اثر هشت هفته ورزش در آب بر قدرت عضلات اندام تحتاني در بيماران مبتلا به پاركينسون

Effects of 8 weeks of water-based exercise on the lower limb muscles strength in Parkinson's patients

ﺳﺎﺑﻘﻪ و ﻫﺪف: ﺿﻌﻒ ﻗﺪرت ﻋﻀﻼﻧﯽ ﺑﻪ وﯾﮋه ﺿﻌﻒ ﻋﻀﻼت اﻧﺪام ﺗﺤﺘﺎﻧﯽ از ﻧﺸﺎﻧﻪﻫﺎ و ﻋـﻮارض ﺑﯿﻤـﺎري ﭘﺎرﮐﯿﻨﺴـﻮن ﻣﯽ ﺑﺎﺷﺪ ﮐﻪ در ﺗﺮﮐﯿﺐ ﺑﺎ ﺳﺎﯾﺮ ﻋﻼﺋﻢ و ﻧﺸﺎﻧﻪ ﻫﺎ ﻣﺸﮑﻼت ﺣﺮﮐﺘﯽ ﻣﺨﺘﻠﻔﯽ ﺑﻪ دﻧﺒﺎل ﺧﻮاﻫﺪ داﺷـﺖ. اﯾـﻦ ﺗﺤﻘﯿﻖ ﺑـﺮ اي ارزﯾﺎﺑﯽ اﺛﺮﺑﺨﺸﯽ ﯾﮏ ﺑﺮﻧﺎﻣﻪ ورزش در آب ﺑﺮ ﻗﺪرت ﻋﻀﻼت اﻧﺪام ﺗﺤﺘﺎﻧﯽ در ﺑﯿﻤﺎران ﻣﺒﺘﻼ ﺑﻪ ﭘﺎرﮐﯿﻨﺴﻮن ﻃﺮاﺣﯽ ﺷﺪه اﺳﺖ. ﻣﻮاد و روش ﻫﺎ: در ﯾﮏ ﺗﺤﻘﯿﻖ ﻧﯿﻤﻪ ﺗﺠﺮﺑﯽ، ﺗﻌﺪاد 20 ﺑﯿﻤﺎر ﻣﺮاﺟﻌﻪ ﮐﻨﻨﺪه ﺑﻪ ﻣﻄﺐ ﻣﺘﺨﺼﺼﯿﻦ ﻣﻐـﺰ و اﻋﺼـﺎب ﺷـﻬﺮ اﺻﻔﻬﺎن ﺑﻪ ﻃﻮر داوﻃﻠﺒﺎﻧﻪ اﻧﺘﺨﺎب و ﺳﭙﺲ ﺑﻪ ﺻﻮرت ﺗﺼﺎدﻓﯽ در دو ﮔﺮوه ﺗﺠﺮﺑﯽ (10) ﻧﻔﺮ و ﮐﻨﺘﺮل (10) ﻧﻔﺮ ﻗﺮار ﮔﺮﻓﺘﻨﺪ. آزﻣﻮدﻧﯽ ﻫﺎي ﮔﺮوه ورزش در آب ﺑﻪ ﻣﺪت ﻫﺸﺖ ﻫﻔﺘﻪ، ﻫﺮ ﻫﻔﺘﻪ ﺳﻪ ﺟﻠﺴـﻪ ي 60 دﻗﯿﻘـﻪ اي ﺑـﻪ اﻧﺠـﺎم ﻓﻌﺎﻟﯿـﺖ در آب ﭘﺮداﺧﺘﻨﺪ، در ﺣﺎﻟﯽ ﮐﻪ ﮔﺮوه ﮐﻨﺘﺮل در اﯾﻦ ﻣﺪت ﻫﯿﭻ ﮔﻮﻧﻪ ﻓﻌﺎﻟﯿﺖ ورزﺷﯽ را ﺗﺠﺮﺑﻪ ﻧﻨﻤﻮدﻧﺪ و ﻓﻘﻂ ﭘﯿﮕـﺮي ﺷـﺪﻧﺪ. در اﺑﺘﺪا و اﻧﺘﻬﺎي دوره، ﻗﺪرت ﻋﻀﻼت اﻧﺪام ﺗﺤﺘﺎﻧﯽ ﺑﺮاي اﻧﺠﺎم ﺣﺮﮐﺎت اﮐﺴﺘﻨﺸﻦ و ﻓﻠﮑﺸﻦ در دو ﺳﺮﻋﺖ 60 و 180 درﺟﻪ ﺑﺮ ﺛﺎﻧﯿﻪ ﺗﻮﺳﻂ دﺳﺘﮕﺎه ﻧﯿﺮوﺳﻨﺞ آﯾﺰوﮐﻨﺘﯿﮏ (Biodex, Systems III) ارزﯾﺎﺑﯽ ﺷﺪ. ﯾﺎﻓﺘﻪ ﻫﺎ: اﻓﺰاﯾﺶ ﻣﻌﻨﺎداري را در اوج ﮔﺸﺘﺎور ﻓﻠﮑﺴﻮرﻫﺎ و اﮐﺴﺘﻨﺴﻮرﻫﺎي ﻋﻀﻼت زاﻧﻮ در ﻫـﺮ دو ﺳـﺮﻋﺖ 60 و 180 درﺟﻪ ﺑﺮ ﺛﺎﻧﯿﻪ در ﮔﺮوه ﺗﻤﺮﯾﻦ ﻗﺒﻞ و ﭘﺲ از ﻫﺸﺖ ﻫﻔﺘﻪ ورزش در آب ﻣﺸﺎﻫﺪه ﺷﺪ. درﺻﺪ ﺗﻐﯿﯿﺮات اﺛﺮ ﻣﺜﺒﺖ ورزش در آب را ﺗﺄﯾﯿﺪ ﮐﺮد، ﺑﻪ ﻃﻮري ﮐﻪ درﺻﺪ ﺗﻐﯿﯿﺮات در اوج ﮔﺸﺘﺎور ﻓﻠﮑﺴﻮرﻫﺎ و اﮐﺴﺘﻨﺴﻮرﻫﺎي ﻋﻀﻼت زاﻧﻮ در ﻫﺮ دو ﺳﺮﻋﺖ 60 و 180 درﺟﻪ ﺑﺮ ﺛﺎﻧﯿﻪ ﭘﺲ از ﻣﻄﺎﻟﻌﻪ ﺑﯿﻦ دو ﮔﺮوه ﻣﻌﻨﺎدار ﺑﻮد (0/05>p). ﻧﺘﯿﺠﻪ ﮔﯿﺮي: ﻣﺎ ﻧﺘﯿﺠﻪ ﮔﺮﻓﺘﯿﻢ ﮐﻪ ورزش در آب ﻣﯽ ﺗﻮاﻧﺪ ﺑﻪ ﻋﻨﻮان ﯾﮏ روش درﻣﺎﻧﯽ ﻣﻔﯿﺪ و ﻣﺆﺛﺮ در ﺟﻬـﺖ ﺑﻬﺒـﻮد ﻗﺪرت ﻋﻀﻼت ﭘﺎﯾﯿﻦ ﺗﻨﻪ در ﺑﯿﻤﺎران ﻣﺒﺘﻼ ﺑﻪ ﭘﺎرﮐﯿﻨﺴﻮن ﻣﻮرد اﺳﺘﻔﺎده ﻗﺮار ﮔﯿﺮد.

