تأثیر توانبخشی شناختی و بازی های حرکتی هدفمند بر حافظه کاری کودکان دارای اختلال هماهنگی رشدی

نوع مقاله: مقاله پژوهشی

نویسندگان

1 گروه رفتار حرکتی، واحد تهران مرکزی، دانشگاه آزاد اسلامی، تهران، ایران

2 استادیار رفتار حرکتی پژوهشگاه تربیت بدنی و علوم ورزشی، تهران، ایران

3 گروه رفتار حرکتی، دانشگاه تهران، تهران، ایران

4 گروه مدیریت ورزشی، واحد تهران مرکزی، دانشگاه آزاد اسلامی، تهران، ایران

چکیده

مقدمه و اهداف
کودکان مبتلا به اختلال هماهنگی رشدی در حافظه کاری به ویژه حافظه بینایی- فضایی دچار کمبود می­باشند. در پژوهش حاضر، اثربخشی مداخلات مبتنی بر توان­بخشی شناختی و بازی­های حرکتی هدفمند در بهبود عملکرد حافظه­ کاری دختران 7 تا 10 سال دارای اختلال هماهنگی رشدی مورد بررسی قرار گرفت.
مواد و روش­ ها
روش پژوهش از نوع تجربی با طرح پیش ­آزمون- پس ­آزمون با یک گروه کنترل بود. شصت دختر 10-7 سال (میانگین سنی 8/43 سال) از بین دانش­ آموزان مقطع ابتدایی شهر بروجن با استفاده از روش خوشه­ای چند مرحله ­ای انتخاب و به ‌صورت تصادفی در چهار گروه جای گرفتند (سه گروه آزمایشی و یک گروه کنترل، هر گروه 15 نفر). از پرسشنامه اختلال هماهنگی رشدی - نسخه والدین و آزمون هوش ریون برای غربال­گری اولیه و از آزمون اِن- بک (N-Back) برای سنجش عملکرد حافظه کاری قبل و بعد از دوره آزمایشی (24 جلسه 45 دقیقه­ ای، سه جلسه در هفته به مدت هشت هفته) استفاده شد. پروتکل آزمایشی برای توان­بخشی شناختی، تمرین مهارت­ های حل مسئله، هماهنگی حسی و حرکتی و هماهنگی دست و چشم و برای بازی ­های هدفمند حرکتی، تمرین مهارت­ های حرکتی ظریف و درشت با تأکید بر تعادل، هماهنگی و جهت­ یابی بودند. داده­ ها با استفاده از آزمون t جفت ­شده و تحلیل کوواریانس در سطح اطمینان 95 درصد تحلیل شدند.
یافته ­ها
عملکرد حافظه کاری در گروه­های توان­بخشی شناختی، بازی هدفمند و مداخله ترکیبی از پیش­آزمون به پس­آزمون به طور معنادار افزایش یافت (0/001> p)، در حالیکه در گروه کنترل تغییر معنادار مشاهده نگردید (0/05< p). پس از کنترل تفاوت گروه ­ها در پی ش­آزمون، عملکرد حافظه کاری گروه ­های ترکیبی (98/86= M) و توان­بخشی شناختی (95/63= M) در پس­آزمون، به طور معناداری بالاتر از گروه­های بازی هدفمند (86/54= M) و کنترل (57/01= M) بود و عملکرد حافظه کاری گروه باز­ی هدفمند نیز به طور معناداری بالاتر از گروه کنترل قرار داشت.
نتیجه ­گیری
ترکیب توان­بخشی شناختی با بازی­ های هدفمند مبتنی بر فعالیت­ های ادراکی- حرکتی می­ تواند به اثربخشی بیشتری در بهبود حافظه کاری دختران 7 تا 10 سال دارای اختلال هماهنگی رشدی منجر شود.

کلیدواژه‌ها

موضوعات


عنوان مقاله [English]

Effect of Cognitive Rehabilitation and Purposeful-Movement Plays on Working Memory among Children with Developmental Coordination Disorder

نویسندگان [English]

  • Rezvan Abbasian Borujeni 1
  • Saleh Rafiee 2
  • Mahdi Namazizadeh 3
  • Farshad Tojari 4
1 Department of Motor Behavior, Central Tehran Branch, Azad Islamic University, Tehran, Iran
2 PhD, Assistant Professor in motor behavior, Institute of Physical Education and Sport Sciences, Tehran, Iran
3 Department of Motor Behavior, University of Tehran, Tehran, Iran
4 Department of Sport Management, Central Tehran Branch, Azad Islamic University, Tehran, Iran
چکیده [English]

Background and Aims: Children with developmental coordination disorder show deficits in working memory, especially visual-spatial memory. In the present study, we investigated the efficacy of interventions based on the cognitive rehabilitation and purposeful-movement plays in improving working memory performance among 7-10 year-old girls with developmental coordination disorder.
Materials and Methods: The research method was experimental with pre- and post-test design and a control group. A total of 60 girls, aged 7-10 years (mean age 8.43 years), were selected from among all elementary school students in Broujen using multistage cluster sampling and were randomly divided into four groups (three experimental groups and a control, each group including 15 individuals). Developmental Coordination Disorder Questionnaire - Parent Version and Raven’s Intelligence Test were used for initial screening and the N-Back Test was applied to measure the performance of working memory before and after the experimental period (24 sessions, each for 45 minutes, three sessions per week for eight weeks). Experimental protocol for cognitive rehabilitation was designed to improve problem-solving skills, sensory-motor coordination, and hand-eye coordination. Also, purposeful-movement plays were designed to develop fine and gross motor skills with an emphasis on the balance, coordination, and lateralization. Data were analyzed using paired-samples t test and covariance analysis at the confidence level of95%.
Results: The performance of working memory was significantly increased from pre-test to post-test in the groups of cognitive rehabilitation, purposeful play, and combined intervention (p < .001), whereas no significant change was observed in the control group (p > .05). After controlling for differences of groups in the pre-test, the working memory of the combined intervention (M = 98.86) and cognitive rehabilitation (M = 95.63) in the post-test were significantly higher than those of the purposeful play (M = 86.54) and control (M = 57.01) groups and the working memory performance in the group of purposeful play was significantly higher than that of the control group (p < .001).
Conclusion: Combining cognitive rehabilitation with purposeful games based on the perceptual-motor activities can lead to greater efficacy in improving working memory among 7-10 year-old girls with developmental coordination disorder.

کلیدواژه‌ها [English]

  • developmental coordination disorder
  • Working memory
  • Play
  • Cognitive rehabilitation
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