تاثیر تمرینات تعادلی بر سازگاری کینماتیک مفاصل ران، زانو و مچ پای زنان سالمند در حین راه رفتن

نوع مقاله : مقاله پژوهشی

نویسندگان

1 دانشیار رفتارحرکتی، دانشکده تربیت بدنی و علوم ورزشی، دانشگاه شهید بهشتی، تهران، ایران

2 استاد دانشکده علوم توانبخشی، دانشگاه علوم پزشکی ایران، تهران، ایران

3 دانشجوی دکتری رفتار حرکتی، دانشکده تربیت بدنی و علوم ورزشی، دا‌نشگاه شهید بهشتی، تهران، ایران

چکیده

مقدمه و اهداف
یکی از آسیب­های دوران سالمندی، آسیب های ناشی از افتادن حین راه رفتن است هدف از تحقیق حاضر بررسی تاثیر شش هفته تمرینات تعادلی بر سازگاری کینماتیک مفاصل ران، زانو و مچ پا  در راه رفتن زنان سالمند بود.
مواد و روش­ها
تحقیق به روش نیمه تجربی انجام شد. بدین منظور20زن سالمند با دامنه سنی 75-60 (84/4±72/67 سال) به روش نمونه گیری در دسترس انتخاب  و از طریق گمارش تصادفی ساده به دو گروه ده نفری کنترل و تمرین تقسیم شدند. سپس از آزمودنی‌های هر دو گروه یک آزمون مشابه پیاده‌روی در یک مسیر هفت متری با سرعت گام برداری مورد دلخواه طی دو جلسه پیش و پس آزمون به فاصله شش هفته از هم گرفته شد. گروه تمرین به طور منظم هفته ای 3 جلسه و در مجموع 18 جلسه تمرینات تعادلی (شامل انواع ایستادن‌ها و راه رفتن‌ها) را بر اساس پروتکل تعیین شده انجام دادند. با استفاده از دستگاهتحلیل حرکتیویژگی‌های کینماتیک راه رفتن شامل دامنه حرکت مفاصل ران، زانو و مچ پا جمع‌آوری و از طریق نرم افزار کرتکس تحلیل شد. داده‌ها با استفاده از تحلیل واریانس مرکب (2 گروه × 2 زمان) تحلیل شدند.
یافته‌ها
 نتایج تحقیق بهبود معنی‌دار در دامنه حرکت مفصل ران (03/0=P) در گروه تمرین در مقایسه با گروه کنترل نشان داد. دامنه حرکتی مفصل زانو (12/0=P) در گروه تمرین، نسبت به گروه کنترل معنی‌دار نبود. تفاوت معنی­داری در دامنه حرکتی مچ پا در دو گروه تمرین تعادلی و کنترل مشاهده نشد(28/0=P).
نتیجه‌گیری
 نتایج نشان داد که سازگاری‌های کینماتیک مفصل ران در زنان سالمند زیر تاثیر شش هفته تمرینات تعادلی قرار می گیرند. بنابراین، مداخله تمرینات تعادلی می تواند رویکرد موثری در بهبود فاکتورهای خطرزا در افتادن و توسعه جابجایی ایمن در جمعیت افراد سالمند باشد.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

The effect of balance training on hip, knee, and ankle joints Kinematic compatibility of older women during walking

نویسندگان [English]

  • Alireza Farsi 1
  • hasan Ashayeri 2
  • Sahar Mohammadzadeh 3
1 Associate Professor of Motor Behavior, University of Shahid Beheshti, Tehran, Iran
2 Professor of College of Rehabilitation Sciences, University of Iran Medical sciences, Tehran, Iran
3 PhD Student of Motor Behavior, University of Shahid Beheshti, Tehran,
چکیده [English]