Introduction: Muscular weakness, particularly weakness of lower limb muscles is a symptom of Parkinson disease, which, together with other symptoms, will result in a variety of movement disorders. This research is designed to assess the effectiveness of a water-based exercise program on the lower limb muscles strength of Parkinson patients' knee joints. Materials and Methods: In a semi-experimental study, 20 patients who referred to neurologist offices in the city of Isfahan volunteered for this study, and then randomly selected an exercise (n=10) and control (n=10) groups. Subjects of exercise group completed a eight-week water-based exercise training program consisted of three sessions per week, each session lasting 45 to 60 minutes, while the control group were followed and during this period they did not experience any exercise. Peak torque of the knee flexors and extensors using isokinetic dynamometer (Biodex, Systems III) during eccentric and concentric contractions at velocities of 60 and 180 degrees/s before and after 8 weeks of water-based exercise program were measured. Results: The exercise group demonstrated significant increases in peak torque of the knee flexors and extensors at velocities of 60 and 180 degrees/s before and after 8 weeks of water-based exercise program (p<0.05). The percentage change confirmed the positive effect of water-based exercise training, the change in peak torque of the knee flexors and extensors at velocities of 60 and 180 degrees/s after study being significantly different between the groups (p<0.05). Conclusion: We conclude that water-exercise can be a useful and effective treatment method for improvement strengthening the muscles in Parkinson patients'.