تاثیر اکتیو وستیبولار تراپی بر اختلالات حرکتی کودکان با اختلال نقص توجه-بیش فعالی

نوع مقاله : مقاله پژوهشی

نویسندگان

1 دانشجوی کارشناسی ارشد کاردرمانی، گروه آموزشی کاردرمانی، دانشگاه علوم بهزیستی و توانبخشی، تهران، ایران

2 دکترای علوم اعصاب، دانشیار، گروه آموزشی کاردرمانی، دانشگاه علوم بهزیستی و توانبخشی، تهران، ایران

3 دکترای علوم اعصاب، استادیار، گروه آموزشی کاردرمانی، دانشگاه علوم بهزیستی و توانبخشی، تهران، ایران

4 دکترای کاردرمانی، دانشیار، گروه آموزشی کاردرمانی، دانشگاه علوم بهزیستی و توانبخشی، تهران، ایران

5 دکترای آمار حیاتی، گروه آمار دانشگاه علوم بهزیستی و توانبخشی، تهران، ایران

6 دانشجوی دکتری شنوایی شناسی، گروه آموزشی شنوایی شناسی، دانشگاه علوم بهزیستی و توانبخشی، تهران ایران

7 دپارتمان روانشناسی، دانشکده روانشناسی و علوم تربیتی دانشگاه تهران، ایران

8 دکترای بهداشت سلامت، استادیار دپارتمان روانشناسی دانشکده روانشناسی و علوم تربیتی دانشگاه شهید بهشتی، تهران، ایران

9 روانشناس، دپارتمان روانشناسی دانشکده روانشناسی و علوم تربیتی دانشگاه تهران، تهران، ایران

چکیده

مقدمه و اهداف
با توجه به اختلالات تعادلی مشهود در کودکان با اختلال نقص توجه-بیش فعالی، در تحقیق حاضر تاثیر اکتیو وستیبولار تراپی بر اختلالات حرکتی این کودکان بررسی شد.
مواد و روش­ها
در مطالعه تجربی حاضر 38 کودک 7 تا 12 سال با اختلال ADHD نوع ترکیبی با تشخیص روان­پزشک بر اساس ملاک­های DSM-IV-TR، که از لحاظ بهره هوشی (آزمون هوش وکسلر) در سطح نرمال قرار داشتند (90< IQ)، به­طور تصادفی به دو گروه کنترل و آزمون تقسیم و قبل و بعد از مداخله با ابزار اندازه­گیری مجموعه­ی آزمون برونینکس اوزرتسکی با هم مقایسه شدند. برنامه درمانی منتخب شامل تمرینات توانبخشی وستیبولار طبق پروتکل تعیین شده به مدت 2ماه هفته­ای 3جلسه، هر جلسه 30 دقیقه برای گروه آزمون و آموزش­های کلاسیک تحصیلی برای گروه کنترل بود.
یافته­ها
برنامه وستیبولوتراپی در گروه آزمون تغییرات معناداری در بعضی متغیرهای پژوهش در مقایسه با گروه کنترل ایجاد کرد. تغییرات در گروه آزمون شامل: مهارت­های حرکتی درشت (006/0=P) و تعادل (001/0P<)، کنترل بینایی-حرکتی (007/0=P) به­علاوه نمره کلی آزمون برونینکس اوزرتسکی در گروه مداخله بود (006/0=P).
نتیجه­گیری
با توجه به نتایج مطالعه حاضر می­توان ادعا کرد برنامه درمانی وستیبولار می­تواند موجب تقویت تعادل، مهارت­های حرکتی درشت و کنترل بینایی-حرکتی در کودکان با اختلال نقص توجه-بیش فعالی شود.

کلیدواژه‌ها

موضوعات


عنوان مقاله [English]

Effects of Active Vestibulotherapy on Motor Disorders in Children with Attention Deficit Hyperactivity Disorder

نویسندگان [English]

