تاثیر توانبخشی شناختی مبتنی بر حرکت بر بهبود توجه پایدار و انعطافپذیری شناختی کودکان مبتلا به اختلال نقص توجه و بیش فعالی

نوع مقاله : مقاله پژوهشی

نویسندگان

1 کارشناس ارشد روانشناسی بالینی کودک و نوجوان، دانشگاه شهید بهشتی، تهران، ایران

2 دانشیار علوم اعصاب شناختی، گروه علوم شناختی، پژوهشکده علوم شناختی و مغز، دانشگاه شهید بهشتی، تهران، ایران.

چکیده

مقدمه و اهداف
اختلال نقص­توجه و بیش­فعالی، اختلالی عصب-تحولی است. نقص کارکردهای اجرایی خصیصه فراگیر این اختلال محسوب می­شود. هدف از مطالعه حاضر بررسی اثربخشی توانبخشی شناختی مبتنی بر حرکت بر بهبود توجه پایدار و انعطاف­پذیری شناختی در کودکان مبتلا به اختلال نقص­توجّه/بیش­فعالی می­باشد.
مواد و روش ها
پژوهش حاضر از نوع شبه آزمایشی که در آن از طرح کارآزمایی بالینی تصادفی (پیش­آزمون-پس­آزمون با گروه کنترل) استفاده شده است. در مطالعه حاضر30 کودک 7 تا 12 ساله مراجعه­کننده به کلینیک­های شهر تهران که توسط روان پزشک دارای تشخیص اختلال نقص توجّه/بیش فعالیبودند با استفاده از نمونه­گیری در دسترس انتخاب و به صورت تصادفی به دو گروه آزمایش و کنترل تقسیم شدند.توجه پایدار و انعطاف­پذیری شناختی با آزمون­های ثبت توجه و ردیابی الف و ب ارزیابی شد. داده­های پژوهش حاضر با آزمون آماری  tمستقل، تحلیل واریانس آمیخته و به کمک نرم­افزار  SPSS20مورد تجزیه و تحلیل قرار گرفت.
یافته ها
نتایج به دست آمده از پژوهش نشان داد که در توجه پایدار (01/0>P) و انعطاف­پذیری شناختی (01/0>P) گروه درمان بعد از مداخله بهبود حاصل شد. به این صورت که در پیش آزمون تفاوت چندانی بین گروه کنترل و آزمایش در توجه پایدار و انعطاف­پذیری شناختی دیده نشد، امّا در پس آزمون نمرات گروه آزمایش به طور معناداری از گروه کنترل افزایش یافته بود.
نتیجه گیری
نتایج حاصل از تحلیل آماری داده­ها نشان می­دهد که با در نظر گرفتن گروه کنترل و درمان توانبخشی شناختی مبتنی بر حرکت موجب تقویت توجه پایدارو انعطاف­پذیری شناختی کودکان مبتلا به اختلال نقص­توجّه/ بیش­فعالی شده است.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

Effectiveness of Motor Based Cognitive Rehabilitation on Improvement of Sustained Attention and Cognitive Flexibility of Children with ADHD

نویسندگان [English]

  • Asal Najian 1
  • Vahid Nejati 2
1 MA Student in Clinical Psychology, Shahid Beheshti University, Tehran, Iran
2 Associate Professor in Cognitive Sciences, Brain and Cognitive Science Institute, Shahid Beheshti University, Tehran, Iran.
چکیده [English]

Background and Aim: Attention Deficit and Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder. Executive functions defect is considered as a general feature of the disorder. The aim of the present study was to examine the effectiveness of motor based cognitive rehabilitation on the improvement of sustained attention and cognitive flexibility in children with ADHD.
Materials and Methods: The present study followed a quasi-experimental randomized clinical trial design (pretest-posttest with control group). A total of 30 children aged 7 to 12 referring to the clinics in Tehran were diagnosed by a psychiatrist with ADHD. Participants were selected using convenience sampling and then randomly divided into control and experimental groups. Sustained attention and cognitive flexibility were evaluated using recording attention tests and tracking A and B. Data were analyzed running independent t-test and mixed ANOVA in SPSS, version 20.
Results: The results of the study showed that sustained attention (P<0/01) and cognitive flexibility (P<0/01) of the experimental group improved after the intervention, meaning that in the pretest, little difference was observed between the control and experimental groups in sustained attention and cognitive flexibility, but in post-test, scores of experimental group were significantly higher than those of the control group.
Conclusions: The results of the statistical analysis showed that with regard to the control group, gesture-based cognitive rehabilitation therapy improved sustained attention and cognitive flexibility in children with ADHD.

