بررسی تاثیر فوری یک جلسه ارتعاش کامل بدن بر روی شاخص های تعادلی در زنان مبتلا به نوروپاتی دیابتی نوع 2

نوع مقاله: مقاله پژوهشی

نویسندگان

1 کمیته پژوهشی دانشجویان، دانشجوی کارشناسی ارشد فیزیوتراپی، گروه فیزیوتراپی، دانشکده علوم توانبخشی،دانشگاه علوم پزشکی شهید بهشتی،تهران، ایران

2 دکترای تخصصی فیزیوتراپی، دانشیار گروه فیزیوتراپی، دانشکده علوم توانبخشی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران

3 دکترای تخصصی فیزیوتراپی، استاد گروه فیزیوتراپی، دانشکده علوم توانبخشی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران

4 استاد آمار زیستی، گروه علوم پایه، دانشکده علوم توانبخشی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران

5 دانشجوی دکترای پرستاری، گروه پرستاری، دانشکاه علوم پزشکی ایران، تهران، ایران

چکیده

مقدمه و اهداف
نوروپاتی دیابتی به علت درگیری اعصاب محیطی، باعث کاهش تعادل می­شود. پژوهش­ های کمی، تغییرات شاخص­ های تعادلی را بعد از استفاده از دستگاه لرزش کلی بدن (Whole Body Vibration) بیان کرده ­اند. هدف مطالعه حاضر، بررسی تغییرات شاخص­ های تعادلی به ­صورت فوری بعد از استفاده از دستگاه لرزش کلی بدن در بیماران نوروپاتی دیابتی نوع دو است.
مواد و روش­ ها
مطالعه حاضر، تک­ جلسه­ ای و از نوع کارآزمایی بالینی یک­ سوکور است. 32 بیمار نوروپاتی دیابتی، به دو گروه مداخله و درمان­ نما تقسیم شدند. بیماران در گروه مداخله 6 بار با استراحت یک دقیق ه­ای، روی دستگاه لرزش کلی بدن، با فرکانس HZ30 و آمپلی­تود mm2، با زانوهای خم­شده تا 30 درجه ایستادند. در گروه درمان ­نما، بیماران با همان شرایط گروه مداخله، اما روی صفحه دستگاه خاموش قرار گرفتند. بیماران هر دو گروه قبل و بعد از مداخله، با دستگاه بایودکس مورد ارزیابی قرار گرفتند. با توجه به توزیع نرمال داده ­ها با استفاده از آزمون شاپیرو-ویلک، برای مقایسه بین گروهی از تحلیل کوواریانس و برای مقایسه درون­ گروهی از آزمون t-زوجی استفاده شد.
یافته ­ها
یافته ­ها نشان داد بر اساس آزمون t-زوجی، تعادل کلی (p=0.000)، تعادل در جهت قدامی-خلفی (p=0.000) و تعادل در جهت طرفین (p=0.033)، قبل و بعد در گروه مداخله، تغییرات معناداری را نشان دادند، اما در گروه درمان­نما، تعادل کلی (p=0.06)، تعادل در جهت قدامی-خلفی (p=0.33) و تعادل در جهت طرفین (p=0.79)، تغییرات معناداری مشاهده نشد. در مقایسه نتایج دو گروه، با استفاده از آزمون t-مستقل، تعادل کلی (p=0.000)، تعادل در جهت قدامی-خلفی (p=0.000) و تعادل طرفین (p=0.027) به دست آمد، هر سه متغیر دارای اختلاف معناداری شد.
نتیجه­ گیری
به نظر می‌رسد دستگاه لرزش کل بدن می­تواند در کوتاه­مدت در بهبود تعادل در زنان مبتلا به نوروپاتی دیابتی موثر باشد.