Background and Aim: One of the main causes of death in the elderly is related to the injuries from falls during walking. The aim of the present study was to examine the effect of 6 weeks of balance training on kinematic compatibility of hips, knees, and ankles joints during walking in elderly women.
Materials and Methods: In the current semi-experimental study, 20 elderly women with the age range of 60-75 (67.72± 4.48 ages) were selected based on convenience sampling procedure to participate in the present study. The participants were randomly divided into control and experiment groups. Participants in each group took a walking test in a pre-test session followed by a post-test after 6 weeks .Participants in the experimental group performed the balance training systematically for 3 sessions in a week. Overall, they were trained for 18 sessions of balance training (including various modes of standing and walking) based on the decided protocol. Making use of motion analysis system, Kinematic features of the walking such as range of motion of hip, knee and ankle joints were collected and analyzed using the Cortex software. Repetitive ANOVA (2 × 2) was run for the purpose of data analysis.
Results: The results of the present study showed significant improvement in range of motion of hip joint (p=0.03) in elderly women of the experiment group compared with that in the control group. Although the variables range of motion of knee (p=0.12) and ankle (p=0.28) joints increased in the experiment group, these increases were not significant in comparison with that in the control group.
Conclusion: The results revealed that kinematic compatibility of hip joint in older women is affected by 6 weeks of balance training. Therefore, it can be suggested that this balance training intervention could be an effective approach to ameliorate the risk factors for falls and to promote safer locomotion in elderly community-dwelling women.

کلیدواژه‌ها [English]

