مقايسه اثر تمرين منتخب ورزشي، ذهني و تركيبي بر اجراي مهارت هاي حركتي كودكان پسر داراي اختلال هماهنگي رشدي

The comparison of physical, mental and compound training effect on motor development of boys with Developmental coordination disorder

زمينه و هدف پنج تا شش‌درصد از كودكان مقطع دبستان دچار نقص هماهنگي رشدي هستند. هدف، مقايسه تمرين منتخب ورزشي، ذهني، تركيبي و گزينش بهترين روش براي رشد مهارت حركتي پسران داراي اختلال هماهنگي رشدي بود. روش‌بررسي طرح پژوهش تجربي از نوع پيش‌آزمون-‌پس‌آزمون، با گروه گواه بود. تعداد 55 پسر نه تا ده‌ساله شيرازي توسط پرسش‌نامه اختلال هماهنگي رشدي و آزمون ارزيابي حركتي كودكان-2 غربال و پس از همسان‌سازي شفافيت تصويرسازي ديداري به‌شكل تصادفي در سه گروه تجربي (چهارده نفر) و يك گروه گواه (سيزده نفر) قرار گرفتند. مداخله به‌شكل تمرين بدني، ذهني و تركيبي به‌‌مدت 24 جلسه‌ 45دقيقه‌اي اجرا شد و به‌منظور تحليل داده‌ها از آزمون شاپيرو-ويلك براي نرمال‌بودن توزيع متغيرهاي وابسته، آزمون تحليل كوواريانس با استفاده از پيش‌آزمون به‌عنوان كووريت و آزمون تي هم‌بسته براي ارزيابي اثر مداخله، آزمون لوين براي همگني واريانس‌ها و از آزمون بونفروني به‌عنوان آزمون تعقيبي استفاده ‌شد. يافته‌ها يافته‌هاي پژوهش نشان داد ميانگين و انحراف معيار اجراي مهارت‌هاي حركتي سه گروه تمرين ذهني، بدني‌ و تركيبي در نوبت پس‌آزمون به‌ترتيب (3٫671±62٫231 و 4٫235±63٫502 و 2٫773 ±65٫794=mean±sd) در مقايسه با نوبت پيش‌آزمون بهبود معناداري داشت (0٫001>p). مقايسه بين گروه‌ها از سودمندي بيشتر تمرين تركيبي به‌شكل معناداري (0٫001>p) حمايت كرد. نتيجه‌گيري نتايج نشان داد در پسران نه تا ده‌ساله داراي اختلال هماهنگي رشدي، مي‌توان با استفاده از تمرين ورزشي و ذهني، بهبودي معناداري در رشد مهارت‌هاي حركتي ايجاد كرد و بهترين شيوه براي تسريع رشد حركتي استفاده از تمرينات تركيبي است.

Background & Objective: Developmental coordination disorder (DCD) affects 5–6% of school-aged children. The impacts of DCD are also not just confined to daily activities and educational function, but are associated with poor physical health, fitness, psychological and social outcomes. The aim of this study was to compare effectiveness of different type of selected training programs (physical, mental and compound) to investigate the best intervention method in order to improve motor skills performance of children with developmental coordination disorder. Methods: This empirical study, pre and post-test with control group design consisted of 55 school age (9-10 year old) boys diagnosed to have developmental coordination disorder according to developmental coordination disorder questionnaire )ِDCDQ-07) and movement assessment battery for children second edition (MABC-2). The subjects were selected based on a degree of homogeneity of their answers to visual vividness questionnaire and accidentally divided to 4 groups, 3 training groups (physical, mental and compound) each group (n=14) and the control group (n=13). The programs include selected physical training in group, individual mental training conducting PETTLEP (physical, environment, task, timing, learning, emotion, perspective) method and a compound training, the one gives a training order in different turns (physical+ mental and vice versa). No intervention was assigned to control group. To modify cognitive and arousal effects induced by training order, counterbalance method was recruited. All measures were administered pre and post an 8-week 3 times a week training program involved 24 sessions of 45 min each. To identify the changes in motor skills performance associated with trainings Ancova and paired sample T-Test were conducted to detect differences between the pre- and post-test, after making sure of normal distribution of data utilizing Shapiro-Wilks normality test, Levene’s test was used for testing equality of variances and Post-Hoc comparisons were carried out with Bonfrroni test (set at 0.05). All data were analyzed using SPSS19 for windows. Results: Mean±SD score on all 3 training groups (mental, physical and compound) respectively indicates significant improvement (p<0.001) in motor skills performance from pre-test (58.851±4.102, 57.503±6.823, 57.793±4.357) to post-test (62.231±3.671, 63.502±4.235, 65.794±2.773). Within group comparisons implies that compound training significantly (p<0.05) caused more effect than the others. Conclusion: This study set out with the aim of comparison effectiveness of different type of selected training programs (physical, mental and compound) to investigate the best intervention method in order to improve the motor skill performance of children with developmental coordination disorder. The result determined significant improvement in motor skill performance that could be reached by using physical and mental trainings for 9-10 year old boys who had developmental coordination disorder, and compound training might be the best way to facilitate motor development in DCD children. Literature focuses on measurement of impairment and description of intervention approaches for individual children. Nevertheless, some studies are known about the principles that should guide best practice and service delivery for children with DCD as a population though. This study might help to develop training protocol for DCD children based on more document, which improves our knowledge of both physical and mental trainings functions that would be beneficial for DCD children and therapists