Zahir M. Effectiveness of the challenge point framework on some of the movement disorders in multiple sclerosis patients (Master dissertation). University of Tehran; 2015. (In Persian).
  2. Akizuki K, Ohashi Y. Changes in practice schedule and functional task difficulty: A study using the probe reaction time technique. Journal of Physical Therapy Science. 2013; 25(7): 827.
  3. Guadagnoli, M. A., & Bertram, C. P. (2014). Optimizing practice for performance under pressure. International Journal of Golf Science, 3(2), 119-127.
  4. Onla-or, S., & Winstein, C. J. (2008). Determining the optimal challenge point for motor skill learning in adults with moderately severe Parkinson's disease. Neurorehabilitation and neural repair, 22(4), 385-395.
  5. Guadagnoli M, Aylsworth B. Efficiency in transfer from the anchored to standard golf putter. International Journal of Sports Science and Coaching. 2013; 8(4): 755-68.
  6. Guadagnoli M A, Lee T D. Challenge point: A framework for conceptualizing the effects of various practice conditions in motor learning. Journal of Motor Behavior. 2004; 36(2): 212-24.
  7. Ghasemi M, Gorji Y, Ashtar F, Ghasemi M. A study of psychological well-being in people with multiple sclerosis and their primary caregivers. Advanced Biomedical Research. 2015; 4. (In Persian).
  8. Lapierre Y, O’Connor P, Devonshire V, Freedman M S, Kremenchutzky M, Yeung M, et al. Canadian experience with fingolimod: Adherence to treatment and monitoring. Canadian Journal of Neurological Sciences/ Journal Canadien des Sciences Neurologiques. 2016; 43(02): 278-83.
  9. Martino, D., Espay, A. J., Fasano, A., & Morgante, F. (2016). Abnormalities of Muscle Tone. In Disorders of Movement (pp. 49-95). Springer Berlin Heidelberg.
  10. Blair T C, Manoharan M, Rawlings-Rhea S D, Tagge I, Kohama S G, Hollister-Smith J, et al. Immunopathology of Japanese macaque encephalomyelitis is similar to multiple sclerosis. Journal of Neuroimmunology. 2016; 291: 1-10.
  11. Sebastião, E., Sandroff, B. M., Learmonth, Y. C., & Motl, R. W. (2016). Validity of the timed up and go test as a measure of functional mobility in persons with multiple sclerosis. Archives of physical medicine and rehabilitation, 97(7), 1072-1077.
  12. Pollock C L, Boyd L A, Hunt M A, Garland S J. Use of the challenge point framework to guide motor learning of stepping reactions for improved balance control in people with stroke: A case series. Physical Therapy. 2014; 94(4): 562-70.
  13. Karlsson A, Persson T. The ankle strategy for postural control—a comparison between a model-based and a marker-based method. Computer Methods and Programs in Biomedicine. 1997; 52(3): 165-73.
  14. Vaseghnia, Asharf, Ebrahimi Takamjani I, Sarrafzadeh J. The effect of heel height on standing balance indices. RJMS. 2008; 15(58):187-98. (In Persian).
  15. Mount J, Dacko S. Effects of dorsiflexor endurance exercises on foot drop secondary to multiple sclerosis: A pilot study. Neuro Rehabilitation. 2006; 21(1): 43-50.
  16. Rampello A, Franceschini M, Piepoli M, Antenucci R, Lenti G, Olivieri D, et al. Effect of aerobic training on walking capacity and maximal exercise tolerance in patients with multiple sclerosis: A randomized crossover controlled study. Physical Therapy. 2007; 87(5): 545-55.
  17. Motl R W, Smith D C, Elliott J, Weikert M, Dlugonski D, Sosnoff J J. Combined training improves walking mobility in persons with significant disability from multiple sclerosis: A pilot study. Journal of Neurologic Physical Therapy. 2012; 36(1): 32-7.
  18. Ezabad A, Alijani festival, Shabestari M. The effect of 8 weeks aquatic aerobic training on speed of walking and expanded disability dtatues dcale (EDSS) in women with multiple sclerosis. Journal of Sport Biosciences. 2015; 7(3): 489-502. (In Persian).
  19. Shams A, Taheri H R, Compassionate K. The effect of 8 weeks selective training programs with instructions focus of attention on walking speed of patients with multiple sclerosis (MS). Medical Journal of Mashhad University of Medical Sciences. 2015; 57(9): 969-75. (In Persian).
  20. Sabzi K. The effects of two training programs of core stability and neurofeedback on balance, fatigue, depression and quality of life in patients with multiple sclerosis (Master dissertation). University of Tehran; 2014. (In Persian)
  21. Romberg A, Virtanen A, Ruutiainen J, Aunola S, Karppi S L, Vaara M, et al. Effects of a 6-month exercise program on patients with multiple sclerosis A randomized study. Neurology. 2004; 63(11): 2034-8.
  22. Newman M, Dawes H, Van den Berg M, Wade D, Burridge J, Izadi H. Can aerobic treadmill training reduce the effort of walking and fatigue in people with multiple sclerosis: A pilot study. Multiple Sclerosis. 2007; 13(1): 113-9.
  23. Kileff J, Ashburn A. A pilot study of the effect of aerobic exercise on people with moderate disability multiple sclerosis. Clinical Rehabilitation. 2005; 19(2): 165-9.
  24. Balouchy R, Ghiasi A, Naderi E, Sodoghi H. The survey of Cawthorne and Cooksey exercise on the quality of life, balance and fatigue in patients with multiple sclerosis. Journal of Ilam University of Medical Sciences. 2014; 21(7): 43-53. (In Persian).
  25. Sari aslani S, Azan M R, Eftekhar bina. Evaluate the effects of balance exercises on improving the stability of nonlinear analysis of samples of multiple sclerosis patients using entropy. Research in Rehabilitation Sciences. 2014; 10(3): 444-58. (In Persian).
  26. Dodd K, Taylor N, Shields N, Prasad D, McDonald E, Gillon A. Progressive resistance training did not improve walking but can improve muscle performance, quality of life and fatigue in adults with multiple sclerosis: A randomized controlled trial. Multiple Sclerosis Journal. 2011; 17(11): 1362-74.
  27. Wu, W. F., Young, D. E., Schandler, S. L., Meir, G., Judy, R. L., Perez, J., & Cohen, M. J. (2011). Contextual interference and augmented feedback: is there an additive effect for motor learning?. Human movement science, 30(6), 1092-1101.

  • تاریخ دریافت 30 اردیبهشت 1395
  • تاریخ بازنگری 11 شهریور 1395
  • تاریخ پذیرش 07 مهر 1395

صفحه اصلی

داوران

ارسال مقاله

اصول اخلاقی

اخبار و اعلانات

اطلاعات آماری نشریه

تماس با ما