کلیدواژه‌ها [English]

  • Attention Deficit and Hyperactivity Disorder (ADHD)
  • Motor based cognitive rehabilitation
  • Cognitive flexibility
  • Sustained attention

مراجع

  1. Fredericks CR., Kokot SJ, Krog S. Using a developmental movement programme to enhance academic skills in grade 1 learners. South African Journal for Research in Sport, Physical Education and Recreation 2006; 28(1): 29-42.##
  2. Smith AL, Hoza B, Linnea K, McQuade JD, Tomb M, Vaughn AJ, … Hook H. pilot physical activity intervention reduces severity of ADHD symptoms in young children. Journal of Attention Disorders 2013; 17:70-82. ##
  3. Verret C, Guay MC, Berthiaume C, Gardiner P, Beliveau l. A physical activity program improves behavior and cognitive functions in children with ADHD: An exploratory study. Journal of Attention Disorders 2012; 16:71-80. ##
  4. Alizadeh H. Attention deficit hyperactivity disorder (characteristics, assessment and treatment). Tehran, Iran:Roshd Press; 2006. [In Persian]. ##
  5. Ploughman M. Exercise is brain food: the effects of physical activity on cognitive function. Dev Neurorehabil 2008; 11(3): 236-40. ##
  6. Nejati V, Aghaee Shabet S, Khoshhalipanah M. Social cognition in children with attention deficit/hyperactivity disorder. J Social Cognition 2014; 2(2):45-47. ##
  7. Nelson RW, Israel AC. Behavior Disorders in Childhood. (4th Ed.). Upper Saddle River, NJ: Prentice Hall; 2003. ##
  8. Brown TE. Attention Deficit Disorder: The Unfocused Mind in Children and Adults. New Haven, CT: Yale University Press; 2005. ##
  9. Brown TE. (ADHD) co morbidity. Hand book for ADHD comprehention children and adult. Vashington D.C American psychiatric; 2008. ##
  10. Sohlberg M, Mateer C. Cognitive Rehabilitation:an integrative neuropsychological approach. New York London:The Guilfordpress 2001; P125-130. ##
  11. Tucha O, Walitza S, Mechlinger L, Sontag TA, Kubber S, Linder M, Lange KW. Attentional Functioning in children with ADHD-predominantly hyperactive-impulsive type and children with ADHD-combind type. Journal of Neural Transmission 2006; 113:1943-1953. ##
  12. Swanson JM, Posner MI, Canwell D, Wigal S. Attention Deficit Hyperactivity Disorder: Symptom domains,cognitive process and neural networks.INR.Parasurman(Ed).The Attentive Brain 1998; p445-560. ##
  13. Barkley RA. Behavioral inhibition, Sustained attention and Executive function: Psychological Bulletin 1997; 121(1): 65-94. ##
  14. Nazifi M, Rasoul-zadeh Tabatabie K, Azad-Fallah P, Moradi AR. Sustained Attention and Response Inhibition in Children with Attention Deficit/Hyperactivity Disorder Compared to Normal Children. Journal of Clinical Psychology 2011; 3(2): 55-64. ##
  15. Cañas JJ, Quesada JF, Antolí A, Fajardo I. Cognitive flexibility and adaptability to environmental changes in dynamic complex problem-solving tasks, Ergonomics 2003; 46: 482. ##
  16. Badre D, Wagner AD. Computational and neurobiological mechanisms underlying cognitive flexibility. Proc.Natl.Acad.Sci 2006; 103:7186–7191. ##
  17. Leuner B, Gould E. Dendritic growth in medial prefrontal cortex and cognitive flexibility are enhanced during the postpartum period. J. Neurosci 2010; 30: 13499–13503. ##
  18. Collins A, Koechlin E. Reasoning, learning, and creativity: frontal lobe function and human decision-making. PLoS Biol 2012; 10: e1001293. ##
