مطالعه اثربخشی هشت هفته تمرینات اصلاحی در محیط آب، بر تعادل ایستا و نیمه‌پویای مردان مبتلا به سندرم متقاطع فوقانی (رویکرد جاندا)

نوع مقاله : مقاله پژوهشی

نویسندگان

1 کارشناس ارشد آسیب شناسی ورزشی و حرکات اصلاحی، دانشکده علوم ورزشی، دانشگاه بوعلی سینا، همدان، ایران

2 دانشیار گروه توانبخشی ورزشی، دانشکده تربیت بدنی و علوم ورزشی، دانشگاه بوعلی سینا، همدان، ایران

3 استادیار گروه حرکات اصلاحی و آسیب شناسی ورزشی، دانشکده علوم ورزشی، دانشگاه رازی، کرمانشاه، ایران

چکیده

مقدمه و اهداف
سندرم متقاطع فوقانی، نوعی اختلال اسکلتی–عضلانی در اندام فوقانی است که منجر به دفورمیتی‌هایی چون سربه­جلو، شانه گرد و کایفوز می‌شود. هدف از مطالعه حاضر، بررسی اثر هشت هفته تمرینات اصلاحی جامع در محیط آب بر تعادل ایستا و نیمه ­پویا در مردان مبتلا به سندرم متقاطع فوقانی بود.
مواد و روش ­ها
در مطالعه کارآزمایی‌بالینی کنترل­شده تصادفی حاضر، پس از غربالگری، 30 دانشجوی دارای سندرم به­ صورت هدفمند انتخاب شدند و تصادفاً در دو گروه تجربی (14 نفر) و کنترل (16 نفر) قرار گرفتند. قبل و پس از مداخله، تعادل ایستا و نیمه­ پویا با دستگاه بایودکس، زوایای سربه­ جلو و شانه گرد با عکس برداری و زاویه کایفوز به­ وسیله خط‌ کش منعطف، اندازه‌ گیری شد. داده‌ها با نرم­افزار SPSS نسخه 20 تحلیل گردید و سطح معناداری 0/05 در نظر گرفته شد. جهت مقایسه درون‌گروهی از آزمون t- زوجی و جهت مقایسه اختلاف میانگین-های بین‌ گروهی از آزمون t-مستقل استفاده گردید.
یافته ­ها
یافته­ ها نشان داد تمرینات در گروه تجربی در افزایش میزان تعادل ایستا (0/005=P) و نیمه­پویا (0/002=P) (ثبات کلی)، همچنین افزایش تعادل ایستا (0/001=P) و نیمه ­پویا (0/003=P) در سطح قدامی-خلفی، اثر معناداری داشته است، اما در تعادل ایستا (0/72=P) و نیمه­ پویا (0/42=P) جانبی (ثبات جانبی) تاثیر معناداری نداشته است.
نتیجه ­گیری
در مطالعه حاضر، تمرکز پروتکل تمرینات اصلاحی بر اصلاح پاسچر و تاثیر آن بر افزایش تعادل این افراد بوده است. پس از اصلاح ناهنجاری‌ها مشاهده گردید که ثبات کلی و ثبات قدامی-خلفی بهبود یافته است؛ بنابراین می­توان این پروتکل اصلاحی را به­عنوان روشی مؤثر، جهت بهبود پاسچر و افزایش تعادل در افراد مبتلا به سندرم متقاطع فوقانی به متخصصین توصیه نمود.

کلیدواژه‌ها

موضوعات


عنوان مقاله [English]

Effect of Eight Weeks of Corrective Exercises Carried Out in Water on Static and Semi Dynamic Balance on Students with Upper Crossed Syndrome )Janda approach(

نویسندگان [English]

  • Hossein Ahmadi 1
  • Ali Yalfani 2
  • Farzaneh Gandomi 3
1 Master of Science. Department of Sport Injuries and Corrective Exercise, University of Bu-Ali, Hamedan, Iran.
2 Associate Professor, Department of Sports Rehabilitation, Faculty of Physical Education and Sport Sciences, Bu-Ali Sina University, Hamadan, Iran
3 Assistant Professor, Sport Injuries and Corrective Exercises Department, Sport Sciences Faculty, Razi University, Kermanshah, Iran.
چکیده [English]

