پديد آورندگان :
رﺿﺎﯾﯽ، ﻫﺎﻧﯿﻪ دانشگاه شيراز , ﮐﻮﺷﮑﯽ ﺟﻬﺮﻣﯽ، ﻣﺮﯾﻢ دانشگاه شيراز , ﺛﺎﻟﺜﯽ، ﻣﺤﺴﻦ دانشگاه شيراز , اﯾﺰدي، ﺻﺎدق داﻧﺸﮕﺎه ﻋﻠﻮمﭘﺰﺷﮑﯽ ﺷﯿﺮاز
كليدواژه :
آﻣﺎدﮔﯽ ﺟﺴﻤﺎﻧﯽ , ﺗﻤﺮﯾﻨﺎت ﺛﺒﺎت ﻣﺮﮐﺰي , وﯾﺘﺎﻣﯿﻦ D , ﺑﯿﻤﺎري ام.اس
چكيده فارسي :
ﻫﺪف از ﭘﮋوﻫﺶ ﺣﺎﺿﺮ، ﺗﻌﯿﯿﻦ ﺗﺄﺛﯿﺮ ﺗﻤﺮﯾﻨﺎت ﺛﺒﺎت ﻣﺮﮐﺰي و وﯾﺘﺎﻣﯿﻦ D ﺑﺮ ﺷﺎﺧﺺﻫﺎي آﻣﺎدﮔﯽ ﺟﺴﻤﺎﻧﯽ زﻧﺎن ﺟﻮان ﻣﺒﺘﻼ ﺑﻪ ام.اس ﺑﻮد. ﺑﺪﯾﻦﻣﻨﻈﻮر، 36 زن ﻣﺒﺘﻼ ﺑﻪ ام.اس از ﻧﻮع ﻋﻮدﮐﻨﻨﺪه ـ ﻓﺮوﮐﺶﮐﻨﻨﺪه ﺑﺎ ﺳﻄﺢ وﺿﻌﯿﺖ ﻧﺎﺗﻮاﻧﯽ ﮔﺴﺘﺮش ﯾﺎﻓﺘﻪ) EDSS ( ﮐﻤﺘﺮ ﯾﺎ ﻣﺴﺎوي ﺳﻪ )ﺑﺎ ﻣﯿﺎﻧﮕﯿﻦ ﺳﻨﯽ 6/57±32/72 ﺳﺎل؛ ﻗﺪ 4/23±164 ﺳﺎﻧﺘﯽﻣﺘﺮ؛ وزن 11/4±65/1 ﮐﯿﻠﻮﮔﺮم؛ ﺳﺎﺑﻘﮥ ﺑﯿﻤﺎري 1/20±4 ﺳﺎل( ﺑﻪﻃﻮر داوﻃﻠﺒﺎﻧﻪ در ﭘﮋوﻫﺶ ﺷﺮﮐﺖ ﮐﺮدﻧﺪ و ﺑﻪﺷﮑﻞ ﺗﺼﺎدﻓﯽ ﺑﻪ ﭼﻬﺎر ﮔﺮوه )ﺷﺎﻣﻞ: ﺳﻪ ﮔﺮوه ﻣﮑﻤﻞ، ﺗﻤﺮﯾﻦ و ﺗﺮﮐﯿﺐ ﺗﻤﺮﯾﻦ + ﻣﮑﻤﻞ و ﮔﺮوه ﮐﻨﺘﺮل( ﺗﻘﺴﯿﻢ ﺷﺪﻧﺪ. ﻗﺒﻞ و ﺑﻌﺪ از دورة آزﻣﺎﯾﺶ، ﺗﻤﺎﻣﯽ آزﻣﻮدﻧﯽﻫﺎ در آزﻣﻮن ﻗﺪرت ﻋﻀﻼت اﮐﺴﺘﻨﺴﻮر ﺑﺎﻻﺗﻨﻪ ﺑﺎ دﯾﻨﺎﻣﻮﻣﺘﺮ، اﺳﺘﻘﺎﻣﺖ ﻋﻀﻼت ﻓﻠﮑﺴﻮر ﺗﻨﻪ ﺑﺎ آزﻣﻮن ﻧﮕﻪداري ﺗﻨﻪ در زاوﯾﮥ 60 درﺟﻪ، اﻧﻌﻄﺎفﭘﺬﯾﺮي ﺑﺎ آزﻣﻮن وﻟﺰ، ﻫﻤﺎﻫﻨﮕﯽ ﺑﺎ آزﻣﻮن ﭘﺮﺗﺎب ﭘﯽدرﭘﯽ ﺗﻮپ ﺗﻨﯿﺲ و ﺗﻌﺎدل ﺑﺎ آزﻣﻮن اﯾﺴﺘﺎدن ﺗﮏﭘﺎ ﺷﺮﮐﺖ ﮐﺮدﻧﺪ. ﺗﻤﺮﯾﻨﺎت ﺛﺒﺎت ﻣﺮﮐﺰي ﺑﻪﻣﺪت ﻫﺸﺖ ﻫﻔﺘﻪ و ﺑﻪﺻﻮرت ﺳﻪﺑﺎر در ﻫﻔﺘﻪ ﺑﻪﻃﻮر ﻓﺰاﯾﻨﺪه )ﺟﻠﺴﮥ اول، ﭘﻨﺞ ﺛﺎﻧﯿﻪ ﺣﻔﻆ ﺣﺮﮐﺖ ﺑﺎ ﺷﺶ ﺗﮑﺮار ﺗﺎ ﺟﻠﺴﮥ آﺧﺮ، ﻫﺸﺖ ﺛﺎﻧﯿﻪ ﺣﻔﻆ ﺣﺮﮐﺖ ﺑﺎ 10 ﺗﮑﺮار( اﺟﺮا ﮔﺸﺖ. ﮔﺮوهﻫﺎي ﻣﮑﻤﻞ ﻫﺮ دو ﻫﻔﺘﻪ، ﯾﮏﺑﺎرﮐﭙﺴﻮل 1500 IU وﯾﺘﺎﻣﯿﻦ D را ﻣﺼﺮف ﻣﯽﮐﺮدﻧﺪ. از آزﻣﻮن آﻣﺎري ﺗﺤﻠﯿﻞ ﮐﻮوارﯾﺎﻧﺲ ﺑﺮاي ارزﯾﺎﺑﯽ اﻃﻼﻋﺎت اﺳﺘﻔﺎده ﺷﺪ. ﯾﺎﻓﺘﻪﻫﺎ ﻧﺸﺎن ﻣﯽدﻫﺪ ﮐﻪ ﺗﻤﺮﯾﻦ ورزﺷﯽ ﻫﻤﺮاه ﺑﺎ ﻣﺼﺮف وﯾﺘﺎﻣﯿﻦ D درﻣﻘﺎﯾﺴﻪ ﺑﺎ ﮔﺮوه ﮐﻨﺘﺮل ﻣﻮﺟﺐ ﺑﻬﺒﻮد ﻗﺪرت (P=0.002) و اﺳﺘﻘﺎﻣﺖ (0.001=P) ( ﻋﻀﻼﻧﯽ، اﻧﻌﻄﺎفﭘﺬﯾﺮي (P=0.001)، ﻫﻤﺎﻫﻨﮕﯽ )P=0.001( و ﺗﻌﺎدل )P=0.001( ﺷﺪه و درﻣﻘﺎﯾﺴﻪ ﺑﺎ ﻣﺼﺮف وﯾﺘﺎﻣﯿﻦ D، ﻣﻨﺠﺮ ﺑﻪ ﺑﻬﺒﻮد اﺳﺘﻘﺎﻣﺖ ﻋﻀﻼﻧﯽ (P=0.001)، اﻧﻌﻄﺎفﭘﺬﯾﺮي (0.001=P)، ﻫﻤﺎﻫﻨﮕﯽ (P=0.001) و ﺗﻌﺎدل (P=0.001) ﻣﯽﮔﺮدد. ﻫﻤﭽﻨﯿﻦ، ﺗﻤﺮﯾﻦ ورزﺷﯽ ﺑﺪون ﻣﺼﺮف وﯾﺘﺎﻣﯿﻦ D درﻣﻘﺎﯾﺴﻪ ﺑﺎ ﮔﺮوه ﻣﺼﺮف وﯾﺘﺎﻣﯿﻦ D ﻣﻮﺟﺐ ﺑﻬﺒﻮد اﺳﺘﻘﺎﻣﺖ ﻋﻀﻼﻧﯽ (P=0.015) ﺷﺪه و درﻣﻘﺎﯾﺴﻪ ﺑﺎ ﮔﺮوه ﮐﻨﺘﺮل ﻣﻮﺟﺐ ﺑﻬﺒﻮد اﺳﺘﻘﺎﻣﺖ (P=0.002)، ﻫﻤﺎﻫﻨﮕﯽ )P=0.031( و ﺗﻌﺎدل(P=0.001) ﮔﺸﺘﻪ اﺳﺖ؛ اﻣﺎ ﻣﺼﺮف وﯾﺘﺎﻣﯿﻦ D ﺑﻪﺗﻨﻬﺎﯾﯽ، ﺗﺄﺛﯿﺮ ﻣﺜﺒﺖ و ﻣﻌﻨﺎداري ﺑﺮ ﻣﺘﻐﯿﺮﻫﺎي ﭘﮋوﻫﺶ ﻧﺪاﺷﺖ (P>0.05). ﺑﺎ ﺗﻮﺟﻪ ﺑﻪ ﻧﺘﺎﯾﺞ ﭘﮋوﻫﺶ ﻣﯽﺗﻮان ﮔﻔﺖ ﮐﻪ ﺑﻪﺗﺮﺗﯿﺐ اوﻟﻮﯾﺖ، ﺗﻤﺮﯾﻦ ورزﺷﯽ ﻫﻤﺮاه ﺑﺎ ﻣﺼﺮف وﯾﺘﺎﻣﯿﻦ D و ﺳﭙﺲ ﺗﻤﺮﯾﻦ ورزﺷﯽ، ﺗﺄﺛﯿﺮ ﻣﻄﻠﻮﺑﯽ ﺑﺮ ﺑﻬﺒﻮد ﺷﺎﺧﺺﻫﺎي آﻣﺎدﮔﯽ ﺟﺴﻤﺎﻧﯽ دارد.
چكيده لاتين :
The purpose of present study was evaluating the influence of core stability exercise and vitamin D on some of physical fitness indices in young multiple sclerosis (MS) women. 36 relapsing remitting MS women with EDSS≤3 (age: 32.72±6.57y, height:164±4.23 cm, weight: 65.1±11.4 kg, disease duration:4±1.20) participated in the study voluntarily and were divided randomly to four groups including three experimental groups of supplementations (SUP), exercise, SUP + exercise and one control group. Before and after experimental period, all subjects participated in exercise tests including back muscle extensor strength test using dynamometer, muscular endurance of trunk using keeping trunk in angle of 60-degree, flexibility using Velez test, coordination test by repeated throwing of tennis ball, balance test using one leg stance. Core stability exercise was performed during 8 weeks and 3 times a week progressively (first session: keeping the motion for 5 S, with 6 repetitions, last session keeping the motion for 8 second with 10 repetition). Supplementation groups consumed 1500 IU vitamin D every two weeks. Statistical test of Analysis of Covariance was used for data analysis. Findings of the study indicated that in SUP + exercise group compared to control group significant increasing was observed in muscle strength (P=0.002) and endurance (P=0.001), flexibility (P=0.001) coordination (P=0.001) and balance(P=0.001), and compared to SUP significant increasing was found in muscle endurance (P=0.001), flexibility (P=0.001), coordination (P=0.001) and balance (P=0.001). Exercise (without SUP) compared to SUP caused increasing of muscle endurance (P=0.015), and compared to control group improved muscle endurance (P=0.02), coordination (P=0.031) and balance (P=0.001). SUP by itself did not cause any significant improvement in none of variables (P>0.05). According to priority exercise+SUP and exercise indicate positive influence on improving physical fitness indices.
