اثرات راه رفتن با توجه درونی و بیرونی بر تعادل و الگوی توزیع فشار کف پایی در بیماران کمردرد

نوع مقاله: مقاله پژوهشی

نویسندگان

1 استادیار رفتارحرکتی، گروه تربیت بدنی و علوم ورزشی، دانشکده روانشناسی و علوم تربیتی، دانشگاه محقق اردبیلی، اردبیل، ایران

2 استادیار بیومکانیک ورزشی، گروه تربیت بدنی و علوم ورزشی، دانشکده علوم تربیتی و روانشناسی، دانشگاه محقق اردبیلی، اردبیل، ایران

3 استادیار مدیریت ورزشی، گروه تربیت بدنی و علوم ورزشی، دانشکده علوم تربیتی و روانشناسی، دانشگاه محقق اردبیلی، اردبیل، ایران

4 کارشناس ارشد بیومکانیک ورزشی، گروه تربیت بدنی و علوم ورزشی، دانشکده علوم تربیتی و روانشناسی، دانشگاه محقق اردبیلی، اردبیل، ایران

چکیده

مقدمه و اهداف
متغیرهای فشار کف پایی و اندازه­گیری و مقایسه آن­ها را می­توان ابزار مناسبی جهت ارزیابی و سنجش کارایی حرکت به ویژه در افراد دارای کمردرد دانست. هدف از پژوهش حاضر بررسی اثرات راه رفتن با توجه درونی و بیرونی بر تعادل و الگوی توزیع فشار کف پایی در بیماران دارای کمردرد بود.
مواد و روش ها
نمونه پژوهش حاضر از نوع کارآزمایی بالینی شامل 15 زن (سن: 15/1±86/22 سال، قد:54/1±53/162 سانتی­متر، وزن: 42/2±06/61 کیلوگرم) دارای عارضه کمردرد بود. مقادیر فشار کف پایی طی سه شرایط راه رفتن عادی، با توجه درونی و بیرونی توسط دستگاه فوت اسکن با نرخ نمونه­برداری 300 هرتز ثبت شد. تمام تحلیل­ها با استفاده از نرم­افزار اس.پی.اس.اس نسخه 22 انجام پذیرفت. از آزمون آماری آنالیز واریانس با اندازه­های تکراری جهت تحلیل آماری داده­ها استفاده شد.
یافته­ ها
نتایج نشان داد که مقادیر زمان رسیدن به اوج نیروی عکس­العمل زمین طی فازهای تماس پاشنه، میانه استقرار و هل دادن در شرایط راه رفتن با توجه درونی نسبت به راه رفتن عادی و در شرایط راه رفتن با توجه درونی نسبت به راه رفتن با توجه بیرونی افزایش معناداری داشت. مقادیر اوج نیرو و فشار وارده بر ناحیه کف پایی دوم در شرایط راه رفتن عادی نسبت به راه رفتن با توجه درونی و در شرایط راه رفتن با توجه بیرونی نسبت به راه رفتن با توجه درونی افزایش معناداری یافت. مقادیر اوج نیروی وارده بر ناحیه خارجی پاشنه در شرایط راه رفتن عادی نسبت به راه رفتن با توجه درونی و در شرایط راه رفتن با توجه بیرونی نسبت به راه رفتن با توجه درونی افزایش یافت.
نتیجه­ گیری
شرایط راه رفتن با توجه بیرونی و درونی بر روی مدت زمان اتکا اثر معناداری را دارا نمی­باشد. همچنین، میزان نرخ بارگذاری نیروی عمودی عکس­العمل زمین در شرایط راه رفتن با توجه درونی نسبت به راه رفتن با توجه بیرونی کاهش یافت.

کلیدواژه‌ها

موضوعات


عنوان مقاله [English]

Effects of Walking with Internal and External Attention on the Balance and Plantar Pressure Pattern in Patients with Low Back Pain

نویسندگان [English]

  • Mahrokh Dehghani 1
  • Amiali Jaafarnejad 2
  • Nasrin Azizian 3
  • Seyed Majid Alavi Mehr 4
1 Assistant Professor of Motor Behavior, Department of Physical Education and Sport Sciences, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran
2 Assistant Professor of Sport Management, Department of Physical Education and Sport Sciences, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran
3 Assistant Professor of Sport Biomechanics, Department of Physical Education and Sport Sciences, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran
4 Master of Science of Sport Biomechanics, Department of Physical Education and Sport Sciences, Faculty of Education Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran
چکیده [English]

Background and Aims: Plantar pressure variables and their measurement and comparison can be considered as a useful tool for assessing the effectiveness of motion, especially in patients with low back pain. The aim of the present study was to investigate the effects of walking with internal and external attention on the balance and foot pressure patterns in patients with low back pain.
Materials and Methods: The sample of the present trial study included 15 women (Age: 22.86±1.15 years, Height: 162.53±1.54 cm, Weight: 61.06±2.42 kg) with low back pain. Plantar pressure values were recorded during normal walking, internal, and external attention walking using a foot scan system with 300 Hz sample rate. All analyses were performed using SPSS, version 22. A repeated measures ANOVA was used for statistical analysis.
Results: The results showed an increase in the time to peak of ground reaction force values during heel-contact, mid-stance, and push-off phases in the internal attention walking compared to normal walking conditions and increased walking with internal attention compared to walking with external attention conditions. The ground reaction force and the plantar pressure peak values on the Metatarsal 2 region increased in normal walking compared to walking with internal attention conditions and increased in walking with external attention as compared to walking with internal attention conditions. The ground reaction force peak values on the lateral heel region increased in normal walking compared to internal attention walking conditions and increased in external attention walking compared to internal attention walking conditions.
Conclusion:Internal and external attention walking conditions do not have significant effects on stance time. Also, the loading rate of ground reaction force values decreased in internal attention walking as compared to external attention walking conditions.

کلیدواژه‌ها [English]

  • Internal and external attention
  • gait
  • Low back pain
  • Plantar pressure variables
  1. Jafarnezhadgero A, Majlesi M, Madadi-Shad M. The effects of low arched feet on lower limb joints moment asymmetry during gait in children: A cross sectional study. The Foot. 2018;1:34:63-8##
  2. Burnfield M. Gait analysis: normal and pathological function. Journal of Sports Science and Medicine 2010;9(2):353.##
  3. Mohammadi V, Letafatkar A, Sadeghi H, Jafarnezhadgero A, Hilfiker R. The effect of motor control training on kinetics variables of patientss with non-specific low back pain and movement control impairment: Prospective observational study. Journal of bodywork and movement therapies. 2017; 21(4):1009-16. ##
  4. Meints SM, Mawla I, Napadow V, Kong J, Gerber J, Chan ST, Wasan AD, Kaptchuk TJ, McDonnell C, Carriere J, Rosen B. The relationship between catastrophizing and altered pain sensitivity in patients with chronic low-back pain. Pain. 2019;160(4):833-43. ##
  5. Jafarnezhadgero AA, Shahverdi M, Madadi Shad M. The effectiveness of a novel Kinesio Taping technique on the ground reaction force components during bilateral drop landing in athletes with concurrent pronated foot and patella-femoral pain syndrome. Journal of Advanced Sport Technology. 2017;1(1):22-9. ##
  6. Farahpour N, Jafarnezhad A, Damavandi M, Bakhtiari A, Allard P. Gait ground reaction force characteristics of low back pain patients with pronated foot and able-bodied individuals with and without foot pronation. Journal of biomechanics. 2016; 49(9):1705-10. ##
  7. Jafarnezhadgero A, Madadi-Shad M, Alavi-Mehr SM, Granacher U. The long-term use of foot orthoses affects walking kinematics and kinetics of children with flexible flat feet: A randomized controlled trial. PloS one. 2018 Oct 9;13(10):e0205187. ##
  8. Hamill J, Knutzen KM. Biomechanical basis of human movement: Lippincott Williams & Wilkins; 2006. ##
  9. Lee JH, Fell DW, Kim K. Plantar pressure distribution during walking: comparison of subjects with and without chronic low back pain. Journal of Physical Therapy Science. 2011;23(6):923-6. ##
10. Fayez ES. Foot Pressure Asymmetry in Patients with Mechanical Low Back Pain. Med J Cairo Univ. 2012 Dec 7;80(2). ##

11. Wulf G, Lewthwaite R. Effortless motor learning? An external focus of attention enhances movement effectiveness and efficiency. Effortless attention: A new perspective in attention and action. 2010:75-101. ##

12. Wulf G. Attentional focus and motor learning: A review of 10 years of research (Target article). E-Journal Bewegung und Training [E-Journal Movement and Training), 1, 4Á14. 2007. ##

13. Wulf G, Lewthwaite R. Optimizing performance through intrinsic motivation and attention for learning: The OPTIMAL theory of motor learning. Psychonomic bulletin & review. 2016;23(5):1382-414. ##