  • Walking
  • Elderly woman
  • Balances training
  • Range of motion of joints

مراجع

  1. Imms F, Edholm O. Studies of gait and mobility in the elderly. Age and Ageing; 1981;10(3):147.##
  2. Shigematsu R, Chang M, Yabushita N, Sakai T, Nakagaichi M, Nho H, et al. Dance-based aerobic exercise may improve indices of falling risk in older women. Age Ageing; 2002 Jul;31(4):261-6. ##
  3. President, vice president, strategic planning and oversight of Iran's Statistics Center Selected Population and Housing Census Results rinting. Tehran: Statistical Center of Iran printer;1391; p:20-35. [In Persian]##
  4. Kovacs CR. Age-related changes in gait and obstacle avoidance capabilities in older adults: a review. Journal of applied gerontology; 2005;24(1):21-34##
  5. Robertson DGE. Research methods in biomechanics: Human Kinetics Publishers; 2004.p.67-92.##
  6. Buchner DM, Cress ME, De Lateur BJ, Esselman PC, Margherita AJ, Price R, et al. The effect of strength and endurance training on gait, balance, fall risk, and health services use in community-living older adults. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 1997;52(4):M218-M24.##
  7. Menz HB, Lord SR, Fitzpatrick RC. Age‐related differences in walking stability. Age and Ageing; 2003;32 (2): 42-137.##
  8. Rogers HL, Cromwell RL, Grady JL. Adaptive Changes in Gait in Older and Younger Adults as Responses to Challenges to Dynamic Balance. Journal of aging and physical activity; 2008;16(1):85.##
  9. Howe T, Rochester L, Jackson A, Banks P, Blair V. Exercise for improving balance in older people (Review). 2008.##
  10. Winter DA. Biomechanics and motor control of human gait: normal, elderly and pathological;1991P.95-151.##
  11. Reelick MF, Van Iersel MB, Kessels RPC, Rikkert MGMO. The influence of fear of falling on gait and balance in older people. Age and Ageing. 2009;38(4):435-40.##
  12. Kemoun G, Thoumie P, Boisson D, Guieu JD. Ankle dorsiflexion delay can predict falls in the elderly. Journal of Rehabilitation Medicine. 2002;34(6):278-83.##
  13. Kerrigan DC, Todd MK, Della Croce U, Lipsitz LA, Collins JJ. Biomechanical gait alterations independent of speed in the healthy elderly: evidence for specific limiting impairments. Archives of physical medicine and Rehabilitation ;1998;79(3):317##
  14. Province MA, Hadley EC, Hornbrook MC, Lipsitz LA, Miller JP, Mulrow CD, et al. The Effects of Exercise on Falls in Elderly PatientsA Preplanned Meta-analysis of the FICSIT Trials. JAMA: the journal of the American Medical Association; 1995; 273(17):1341-7.##
  15. Teixeira-Salmela LF, Nadeau S, Milot M-H, Gravel D, Requião LF. Effects of cadence on energy generation and absorption at lower extremity joints during gait. Clinical biomechanics; 2008; 23(6):769-78.##
  16. DiBenedetto M, Innes KE, Taylor AG, Rodeheaver PF, Boxer JA, Wright HJ, et al. Effect of a gentle Iyengar yoga program on gait in the elderly: an exploratory study. Archives of physical medicine and rehabilitation; 2005; 86(9):1830-7.##
  17. Vickers DR, Palk C, McIntosh A, Beatty K. Elderly unilateral transtibial amputee gait on an inclined walkway: a biomechanical analysis. Gait & posture; 2008;27(3):518-29.##
  18. Cao Z-B, Maeda A, Shima N, Kurata H, Nishizono H. The effect of a 12-week combined exercise intervention program on physical performance and gait kinematics in community-dwelling elderly women. Journal of physiological anthropology; 2007; 26(3): 325-32.##
  19. Sadeghi H, Hemati Nezhad MA, Baghban M. The effect of endurance training on a few kinematics parameters in gait of non-active elderly people. Iranian Journal of Ageing; 2009;4(11): 62-9. [In Persian] ##
  20. Kerrigan DC, Lee LW, Collins JJ, Riley PO, Lipsitz LA. Reduced hip extension during walking: healthy elderly and fallers versus young adults. Archives of physical medicine and Rehabilitation; 2001;82(1):26-30.##
  21. Kerrigan DC, Xenopoulos-Oddsson A, Sullivan MJ, Lelas JJ, Riley PO. Effect of a hip flexor-stretching program on gait in the elderly. Archives of physical medicine and Rehabilitation; 2003;84(1):1.##
  22. Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of psychiatric research; 1975;12(3):189-98.##
  23. Seyedian M, Nejat S, Delavar A, Gasemzadeh H.[validity of the farsi version of Mini Mental State Examination (MMSE)]. Journal of Medical Council of Islamic Republic of IRAN; 1997;4(25): 408-414. [In Persian]##
  24. Sutherland, D.H., The evolution of clinical gait analysis: Part II Kinematics. Gait & posture, 2002. 16(2): p. 159-179.##
  25. Scott S. ABLE bodies balance training: Human Kinetics Publishers; 2008.p:200-330.   ##
  26. Judge JO, Ounpuu S, Davis 3rd R. Effects of age on the biomechanics and physiology of gait. Clinics in geriatric medicine; 1996;12(4):659.##
  27. McGraw B, McClenaghan BA, Williams HG, Dickerson J, Ward DS. Gait and postural stability in obese and nonobese prepubertal boys. Archives of physical medicine and rehabilitation; 2000;81(4):484-9.##
  28. Chakravarthy MV, Joyner MJ, Booth FW, editors. An obligation for primary care physicians to prescribe physical activity to sedentary patients to reduce the risk of chronic health conditions. Mayo clinic proceedings; 2002: Elsevier.p:165-17##
  29. Cromwell RL, Meyers PM, Meyers PE, Newton RA. Tae Kwon Do: an effective exercise for improving balance and walking ability in older adults. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences; 2007;62(6):641-6.##
  30. 30.    Lin MR, Hwang HF, Wang YW, Chang SH, Wolf SL. Community-based tai chi and its effect on injurious falls, balance, gait, and fear of falling in older people. Physical therapy. 2006;86(9):1189-201.##


دوماهنامه علمی - پژوهشی طب توانبخشی
دوره 5، شماره 1
فروردین و اردیبهشت 1395
صفحه 135-144

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سابقه مقاله

  • تاریخ دریافت: 17 تیر 1394
  • تاریخ بازنگری: 28 مهر 1394
  • تاریخ پذیرش: 07 آبان 1394
  • تاریخ اولین انتشار: 01 فروردین 1395

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