  19. Gilhooly KJ, Fioratou E, Anthony SH, Wynn V. Divergent thinking: strategies and executive involvement in generating novel uses for familiar objects. Br. J. Psychol 2007; 98: 611–625. ##
  20. Jung-Beeman M, Bowden EM, Haberman J, Frymiare JL, Arambel-Liu S, Kane MJ, con way ARA, Miura TK, Colflesh GJH. "Working memory, attention control, and the N-back task: a question of cons tract validity". Journal of Experimental psychology: learning, memory, and cognition 2004; (33): 615-622. ##
  21. Seidman LJ. Neuropsychological functioning in people with ADHD across the lifespan. Clin psychol Rev 2006; (26): 466-48. ##
  22. Barkley RA, Murphy KR. Attentiondeficit/ hyperactivity disorder: A clinical               workbook (2nd ed.). New York: Guilford Press; 2000. ##
  23. Dawson P, Guare R. Executive skills in children and adolescents: A practical guide to assessment and intervention. New York: Guilford Press; 2004. ##
  24. Baddeley AD. Working Memory: Theory and Practice, London.U.K; Oxford University press; 2000. ##
  25. Nanda NJR, Marieke EA, Leo MJdeS, Cathelijne JMB, Jan B, Jaap O, Joseph AS. Are Motor Inhibition and Cognitive Flexibility Dead Ends in ADHD?J Abnorm Child Psychol 2007; 35:957-967. ##
  26. Lista I, Sorrentino G. Biological mechanisms of physical activity in preven-ting cognitive decline. Cell Mol. Neurobiol 2010; 30: 493–503. ##
  27. Solanto M V. Dopamine dysfunction in AD/HD: integrating clinical and basic neuroscience research. Behavioural brain research 2002; 130(1-2), 65-71. ##
  28. Lafenetre P, Leske O, Ma-Hogemeie Z, Haghikia A, Bichler Z, Wahle P, Heumann R. Exercise can rescue recognition memory impairment ina model with reduced adult hippocampal neurogenesis. Front. Behav. Neurosci 2010; 3:34. ##
  29. Vaynman S, Ying Z, Gomez-Pinilla F. Hippocampal BDNF mediates theefficacy of exercise on synaptic plasticity and cognition. Eur. J. Neurosci 2004; 20: 2580–2590. ##
  30. Schwarz L, Kindermann W. b-Endorfina, adrenocorticotropic, cortisol and catecholamines during aerobic and anaerobic exercise. Eur J Appl Physiol 1990; 61:165–171. ##
  31. Fordyce DE, Farrar RP. Enhancement of spatial learning in F344 rats byphysical activity and related learning-associated alterations in hippocampal andcortical cholinergic functioning. Behav. Brain Res.1991; 46: 123–133. ##
  32. Hotting K, Roder B. Beneficial effects of physical exercise on neuroplasticity and cognition. Biological Psychology and Neuropsychology 2013; 2243-2257. ##
  33. Brefczynski-Lewis JA, Lutz A, Schaefer HS, Levinson DB, Davidson RJ. Neural correlates of attentional expertise in long-term meditation practitioners. Proc.Natl.Acad. Sci.U. S. A. 2007; 104: 11483. ##
  34. Jolles DD, Crone EA. Training the developing brain: a neurocognitive perspective. Frontiers in human neuroscience 2012; 6. ##
  35. Barenberg J, Berse T, Dutke S. Executive functions in learning processes:do they benefit from physical activity? Educ. Psychol. Rev. 2011; 6, 208–222. ##
  36. Beer JS, Shimamura AP, Knight RT. Frontal lobe contributions toexecutive control of cognitive and social behavior. In: Gazzaniga, M. S. (Ed.), The CognitiveNeurosciences III. MIT Press, Cambridge, MA 2004; 1091–1104. ##
  37. Best JR., Miller P H. A developmental perspective on executive function. Child Dev 2010; 81(6), 1641–1660. ##
  38. Best JR. Effects of physical activity on children’s executive function: contrib-utions of experimental research on aerobic exercise. Dev. Rev. 2010; 30: 331–551. ##