14. Wulf G. Attention and motor skill learning: Human Kinetics; 2007.  ##

15. Sacko RS, Nesbitt D, McIver K, Brian A, Bardid F, Stodden DF. Children’s metabolic expenditure during object projection skill performance: New insight for activity intensity relativity. Journal of sports sciences. 2019; 23:1-7. ##

16. Mousavi SJ, Parnianpour M, Mehdian H, Montazeri A, Mobini B. The Oswestry disability index, the Roland-Morris disability questionnaire, and the Quebec back pain disability scale: translation and validation studies of the Iranian versions. Spine. 2006;31(14):E454-E9. ##

17. Alavi-Mehr SM, Jafarnezhadgero A, Salari-Esker F, Zago M. Acute effect of foot orthoses on frequency domain of ground reaction forces in male children with flexible flatfeet during walking. The Foot. 2018; 1;37:77-84. ##

18. Jafarnezhadgero AA, Oliveira AS, Mousavi SH, Madadi-Shad M. Combining valgus knee brace and lateral foot wedges reduces external forces and moments in osteoarthritis patients. Gait & posture. 2018;59:104-10. ##

19. Jafarnezhadgero AA, Shad MM, Majlesi M, Granacher U. A comparison of running kinetics in children with and without genu varus: A cross sectional study. PloS one. 2017 Sep 19;12(9):e0185057. ##

20. Yoon J. The relation study of weight distribution and strength of Lower extremity with and without Low back pain in middle-aged woman. Exercise science: official journal of the Korea Exercise Science Academy. 2008;17:309-16. ##

21. Mehr SM, Jafarnezhadgero AA, Majlesi M. Immediate and long-term effects of foot orthoses on asymmetry index of the ground reaction force frequency spectrum: A clinical trial study. Journal of Gorgan University of Medical Sciences. 2019 Spring; 21(1): 15-22.. ##

22. Alavi, mehr sm, AA Jafarnezhadgero, and M. Majlesi. The immediate effect of medical insole on loading rate, impulse, and free moment in male children with flat foot: a clinical trial. Journal of rafsanjan university of medical sciences and health services. (2018): 17(1): 27-38. ##

23. Seifi-Skishahr F, Alavi Mehr SM, Jafarnezhadgero A, Katanchi M. Effect of elastic gait training on Foot pressure variables in subjects with low back pain during running. Anesthesiology and Pain. 2018 Aug 15;8(4):47-59. ##

24. Taheri B, Barati A, Norasteh AA, Madadi-Shad M. EMG analysis of trunk and lower limb muscles in three different squat exercises in athletes and non-athletes. International journal of Sport Studies for Health. 2018(In Press). ##

25. Filipović V, Ciliga D. Postural adaptation of idiopathic adolescent scolioses (IAS). Kinesiology: International journal of fundamental and applied kinesiology. 2010;42(1):16-27. ##

26. Schizas C, Kramers-de Quervain I, Stüssi E, Grob D. Gait asymmetries in patients with idiopathic scoliosis using vertical forces measurement only. European Spine Journal. 1998;7(2):95-8. ##

27. Menz HB, Dufour AB, Riskowski JL, Hillstrom HJ, Hannan MT. Foot posture, foot function and low back pain: the Framingham Foot Study. Rheumatology. 2013;52(12):2275-82. ##

28. Zachry T, Wulf G, Mercer J, Bezodis N. Increased movement accuracy and reduced EMG activity as the result of adopting an external focus of attention. Brain research bulletin. 2005;67(4):304-9. ##

29. Wulf G, Dufek JS. Increased jump height with an external focus due to enhanced lower extremity joint kinetics. Journal of motor behavior. 2009;41(5):401-9. ##

30. Gill KP, Callaghan MJ. The measurement of lumbar proprioception in individuals with and without low back pain. Spine. 1998;23(3):371-7. ##

31. Willigenburg NW, Kingma I, van Dieën JH. Center of pressure trajectories, trunk kinematics and trunk muscle activation during unstable sitting in low back pain patients. Gait & posture. 2013;38(4):625-30. ##

32. Madadi Shad M, Farahpour N. A Kinematic Analysis of Upper Extremity Joint when Punching by Three Different Methods in Athletes of Different Skill Levels. Journal of Sport Biomechanics. 2017; 15;2(4):19-27. ##

33. Taylor S, Frost H, Taylor A, Barker K. Reliability and responsiveness of the shuttle walking test in patients with chronic low back pain. Physiotherapy Research International. 2001;6(3):170-8. ##

34. Marchant D, Greig M, Scott C. Attentional focusing strategies influence bicep EMG during isokinetic biceps curls. Athletic Insight. 2008;10(2):11. ##