  • Sedigheh Farokhi Moghadam 1
  • Hojjat Allah Haghgoo 2
  • Ebrahim Pishyareh 3
  • Seyed Ali Hosseini 4
  • Enayatollah Bakhshi 5
  • Nima Rezazadeh 6
  • Reza Rostami 7
  • Vahid Sadeghi 8
  • Yousef Khodabandehlou 9
1 MSc, Occupational Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
2 PhD in Medical Neuroscience, Associated Professor, Occupational Therapy Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
3 PhD in Cognitive Neuroscience, Assistant Professor, Occupational Therapy Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
4 PhD in Occupational Therapy, Associated Professor, Occupational Therapy Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
5 PhD in Biostatistics, Associated Professor, Statistics Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
6 Audiologist, PhD, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
7 Chief Executive of Atieh Clinical Neuroscience Center, Tehran, Iran, Department of Psychology, Faculty of Psychology and Educational Sciences, University of Tehran, Tehran, Iran
8 PhD in Health Psychology, Assistant Professor, Department of Psychology, Faculty of Education & Psychology, Shahid Beheshti University Tehran, Iran
9 Psychologist, Department of Psychology, Faculty of Psychology and Educational Sciences, University of Tehran, Tehran, Iran
چکیده [English]

Backgroundand Aim: Children with Attention Deficit Hyperactivity Disorder (ADHD) display obvious balance and motor disorders. Since the vestibular system has a vital role in balance and motor function, the present study was conducted to study the effects of active vestibular stimulation on motor disorders in children with ADHD.
Materials and Methods: A total of 38 children with normal intelligence quotient (above 90), using the Wechsler Intelligence Scale for Children, were diagnosed with ADHD by a psychiatrist based on Diagnostic and Statistical Manual of Mental Disorders )DSM(-IV.TR criteria were included in the study. They were 7-12 years old and were selected from Atieh Rehabilitation Center. Participants were randomly assigned into experimental and control groups, and were evaluated before and after the intervention using the Bruininks-Oseretsky Test of Motor Proficiency (BOTMP). Children in the experimental group received vestibular stimulation intervention three times per week; each session lasted for 30 minutes and was based on a defined protocol. The control group participated only in academic education programs. The collected data were analyzed and compared between the two groups.
Results: Vestibular stimulation resulted in significant changes in gross motor dexterity (P < 0.006), balance (P < 0.001), visual motor control (P=0.007), and total BOTMP test score (P<0.006) in the experimental group when compared to those of the control group.
Conclusion: Vestibular stimulation was effective in improving balance, gross motor function, and visual-motor control in children with ADHD.

کلیدواژه‌ها [English]

  • Vestibular
  • Attention Deficit Hyperactivity disorder
  • Motor Disorder
  1. F. G. Psychiatry for medicine students and physicians. 2000:246-. Tehran: Moasese-e-Farhangi Entesharatie Farhangsazan;##
  2. RA. B. ADHD and the nature of self. 1997. New York: The Guilford Press;.##
  3. Cohen ME. Occupation and visual/vestibular interaction in vestibular rehabilitation. Otolaryngology-Head and Neck Surgery, . 1995;112(4):526-32.##
  4. Pitcher TM PJ, Hay DA. Fine and grossmotor ability in maleswith ADHD. Dev Med Child Neurol. 2003;45:525-35.##
  5. Tseng MH HA, Chow SM,, G. Y. Relationship betweenmotor proficiency, attention, impulse, andactivity in children with ADHD. Dev Med Child Neurol. 2004;46:381-8.##
  6. Kadesjo B, Gillberg C. The comorbidity of ADHD in the general population of Swedish school-age children. J Child Psychol Psychiatry. 2001;42(4):487-92. Epub 2001/06/01.##
  7. Miyahara M PJ, Barrett N. Accuracy ofdrawing in a dual-taskand resistance- to-distraction study: motor orattention deficit? HumMov Sci. 2006;25:100-9.##
  8. Shum S, Pang MY. Children with attention deficit hyperactivity disorder have impaired balance function: involvement of somatosensory, visual, and vestibular systems. The Journal of pediatrics. 2009;155(2):245-9.##
  9. Buderath P, Gärtner K, Frings M, Christiansen H, Schoch B, Konczak J, et al. Postural and gait performance in children with attention deficit-hyperactivity disorder. Gait & posture. 2009;29(2):249-54.##

10. Fliers E, Rommelse N, Vermeulen SH, Altink M, Buschgens CJ, Faraone SV, et al. Motor coordination problems in children and adolescents with ADHD rated by parents and teachers: effects of age and gender. J Neural Transm. 2008;115(2):211-20. Epub 2007/11/13.##

11. Beginnings G. the vestibular system: treting attention deficit disorder. California: www.gr8beginnings.com/articles-vestibular-system.php cited 2010##

