تأثير تمرينات مقاومتي بر تغييرات برخي سايتوكاين‌ها و قدرت عضلاني در زنان مبتلا به مولتيپل اسكلروزيس

The Effect of 8 Weeks of Resistance Training on Changes in IL4, IL17 and Muscle Strength in Women with Multiple Sclerosis

ﻣﺘﺨﺼﺼﺎن ﺳﻼﻣﺘﯽ ﺑﻪ ﻧﻘﺶ ﻣﺆﺛﺮ ﺗﻤﺮﯾﻨﺎت ورزﺷﯽ ﺑﺮ ﺑﻬﺒﻮد ﺳﻄﺢ ﺳﻼﻣﺖ اﻓﺮاد داراي MS اﻋﺘﻘﺎد دارﻧﺪ. ﺗﺤﻘﯿﻖ ﺣﺎﺿﺮ ﺑﻪ ﺑﺮرﺳﯽ ﺗﻐﯿﯿﺮات اﯾﻨﺘﺮﻟﻮﮐﯿﻦ 17و4 ﺳﺮﻣﯽ و ﻫﻤﭽﻨﯿﻦ ﺗﻐﯿﯿﺮات ﻗﺪرت ﻋﻀﻼﻧﯽ ﺑﻪدﻧﺒﺎل 8 ﻫﻔﺘﻪ ﺗﻤﺮﯾﻨﺎت ﻣﻨﻈﻢ ﻣﻘﺎوﻣﺘﯽ در زﻧﺎن ﻣﺒﺘﻼ ﺑﻪ ام.اس ﻣﺸﻬﺪ ﭘﺮداﺧﺖ. ﻣﻄﺎﻟﻌﮥ ﺣﺎﺿﺮ از ﻧﻮع ﮐﺎرﺑﺮدي ﺑﺎ ﻃﺮح ﭘﯿﺶ و ﭘﺲآزﻣﻮن ﺑﻮد. 22 ﻧﻔﺮ از زﻧﺎن ﻣﺒﺘﻼ ﺑﻪ ﻣﺎﻟﺘﯿﭙﻞ اﺳﮑﻠﺮوزﯾﺲ در داﻣﻨﮥ ﺳﻨﯽ 25 ﺗﺎ40 ﺳﺎل و ﺑﺎ درﺟﮥ ﻧﺎﺗﻮاﻧﯽ )EDSS=4( ﺑﻪﺻﻮرت ﻫﺪﻓﻤﻨﺪ در دو ﮔﺮوه ﺗﺠﺮﺑﯽ و ﮐﻨﺘﺮل ﻗﺮار ﮔﺮﻓﺘﻨﺪ. ﮔﺮوه ﺗﻤﺮﯾﻨﯽ 8 ﻫﻔﺘﻪ، 3 ﺟﻠﺴﻪ ﺑﺎ ﺷﺪت 40 ﺗﺎ 60 درﺻﺪ ﯾﮏ ﺗﮑﺮار ﺑﯿﺸﯿﻨﻪ، ﺗﻤﺮﯾﻨﺎت را اﻧﺠﺎم دادﻧﺪ و ﮔﺮوه ﮐﻨﺘﺮل در ﻫﯿﭻ ﻓﻌﺎﻟﯿﺖ ﻣﻨﻈﻢ ﺑﺪﻧﯽ ﺷﺮﮐﺖ ﻧﮑﺮدﻧﺪ. ﻗﺒﻞ و ﺑﻌﺪ از دورة ﺗﻤﺮﯾﻨﯽ آزﻣﻮنﻫﺎي ﺗﻦﺳﻨﺠﯽ )ﺑﺎ اﺳﺘﻔﺎده از ﮐﺎﻟﯿﭙﺮ، ﻣﺘﺮ و ﺗﺮازو(، ﻗﺪرت ﺑﺎﻻﺗﻨﻪ و ﭘﺎﯾﯿﻦﺗﻨﻪ )ﺑﺎ آزﻣﻮن 1RM در ﺣﺮﮐﺎت ﭘﺮس ﺳﯿﻨﻪ و ﭘﺮس ﭘﺎ( و ﻧﻤﻮﻧﻪﮔﯿﺮي ﺧﻮن ﺑﺮاي ﺳﻨﺠﺶ ﻣﻘﺎدﯾﺮ اﯾﻨﺘﺮﻟﻮﮐﯿﻦ 17و4 اﻧﺠﺎم ﮔﺮﻓﺖ. از ﺗﺤﻠﯿﻞ وارﯾﺎﻧﺲ ﯾﮑﻄﺮﻓﻪ ﺑﺮاي ﺗﻔﺎوت اﺣﺘﻤﺎﻟﯽ در ﮔﺮوهﻫﺎ و آزﻣﻮن ﺗﯽ زوﺟﯽ ﺑﻪﻣﻨﻈﻮر ﺑﺮرﺳﯽ ﺗﻐﯿﯿﺮات درونﮔﺮوﻫﯽ ﺑﺎ اﺳﺘﻔﺎده از ﻧﺮماﻓﺰار SPSS ﻧﺴﺨﮥ 18 اﺳﺘﻔﺎده ﺷﺪ. ﺗﺤﻠﯿﻞ آﻣﺎري ﻧﺸﺎن داد ﻗﺪرت ﻋﻀﻼﻧﯽ آزﻣﻮدﻧﯽﻫﺎي ﮔﺮوه ﺗﺠﺮﺑﯽ ﻧﺴﺒﺖ ﺑﻪ ﮔﺮوه ﮐﻨﺘﺮل در دو ﺑﺨﺶ ﺑﺎﻻﺗﻨﻪ و ﭘﺎﯾﯿﻦﺗﻨﻪ اﻓﺰاﯾﺶ ﻣﻌﻨﺎداري داﺷﺖ )0/0001=P=0/001,P(. اﯾﻨﺘﺮﻟﻮﮐﯿﻦ 4 ﻧﯿﺰ در ﮔﺮوه ﺗﺠﺮﺑﯽ ﻧﺴﺒﺖ ﺑﻪ ﮔﺮوه ﮐﻨﺘﺮل اﻓﺰاﯾﺶ ﻣﻌﻨﺎداري ﻧﺸﺎن داد )0/002=P(، اﻣﺎ اﯾﻨﺘﺮﻟﻮﮐﯿﻦ 17 ﺑﯿﻦ دو ﮔﺮوه ﺗﻔﺎوﺗﯽ ﻧﺪاﺷﺖ. ﺑﻪﻧﻈﺮ ﻣﯽرﺳﺪ زﻧﺎن ﻣﺒﺘﻼ ﺑﻪ ﻣﻮﻟﺘﯿﭙﻞ اﺳﮑﻠﺮوزﯾﺲ ﺑﺮاي ﺑﻬﺒﻮد ﮐﺎراﯾﯽ ﺳﯿﺴﺘﻢ اﯾﻤﻨﯽ و ارﺗﻘﺎي ﺳﻄﺢ ﻗﺪرت ﺧﻮد ﺑﺘﻮاﻧﻨﺪ از ﺗﻤﺮﯾﻨﺎت ﻣﻨﻈﻢ ﻣﻘﺎوﻣﺘﯽ ﺑﺎ ﺷﺪت ﻣﺘﻮﺳﻂ ﺑﻬﺮه ﺑﺒﺮﻧﺪ.

Health professionals believe in the effective role of training in improving the health of MS patients. The present study investigated changes in serum IL4 and 17, as well as muscle strength changes after 8 weeks of regular resistance training in women with MS in Mashhad city. The present study was applied with pretest-posttest design. 22 women with multiple sclerosis in the age range of 25 to 40 years old and with disability (EDSS=4) were purposively assigned to experimental and control groups. The experimental group performed the training for 8 weeks, 3 sessions per week with 40-60% 1RM intensity and the control group did not participate in any regular physical activity. Before and after the training, anthropometric tests (using caliper, tape measure and level), upper and lower limb strength (with 1RM test in chest and leg presses) and blood sampling were used to measure the levels of interleukin 17 and 4. One-way ANOVA was used for potential differences in the groups and paired t test was used to examine the within-group changes using SPSS software version 18. Statistical analysis showed that the muscle strength of the subjects in the experimental group was significantly higher in both upper and lower parts of the trunk than the control group (P=0.001, P=0.0001). Interleukin 4 showed a significant increase in the experimental group compared with the control group (P=0.002), but interleukin 17 did not differ between the two groups. It seems that women with multiple sclerosis can use regular resistance training with moderate intensity to improve their immune system's efficiency and enhance their level of strength.