کلیدواژه‌ها

موضوعات


عنوان مقاله [English]

Investigating the Immediate Effect of One Session of Whole Body Vibration on Equilibrium Ondices in Women with Type 2 Diabetes Mellitus

نویسندگان [English]

  • Elnaz Sohrabzadeh 1
  • Sedigheh Sadat Naimi 2
  • khosro khademi-Kalantari 3
  • Alireza Akbarzadeh Baghban 4
  • Fatemeh Sanaeti 5
1 Student Research Committee, MSc Student in Physiotherapy, Department of Physiotherapy, School of Rehabilitation Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2 Associate Professor, Department of Physiotherapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3 Professor, Department of Physiotherapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
4 Professor, Department of Basic Sciences, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
5 PhD Student of Nursing, Iran University of Medical Sciences, Tehran, Iran
چکیده [English]

Background and Aims: Diabetic neuropathy leads to a reduction in the balance due to peripheral nerves involvement. On the other hand, quantitative studies have shown changes in balance indicators after using the body's entire body vibration. The purpose of the present study was to evaluate the changes of equilibrium indices immediately after using the apparatus for whole body vibration in patients with type II diabetic neuropathy.
Materials and Methods: In the current single-session, single-blind clinical trial study, 32 patients with diabetic neuropathy were divided into two experimental and control groups. Patients in the intervention group, stood on the laser screen of the body's total vibration, with a frequency of 30HZ and an amplitude of 2 mm, knees bent to 30 degrees for six times with a one-minute rest. In the control group, there were patients with the same conditions, but they stood still on the device screen. Patients in both groups were evaluated before and after intervention using Biodex device. Regarding the normal distribution of data, Shapiro-Wilk test was used. Also, t-paired test and covariance analysis were run for further comparisons.
Results: Based on t-paired sample test, general balance (p = 0.000), balance in the anterior-posterior direction (p = 0.000), and balance in side direction (p = 0.033), before and after intervention, revealed significant changes (P = 0.06); however, in the control group, general balance (p = 0.06), balance in the anterior-posterior direction (p = 0.33), and balance in side direction (p = 0.79) were not significantly different compared between pretest and posttest. Comparing the results of the two groups, using independent t-test, general equilibrium (p = 0.000), balance in the anterior-posterior direction (p = 0.000), and bilateral balance (p = 0.027) showed statistically significant differences.
Conclusion: According to the results, the whole body vibration can be effective in improving the balance in the short time.

کلیدواژه‌ها [English]

  • diabetic neuropathy
  • complete body vibration
  • Balance
  1. Association AD. Diagnosis and classification of diabetes mellitus. Diabetes care. 2014;37(Supplement 1):S81-S90.##
  2. Patti M-E. Gene expression in humans with diabetes and prediabetes: what have we learned about diabetes pathophysiology? Current Opinion in Clinical Nutrition & Metabolic Care. 2004;7(4):383-90. ##
  3. Guariguata L. Contribute data to the 6th edition of the IDF Diabetes Atlas. Diabetes research and clinical practice. 2013;100(2):280-1. ##
  4. Lotfi MH, Saadati H, Afzali M. Prevalence of diabetes in people aged≥ 30 years: the results of screen-ing program of Yazd Province, Iran, in 2012. Journal of research in health sciences. 2013;14(1):88-92. ##
  5. SAEEDI S, BANDARIAN F, MESHKANI R, NOURBAKHSH M, NASLI-ESFAHANI E, LARIJANI B. Iran Diabetes Research Roadmap (IDRR) Study; Trends of Basic Sciences Publication: A Review Article. Iranian Journal of Public Health. 2017;46:60-7. ##
  6. Laffel L. Ketone bodies: a review of physiology, pathophysiology and application of monitoring to diabetes. Diabetes/metabolism research and reviews. 1999;15(6):412-26. ##
  7. Farmer KL, Li C, Dobrowsky RT. Diabetic peripheral neuropathy: should a chaperone accompany our therapeutic approach? Pharmacological reviews. 2012;64(4):880-900. ##
  8. A Review of the Pathophysiology and Clinical Sequelae of Diabetic Polyneuropathy in the Feet. Journal of Diabetes, Metabolic Disorders & Control. 2016; 3(2). ##
  9. Perkins BA, Olaleye D, Zinman B, Bril V. Simple screening tests for peripheral neuropathy in the diabetes clinic. Diabetes care. 2001;24(2):250-6. ##
10. Cancelliere P. A Review of the Pathophysiology and Clinical Sequelae of Diabetic Polyneuropathy in the Feet. J Diabetes Metab Disord Control. 2016;3(2):00062. ##