  39. Afrouz GH-A. Psychology education of exceptional children. Samt Press; 2002. ##
  40. Nejati V, Pouretemad HR,Bahrami H. Attention Traningin rehabilitation ofchildren with developmental stuttering.NeuroRehabilition 2013; 32:297-303. ##
  41. Nejati V. Attention registration test: design and evaluation psychological characteristics. Journal of Behavoral Sciences,(Accepted published). ##
  42. LIorente AM, Williams J, Staz P, D’Elia LF. Children’s Color Trails Test (CCTT). Odessa, FL: Psychological Assessment Resources; 2003. ##
  43. Lezak D. Neuropsychological assessment. 3rd ed.New York: Oxford University Press; 2005. ##
  44. Stuss DT, Bisschop SM, Alexander MP, Levine B, Katz D, Izukawa D. The Trail Making Test: A study in focal lesion patients. Psychological Assessment, 2001; 13:230–239. ##
  45. Uchiyama CL, Mitrushina MN, D’Elia LF, Satz P, Mathews A. Frontal lobe functioning in geriatric and nongeriartic samples: An argument for multimodal analyses. Archives of Clinical Neuropsychology 1994; 9: 215- 227. ##
  46. Medina JA, Netto TL, Muszkat M, Medina AC, Botter D, Orbetelli R, Miranda MC. Exercise impact on sustained attention of ADHD children, methylphenidate effects. Attention Deficit Hyperactivity Disorder 2010; 2: 49-58. ##
  47. Hillman CH, Pontifex MB, Raine LB, Castelli DM, Hall EE, Kramer AF. The effect of acute treadmill walking on cognitive control and academic achievement in preadolescent children. Neuroscience 2009; 159: 1044-1054. ##
  48. Mattew B, Pontifex MB, Saliba BJ, Raine LB, Picchietti DL, Hillman CH. Exercise improves behavioral, neurocognitive, and scholastic performance in children with attention-deficit/hyperactivity disorder. The Journal of pediatrics 2013; 162(3): 543-551. ##
  49. Callaghan P. Exercise: A neglected intervention in mental health care?Journal of Psychiatric and Mental Health Nursing 2004; 11: 476 –483. ##
  50. Stranahan AM, Khalil D, Gould E. Running induces widespread struc-turalalterations in the hippocampus and entorhinal cortex. Hippocampus 2007; 17:1017–1022. ##
  51. Kiptown h, Green CS, Bevelier D. “Effect of Action video games on the spatial distribution of visuospatial attention”. Journal of Experimental Psychology: Human Perception and performance 2006; 32(6): 465-478. ##
  52. Barkley RA, Fischer M, Edelbrock CS, Smallish L. The adolescent outcome of hyperactive children diagnosed by research criteria: I. An 8 year prospective follow-up study. Journal of the American Academy of Child and Adolescent Psychiatry 2005; 29: 546–557. ##
  53. Abdi A, Arabani Dana A, Hatami J, Parand A. The Effect of cognitive computer games on working memory, attention and cognitive flexibility in students with attention deficit/hyperactivity disorder. J of Exceptional Children 2014; 14(1):20-33. ##
  54. Colcombe SJ, Erickson KI, Scalf PE, Kim JS, Prakash R, McAuley E, Elavsky S, Marquez DX, Hu L, Kramer AF. Aerobic exercise training increasesbrain volume in aging humans. J. Gerontol. A Biol. Sci. Med. Sci 2006; 61: 1166–1170. ##
دوماهنامه علمی - پژوهشی طب توانبخشی
دوره 6، شماره 4
آذر و دی 1396
صفحه 1-12

فایل ها

سابقه مقاله

  • تاریخ دریافت: 24 آذر 1395
  • تاریخ بازنگری: 27 بهمن 1395
  • تاریخ پذیرش: 15 فروردین 1396
  • تاریخ اولین انتشار: 01 دی 1396

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