بررسی تاثیر استفاده از بازی های رایانه ای بر مهارت های تعادلی و ترس ازافتادن بیماران سکته مغزی مزمن:single subject design

نوع مقاله: مقاله پژوهشی

نویسندگان

1 1. دانشجوی کارشناسی ارشد، گروه کاردرمانی، دانشکده توانبخشی دانشگاه علوم پزشکی ایران، تهران، ایران

2 2. دانشیار، مدیر گروه کاردرمانی، دانشکده توانبخشی دانشگاه علوم پزشکی ایران، تهران، ایران

3 3. مربی، گروه کاردرمانی، دانشکده توانبخشی دانشگاه علوم پزشکی ایران، تهران، ایران

4 4. استادیار، گروه کاردرمانی، دانشکده توانبخشی دانشگاه علوم پزشکی ایران، تهران، ایران

5 دانشیار، مدیر گروه فیزیوتراپی، دانشکده توانبخشی دانشگاه علوم پزشکی ایران، تهران، ایران

10.22037/jrm.2015.1100146

چکیده

مقدمه و اهداف
مشکلات تعادلی یکی از شایع­ترین اختلالات ناشی از سکته مغزی به شمارمی­روند. این­گونه اختلالات در بسیاری از مواقع سبب افتادن یا ترس از افتادن در بیماران      می­گردند. در این میان، بازی­های تعادلی رایانه­ای به سبب دارا بودن ویژگی­های منحصر به فرد خود، در توانبخشی بیماران با مشکلات حرکتی مورد استفاده قرار می­گیرند. در این مطالعه به بررسی تاثیر بازی­های رایانه­ای تعادلی  بر عملکرد تعادلی و ترس از افتادن بیماران سکته مغزی مزمن پرداخته شد.
 مواد و روش ها
این مطالعه تجربی به صورت single subject و از نوع A-B در چهار بیمار سکته مغزی مزمن و به صورت انداز­گیری­های مکرر  در دوفاز پایه و سپس دوازده جلسه مداخله  انجام گرفت.  در مطالعه مذکور، آزمون­های تعادلی Berg Balance Scale ، Timed Up and Go، 5 Meter Walking، Functional Reach و Step ، حداکثر میزان وزن­اندازی در جهات مختلف و میزان انحراف از خط وسط جهت بررسی مهارت­های تعادلی و پرسشنامه ترس از افتادن جهت بررسی میزان ترس از افتادن مورد استفاده قرار گرفتند.
 یافته ها
از آزمون­های آماری C Bayesian factor، و Visual Analysis جهت بررسی نتایج استفاده شد. یافته­های تحقیق  برای متغیرهای عملکرد تعادلی ، میزان      وزن­اندازی درجهات مختلف و ترس از افتادن معنادار بود. اما گراف­های میزان تغییرات انحراف از خط وسط الگوی مشخصی را نشان ندادند. 
 نتیجه گیری
بازی­های رایانه­ای می­توانند در بهبود اختلالات تعادلی ناشی از سکته مغزی و ترس از افتادن موثرواقع شوند. هرچند تاثیر اینگونه تمرینات بر ایجاد تقارن وضعیتی و نوسانات نقطه ثقل نیاز به مطالعات بیشتری دارد.

کلیدواژه‌ها


عنوان مقاله [English]

The effect of videogames on balance skills and fear of falling in chronic stroke patients: a single subject design

نویسندگان [English]

  • Neshat Rahimi Shamaei Monfared 1
  • Afsoon Hassani Mehraban 2
  • Ghorban Taghizade 3
  • Malahat Akbarfahimi 4
  • Mehdi dadgoo 5
1 1. M.Sc. student, Occupational therapy Department, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
2 Ph.D., Head of Occupational therapy Department, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
3 3. Ph.D. Student, Occupational therapy Department, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
4 4. Ph.D., Occupational therapy Department, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
5 PhD., Physiotherapy Department, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
چکیده [English]

Background and Aim: Balance disorder is one of the most common problems after stroke causes falling and fear of falling in some patients. The balance based video games are used in people with motor problems. The current study conducted to investigate the effectiveness of videogames on balance and fear of falling in patients with chronic stroke.
Materials and Methods: This experimental study organized in a single subject system, A-B design for four patients with chronic stroke. This method including repetitive measures conducted in two phases, baseline and then twelve intervention sessions. Berg Balance Scale, Timed up and go, Functional Reach, Step test, the maximum weight bearing in different directions and the deviation from center were conducted for balance assessing. Fear of falling questionnaire was used to assess the fear of falling. The results were considered using C-statistic, Bayesian factor, Mann Whitney U, and visual analysis
Results: The results were significant for balance skills, the maximum force produced by lower extremities at different directions and fear of falling parameters but the deviation from center did not show distinct pattern.
Conclusion: The results related to balance skills, the maximum force produced by lower extremities and also fear of falling confirmed the efficacy of videogames, however the deviation from center did not show any improvement.

کلیدواژه‌ها [English]

  • Chronic Stroke
  • Videogames
  • Fear of Falling
  • Balance Skill
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