11. Van Deursen R, Simoneau GG. Foot and ankle sensory neuropathy, proprioception, and postural stability. Journal of orthopaedic & sports physical therapy. 1999;29(12):718-26. ##

12. Hong J. Whole body vibration therapy for Diabetic Peripheral Neuropathic Pain. 2014. ##

13. Hausdorff JM, Rios DA, Edelberg HK. Gait variability and fall risk in community-living older adults: a 1-year prospective study. Archives of physical medicine and rehabilitation. 2001;82(8):1050-6. ##

14. Gillespie LD, Robertson MC, Gillespie WJ, Lamb SE, Gates S, Cumming RG, et al. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2009;2(2). ##

15. Delbaere K, Bourgois J, Van Den Noortgate N, Vanderstraeten G, Willems T, Cambier D. A home-based multidimensional exercise program reduced physical impairment and fear of falling. Acta Clinica Belgica. 2006;61(6):340-50. ##

16. Petrofsky JS, Cuneo M, Lee S, Johnson E, Lohman E. Correlation between gait and balance in people with and without Type 2 diabetes in normal and subdued light. Medical science monitor. 2006;12(7):CR273-CR81. ##

17. Cimbiz A, Cakir O. Evaluation of balance and physical fitness in diabetic neuropathic patients. Journal of Diabetes and its Complications. 2005;19(3):160-4. ##

18. Lee K, Lee S, Song C. Whole-body vibration training improves balance, muscle strength and glycosylated hemoglobin in elderly patients with diabetic neuropathy. The Tohoku journal of experimental medicine. 2013;231(4):305-14. ##

19. Lu J, Xu G, Wang Y. Effects of whole body vibration training on people with chronic stroke: a systematic review and meta-analysis. Topics in stroke rehabilitation. 2015;22(3):161-8. ##

20. Yang X, Zhou Y, Wang P, He C, He H. Effects of whole body vibration on pulmonary function, functional exercise capacity and quality of life in people with chronic obstructive pulmonary disease: a systematic review. Clinical rehabilitation. 2016;30(5):419-31. ##

21. Zafar H, Alghadir A, Anwer S, Al-Eisa E. Therapeutic effects of whole-body vibration training in knee osteoarthritis: a systematic review and meta-analysis. Archives of physical medicine and rehabilitation. 2015;96(8):1525-32. ##

22. Guest A, Apgar M. Promoting and prescribing exercise for the elderly. American family physician. 2002;65:3. ##

23. Cheung W-H, Mok H-W, Qin L, Sze P-C, Lee K-M, Leung K-S. High-frequency whole-body vibration improves balancing ability in elderly women. Archives of physical medicine and rehabilitation. 2007;88(7):852-7. ##

24. Bruyere O, Wuidart M-A, Di Palma E, Gourlay M, Ethgen O, Richy F, et al. Controlled whole body vibration to decrease fall risk and improve health-related quality of life of nursing home residents. Archives of physical medicine and rehabilitation. 2005;86(2):303-7. ##

25. Romaiguère P, Vedel J-P, Pagni S. Effects of tonic vibration reflex on motor unit recruitment in human wrist extensor muscles. Brain research. 1993;602(1):32-40. ##

26. Martin BJ, Park H-S. Analysis of the tonic vibration reflex: influence of vibration variables on motor unit synchronization and fatigue. European journal of applied physiology and occupational physiology. 1997;75(6):504-11. ##

27. Zhang J, Zhang H, Kan L, Zhang C, Wang P. The effect of whole body vibration therapy on the physical function of people with type II diabetes mellitus: a systematic review. Journal of physical therapy science. 2016;28(9):2675-80. ##

28. Baum K, Votteler T, Schiab J. Efficiency of vibration exercise for glycemic control in type 2 diabetes patients. International journal of medical sciences. 2007;4(3):159. ##

29. Yoosefinejad AK, Shadmehr A, Olyaei G, Talebian S, Bagheri H, Mohajeri-Tehrani MR. Short-term effects of the whole-body vibration on the balance and muscle strength of type 2 diabetic patients with peripheral neuropathy: a quasi-randomized-controlled trial study. Journal of Diabetes & Metabolic Disorders. 2015;14(1):45. ##