12. christine S. case study of the effects of vestibular stimulation on reading skill in children with learning disability and occompanying vestibular dysfunction, in occupational therapy. 1994. san jose state university.##

13. Talkowski M, et al. Cognitive requirements for vestibular and ocular motor processing in healthy adults and patients with unilateral vestibular lesions. Journal of cognitive neuroscience. 2005;17(9):1432-41.##

14. Clark DL, et al.,. Vestibular Stimulation for ADHD. Journal of Attention Disorders. 2008;11(5):599.##

15. Ebrahimi M, Mahvashe Wernosfaderani A, Haghgoo HA, Pourmohamad Rezaye Tajrishi M, F. D. The effectiveness of sensory-motor integration with an emphasis on proprioceptive and vestibular senses on the symptoms of Attention Deficit- Hyperactivity Disorder (ADHD). J Res Rehabil Sci 2013; 9(2): 220-31.##

16. Keim RJ, M. Cook, and D. Martini,. Balance rehabilitation therapy. 1992;102(11):1302-7.##

17. Herdman S, Whitney S. Interventions for the patient with vestibular hypofunction. Herdman SJ Vestibular Rehabilitation 3rd ed Philadelphia: FA Davis Co. 2007:309-37.##

18. Han BI, Song HS, Kim JS. Vestibular Rehabilitation Therapy: Review of Indications, Mechanisms, and Key Exercises. J Clin Neurol. 2011;7(4):184-96.29.      Gill-Body KM, Krebs DE, Parker SW, Riley PO. Physical therapy management of peripheral vestibular dysfunction: two clinical case reports. Physical Therapy. 1994;74(2):129-42.##

19. kalan RM, Saccuzzo, Dennis P. princioles, Applications and issues(seventh ed). psychological testing. 2009:262.##

20. Nazari SS, H. & Afroz,GH. Comparing the visual – motor perception of normal children and children with learning disabilities using Bender Geshtalt Test. Journal of Learning Disabilities. Spring 2013;2(3):136-42. [In Persian].##

21. Dalsgaard SN, HS. Simonsen, M. Five-Fold Increase in National Prevalence Rates of Attention-Deficit-Hyperactivi Disorder Medications for Children and Adolescents with Autism Spectrum Disorder, Attention-Deficit-Hyperactivity Disorder,and other Psychiatric Disorders: A Danish Register-Based Study. Journal Child Adolesc Psychopharmacol 2013;23:432-9.##

22. Miller LJ, Nielsen DM, Schoen SA, Brett-Green BA. Perspectives on sensory processing disorder: a call for translational research. Frontiers in integrative neuroscience. 2009;3:22.##

23. Kelley K. Vestibular stimulation: effects on the expressive language of a five year old autistic boy,. 1985. University of Vermont.##

24. hristine S. case study of the effects of vestibular stimulation on reading skill in children with learning disability and occompanying vestibular dysfunction, in occupational therapy1994.##

25. Kelley, K., Vestibular stimulation: effects on the expressive language of a five year         old autistic boy,. 1985.##

26. christine, S., case study of the effects of vestibular stimulation on reading skill in children with learning disability and occompanying vestibular dysfunction, in occupational therapy1994.##

27. Niedermeyer, E. and S.B. Naidu, Attention-deficit hyperactivity disorder (ADHD) and frontal-motor cortex disconnection. Clin Electroencephalogr, 1997. 28(3): p. 130-6.##

28. Bledsoe, J., M. Semrud-Clikeman, and S.R. Pliszka, A magnetic resonance imaging study of the cerebellar vermis in chronically treated and treatment-naive children with attention-deficit-hyperactivity disorder combined type. Biol Psychiatry, 2009. 65(7): p. 620-4.##

29. Zang YF, et al., Altered baseline brain activity in children with ADHD revealed by resting-state functional MRI. Brain Dev., 2007. Mar;29 (2): p. 83-91.##

30. Neal MV. Vestibular Stimulation and Development of the Small Premature Infant. 1975.##

31. Schiff ND, Pulver M. Does vestibular stimulation activate thalamocortical mechanisms that reintegrate impaired cortical regions? Proceedings of the Royal Society of London Series B: Biological Sciences. 1999;266(1417):421-3.##

32. Niklasson M, Niklasson, l & Norlander, T. sensorimotor therpy: using stereotypic movementa and vestibular stimulation to increase sensorimotor proficiency of children with attentional and motor difficulties The American journal of physical therapy. 2009;108(3):643-69.##