بررسـی حس عمقی و کنترل کمری-لگنی، در زنان با و بدون دیاستازیس رکتی و ارتباط آنها با درد و ناتوانی کمری پس از زایمان

نوع مقاله : مقاله پژوهشی

نویسندگان

1 دانشیار، دکتری توانبخشی ورزشی، گروه آسیب شناسی ورزشی و حرکات اصلاحی، دانشکده تربیت بدنی، دانشگاه بوعلی سینا، همدان، ایران

2 دانشجوی کارشناسی ارشد، گروه آسیب شناسی ورزشی و حرکات اصلاحی، دانشکده تربیت بدنی، دانشگاه بوعلی سینا، همدان، ایران

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

4 استادیار، دکترای تخصصی و جراح زنان و زایمان، گروه زنان و زایمان، دانشگاه علوم پزشکی همدان، همدان، ایران

چکیده

مقدمه و اهداف
به افزایش فاصله بین دو عضله راست شکمی در دوران بارداری و پس از آن دیاستازیس رکتی می­ گویند. شیوع این عارضه در زنان پس از زایمان، 66 درصد است. با توجه به بی­ثباتی ستون فقرات و لگن در این افراد، اختلال در حس عمقی و کنترل کمری-لگنی می­تواند یکی از عوامل درد و ناتوانی کمری در آنها باشد؛ در نتیجه هدف از مقاله حاضر بررسـی وضعیت حس عمقی و کنترل کمری-لگنی، در زنان با و بدون دیاستازیس رکتی و ارتباط آنها با درد و ناتوانی کمری پس از زایمان است.
مواد و روش‌ها
18 خانم سالم با میانگین سن 4/55±25/77 سال و 18 خانم مبتلا به دیاستازیس رکتوس با میانگین سنی 5/69±28/83 سال که 2 الی 5 ماه از زایمان آنها گذشته بود، در مطالعه شرکت داشتند. میزان خطای بازسازی زاویه 30 درجه فلکشن کمر با گونیامتر در وضعیت چشم بسته و در حالت ایستاده ارزیابی شد؛  کنترل کمری-لگنی نیز با استفاده از تست میدانی گام جانبی(Lateral Step Down)  اندازه­ گیری شد.
یافته‌ها
یافته­های مطالعه نشان داد که میانگین خطای بازسازی زاویه فلکشن کمری-لگنی در گروه مبتلا به دیاستازیس رکتی به ­طور معناداری بیشتر از گروه سالم بود (0/0001=P). در تست گام جانبی نیز بین گروه سالم و مبتلا به این عارضه تفاوت معناداری دیده شد (0/0001=P).
نتیجه­ گیری
نتایج مطالعه حاضر نشان داد دیاستازیس رکتی که در برخی از خانوم­ها پس از زایمان رخ می­دهد، می­تواند مشکلاتی چون اختلال در حس عمقی و کنترل کمری-لگنی ایجاد نموده که ممکن است به درد و ناتوانی در کمر بیانجامد.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

Proprioception and Control of the Lumbopelvic in Women with and without Diastasis Rectus and Their Relationship with Postpartum Pain and Disability

نویسندگان [English]

  • Ali Yalfani 1
  • Nahid Bigdeli 2
  • Farzaneh Gandomi 3
  • Roghayeh Anvari Aliabad 4
1 Associate Professor, Sport rehabilitation Ph.D, Department of Sport Injuries and Corrective Exercises, Bu Ali Sina University, Hamedan, Iran
2 Master of Sport Injuries and Corrective Exercises, Department of Sport Injuries and Corrective Exercises, Bu Ali Sina University, Hamedan, Iran
3 Assistant Professor, Sport Injuries and Corrective Exercises Department, Sport Sciences Faculty, Razi University, Kermanshah, Iran.
4 Assistant Professor, Department of Gynecology, School of medicine, Hamadan University of Medical Sciences, Hamadan, Iran
چکیده [English]

Background and Aims: Increase in the inter-recti abdominal muscle during pregnancy and postpartum is called diastasis rectus abdominis. Usually this distance must be more than 20 mm above the umbilicus and 25 mm in the umbilicus to be diagnosed. The prevalence of this disorder in women after postpartum is 66%. Due to the instability of the spine and pelvis in these individuals, impairment in proprioception and lumbopelvic control can be the causes of lumbar pain and disability. Thus, the present research was conducted to study the proprioception and lumbopelvic control in women with and without diastasis rectus and their relationship with postpartum pain and disability.
Materials and methods: A total of 18 healthy persons, with the mean age of 25/77±4/55 years, and 18 patients with diastasis rectus, with the mean age of 28/88±5/69 years, with 2-3 years passed since their delivery, were recruited. The amount of error in the reconstruction of the lumbar position was measured using a goniometer with the eye closed while standing at a 30° angle of lumbar flexion and lumbo-pelvic control with lateral step down field test. The results of the tests were calculated and analyzed.
Results:Mean error in 30° angle lumbar flexion reconstruction in patients with diastasis rectus was significantly higher than that in the healthy group (P <0.05). Also, in lateral step down test, there was a significant difference between healthy groups and patients suffering from this disorder (P <0.05).
Conclusion: The results of the present study showed that diastasis rectus causes problems in women with this problem, like disorder in proprioception and lumbopelvic control, which may lead to low back pain and disability.

کلیدواژه‌ها [English]

  • Diastasis Rectus
  • Linea Alba
  • Lumbopelvic Proprioceptive
  • Lumbopelvic Control
  • Low Back Pain

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دوماهنامه علمی - پژوهشی طب توانبخشی
دوره 9، شماره 4
دی 1399
صفحه 257-267

فایل ها

سابقه مقاله

  • تاریخ دریافت: 24 بهمن 1398
  • تاریخ بازنگری: 16 فروردین 1399
  • تاریخ پذیرش: 27 فروردین 1399
  • تاریخ اولین انتشار: 01 دی 1399

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