30. Fedele D, Comi G, Coscelli C, Cucinotta D, Feldman EL, Ghirlanda G, et al. A multicenter study on the prevalence of diabetic neuropathy in Italy. Diabetes Care. 1997;20(5):836-43. ##

31. Sacks DB, Arnold M, Bakris GL, Bruns DE, Horvath AR, Kirkman MS, et al. Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus. Clinical chemistry. 2011;57(6):e1-e47. ##

32. El-Wishy A, Elsayed E. Effect of Proprioceptive Training Program on Balance in Patients with Diabetic Neuropathy: A controlled randomized study. Bulletin of Faculty of Physical Therapy. 2012;17(2). ##

33. AKBARI A, GHIASI F, PAPOLI R, JALALI MA. A Relationship between Static and Dynamic Postural Stability Index and Anthropometrics Index in Healthy Men and Women with Normal BMI Index. 2014. ##

34. Bautmans I, Van Hees E, Lemper J-C, Mets T. The feasibility of whole body vibration in institutionalised elderly persons and its influence on muscle performance, balance and mobility: a randomised controlled trial [ISRCTN62535013]. BMC geriatrics. 2005;5(1):17. ##

35. Johnson S, Gray C, Donnelly B, Fuller D, Caputo J. A Comparison of Changes in Strength And Dynamic Balance Following 8 Weeks of Eccentric Training in Older Adults: 902 Board# 163 May 30 330 PM-500 PM. Medicine & Science in Sports & Exercise. 2018;50(5S):207. ##

36. Timar B, Timar R, Gaiță L, Oancea C, Levai C, Lungeanu D. The impact of diabetic neuropathy on balance and on the risk of falls in patients with type 2 diabetes mellitus: a cross-sectional study. PLoS One. 2016;11(4):e0154654. ##

37. Hijmans JM, Geertzen J, Zijlstra W, Hof AL, Postema K. Effects of vibrating insoles on standing balance in diabetic neuropathy. J Rehabil Res Dev. 2008;45:1442-50. ##

38. del Pozo-Cruz J, Alfonso-Rosa RM, Ugia JL, McVeigh JG, del Pozo-Cruz B, Sañudo B. A primary care–based randomized controlled trial of 12-week whole-body vibration for balance improvement in type 2 diabetes mellitus. Archives of physical medicine and rehabilitation. 2013;94(11):2112-8. ##

39. Arnold BL, Schmitz RJ. Examination of balance measures produced by the Biodex Stability System. Journal of athletic training. 1998;33(4):323. ##

40. Cachupe WJ, Shifflett B, Kahanov L, Wughalter EH. Reliability of biodex balance system measures. Measurement in physical education and exercise science. 2001;5(2):97-108. ##

41. Schmitz R, Arnold B. Intertester and intratester reliability of a dynamic balance protocol using the Biodex Stability System. Journal of sport rehabilitation. 1998;7(2):95-101. ##

42. Rehn B, Lidström J, Skoglund J, Lindström B. Effects on leg muscular performance from whole‐body vibration exercise: a systematic review. Scandinavian journal of medicine & science in sports. 2007;17(1):2-11. ##

43. Verhulst AL, Savelberg HH, Vreugdenhil G, Mischi M, Schep G. Whole-body vibration as a modality for the rehabilitation of peripheral neuropathies: implications for cancer survivors suffering from chemotherapy-induced peripheral neuropathy. Oncology reviews. 2015;9(1). ##

44. Jordan MJ, Norris SR, Herzog W. Vibration training: an overview of the area, training consequences. J Strength Cond Res. 2005;19(2):459-66. ##

45. Suter E, Herzog W. Extent of muscle inhibition as a function of knee angle. Journal of Electromyography and Kinesiology. 1997;7(2):123-30. ##

46. Yoosefinejad AK, Shadmehr A, Olyaei G, Talebian S, Bagheri H. The effectiveness of a single session of Whole-Body Vibration in improving the balance and the strength in type 2 diabetic patients with mild to moderate degree of peripheral neuropathy: a pilot study. Journal of bodywork and movement therapies. 2014;18(1):82-6. ##