Background and Aims: The upper crossed syndrome is a type of musculoskeletal disorder in the upper extremity, leading to deformities such as forward head, round shoulder, and hyper kyphosis. The aim of the present study was to investigate the effect of eight weeks of corrective exercises carried out in water on static and semi dynamic balance on patients with upper crossed syndrome (UCS).
Materials and Methods: In the current randomized controlled clinical trial, after initial screening, 30 students with UCS were selected and were assigned randomly into experimental (n=14) and control (n=16) groups. Before and after the intervention, static and semi dynamic balance variables were measured using Biodex Balance System (BBS). Data was analyzed in SPSS, version 20 (Inc, Chicago, IL). Paired sample t-test was used to compare the mean of the pretest to posttest and independent t-test was run to compare the differences between the two groupsgroups with the significance level set at 0.05.
Results: The results showed that the experimental group had significant improvement in static (P= 0.005) and semi dynamic balance (P= 0.002) (overall stability), as well as in static (P= 0.001) and semi dynamic balance (P= 0.003) (the anterior – posterior stability). But in the static (P = 0.720) and semi dynamic (P = 0.426) balance (lateral stability), the effect was not significant.
Conclusion: According to the results, in the current study, the focus of the corrective exercises protocol was on postural correction and its effects on balance improvement. The overall stability and the stability of the anterior-posterior direction improved after abnormalities correction. So, this protocol can be recommended as an effective protocol to improve posture and balance in the patients with upper crossed syndrome.

کلیدواژه‌ها [English]

  • Balance
  • Aquatic therapy
  • Corrective exercises
  • Upper crossed syndrome
  1. Oh KY, Kim SA, Lee SY, Lee YS. Comparison of manual balance and balance board tests in healthy adults. Annals of rehabilitation medicine. 2011; 35(6):873.##
  2. Prentice, W E, & Kaminski T W. Rehabilitation techniques for sports medicine and athletic training, 5nd. New York: McGraw-Hill, 2011. P.87-112. ##
  3. Houglum, PA. Therapeutic exercise for athletic injuries. Human Kinetics, 2nd. 2001. P.34-117. ##
  4. Sahrmann S, Azevedo DC, & Van Dillen L. Diagnosis and treatment of movement system impairment syndromes. Brazilian Journal of Physical Therapy, 2017. ##
  5. Morris CE, Bonnefin D, & Darville C. The Torsional Upper Crossed Syndrome: A multi-planar update to Janda's model, with a case series introduction of the mid-pectoral fascial lesion as an associated etiological factor. Journal of bodywork and movement therapies, 2015; 19(4), 681-689. ##
  6. Neupane S, Ali U, Mathew A. Text Neck Syndrome-Systematic Review. Imperial J Interdiscipl Res. 2017; 3(7):141-8. ##
  7. Nemmers TM & Miller J W. Factors influencing balance in healthy community-dwelling women age 60 and older. Journal of Geriatric Physical Therapy, 2008; 31(3), 93##
  8. Kang JH, Park RY, Lee SJ, Kim JY, Yoon SR, Jung KI. The effect of the forward head posture on postural balance in long time computer based worker. Annals of rehabilitation medicine. 2012;36(1):98. ##
  9. Sinaki M. Postural Changes in Osteoporosis: Musculoskeletal Consequences. InNon-Pharmacological Management of Osteoporosis 2017 (pp. 207-217). Springer, Cham. ##
  10. Eum R, Leveille SG, Kiely D K, Kiel DP, Samelson E J, & Bean JF.  Is kyphosis related to mobility, balance and disability? American journal of physical medicine & rehabilitation/Association of Academic Physiatrists, 2013; 92(11), 980. ##
  11. Lee J H. Effects of forward head posture on static and semidynamic balance control. Journal of physical therapy science, 2016; 28(1), 274-277. ##
  12. Jang HJ, Hughes LC, Oh DW, Kim SY. Effects of Corrective Exercise for Thoracic Hyperkyphosis on Posture, Balance, and Well-Being in Older Women: A Double-Blind, Group-Matched Design. Journal of geriatric physical therapy (2001). 2017 Sep. ##
  13. Singla D, Veqar Z. Association between forward head, rounded shoulders, and increased thoracic kyphosis: a review of the literature. J Chiropr Med. 2017;16(3):220-9##
  14. Zhu Z, Cui L, Yin M, Yu Y, Zhou X, Wang H, Yan H. Hydrotherapy vs. conventional land-based exercise for improving walking and balance after stroke: a randomized controlled trial. J Clinical rehabilitation. 2016;30(6):587-93. ##
  15. Faul F, Erdfelder E, Lang AG, Buchner A. G* Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39(2):175-91##
  16. Harman K, Hubley-Kozey CL, Butler H. Effectiveness of an exercise program to improve forward head posture in normal adults: a randomized, controlled 10-week trial. J Man Manip Ther. 2005;13(3):163-76. ##
  17. Ruivo RM, Pezarat-Correia P, Carita AI. Intrarater and interrater reliability of photographic measurement of upper-body standing posture of adolescents. Journal of manipulative and physiological therapeutics. 2015 Jan 1; 38(1):74-80. ##
  18. Seidi F, Rajabi R, Ebrahimi E, Alizadeh MH, Daneshmandi H. The effect of a 10-week selected corrective exercise program on postural thoracic kyphosis deformity. J Sport Med 2013; 5-22. [In Persian] ##
  19. Quek J, Pua YH, Clark RA, Bryant AL. Effects of thoracic kyphosis and forward head posture on cervical range of motion in older adults. Manual therapy. 2013 Feb 1; 18(1):65-71. ##
  20. Teixeira FA, Carvalho GA. Reliability and validity of thoracic kyphosis measurements using flexicurve method. Brazilian Journal of Physical Therapy. 2007 Jun; 11(3):199-204. ##
  21. Seidi F. The effect of a 12-week corrective exercises program on Forward head and shoulder deformities. J Sport Med Rev 2014; 5(14): 31-44. [In Persian] ##
  22. Yalfani A, Karami S, Gandomi F. The effect of a new balance training period in the land and water oninstability index, pain, and balance in the athletes with chronic ankle instability. J Shahid Sadoughi Uni Med Sci 2018; 26(5): 374-84. [In Persian] ##
  23. Arifin N, Osman NAA, & Abas WABW. Intrarater test-retest reliability of static and semidynamic stability indexes measurement using the biodex stability system during unilateral stance. J of applied biomechanics, 2014; 30(2), .300-304##
  24. Page P, Frank C, Lardner R. Assessment and treatment of muscle imbalance: the Janda approach. Human kinetics. 2010; 38-56. ##
  25. Falla D, Jull G, Hodges PW. Feedforward activity of the cervical flexor muscles during voluntary arm movements is delayed in chronic neck pain. J Experimental brain research. 2004; 157(1):43-8. ##
  26. Murphy DR, editor. Conservative management of cervical spine syndromes. McGraw-hill professional; 2000. ##
  27. Kisner C, Colby LA, Borstad J. Therapeutic exercise: Foundations and techniques. Fa Davis; 2017 Oct 18:110-370. ##
  28. Booth CE. Water exercise and its effect on balance and gait to reduce the risk of falling in older adults. Activities, adaptation & aging. 2004; 28(4):45-57. ##
  29. Resende SM, Rassi CM. Effects of hydrotherapy in balance and prevention of falls among elderly women. Brazilian Journal of Physical Therapy. 2008; 12(1):57-63. ##
  30. Avelar NC, Bastone AC, Alcântara MA, Gomes WF. Effectiveness of aquatic and non-aquatic lower limb muscle endurance training in the static and semidynamic balance of elderly people. Brazilian Journal of Physical Therapy. 2010; 14(3):229-36. ##
  31. Montagna JC, Santos BC, Battistuzzo CR, Loureiro AP. Effects of aquatic physiotherapy on the improvement of balance and corporal symmetry in stroke survivors. International journal of clinical and experimental medicine. 2014; 7(4):1182. ##
  32. Salehi S, Hedayati R, Ghorbani R. The comparative study of the effect of stabilization exercise and stretching-strengthening exercise on balance parameters in forward head posture patients. Journal of Rehabilitation. 2013; 14(1):50-60. [In Persian] ##
  33. Naderi A, Rezvani M H, Shaabani F, Bagheri S. Effect of Kyphosis Exercises on Physical Function, Postural Control and Quality of Life in Elderly Men With Hyperkyphosis. sija. 2019; 13 (4) :464-479##