ﺗﺄﺛﻴﺮ ﺗﮑﻠﻴﻒ ﺩﻭﮔﺎﻧﻪ ﺣﺮﮐﺘﻲ ﺑﺮ ﻓﻌﺎﻟﻴﺖ ﺍﻟﮑﺘﺮﻭﻣﻴﻮﮔﺮﺍﻓﻲ ﻋﻀﻼﺕ ﺍﻧﺪﺍﻡ ﺗﺤﺘﺎﻧﻲ ﻭ ﺗﻨﻪ ﺑﻴﻤﺎﺭﺍﻥ ﻣﺒﺘﻼ ﺑﻪ ﻓﻠﺞ ﻣﻐﺰﻱ ﻭ ﺍﻓﺮﺍﺩ ﺳﺎﻟﻢ ﻫﻨﮕﺎﻡ ﺭﺍﻩ ﺭﻓﺘﻦ

EFFECT OF MOTOR DUAL TASK ON THE ELECTROMYOGRAPHY OF LOWER LIMB an‎d TRUNK MUSCLES DURING GAIT IN CEREBRAL PALSY an‎d HEALTHY SUBJECTS

ﭘﻴﺶﺯﻣﻴﻨﻪ ﻭ ﻫﺪﻑ: ﻫﺪﻑ ﺍﺯ ﻣﻄﺎﻟﻌﻪ ﺣﺎﺿﺮ ﺑﺮﺭﺳﻲ ﻓﻌﺎﻟﻴﺖ ﺍﻟﮑﺘﺮﻭﻣﻴﻮﮔﺮﺍﻓﻲ ﻋﻀﻼﺕ ﺍﻧﺪﺍﻡ ﺗﺤﺘﺎﻧﻲ ﻭ ﺗﻨﻪ ﺑﻴﻤﺎﺭﺍﻥ ﻣﺒﺘﻼ ﺑﻪ ﻓﻠﺞ ﻣﻐﺰﻱ ﻭ ﺍﻓﺮﺍﺩ ﺳﺎﻟﻢ ﻫﻨﮕﺎﻡ ﺭﺍﻩ ﺭﻓﺘﻦ ﻋﺎﺩﻱ ﻭ ﺭﺍﻩ ﺭﻓﺘﻦ ﺑﺎ ﺗﮑﻠﻴﻒ ﺩﻭﮔﺎﻧﻪ ﺣﺮﮐﺘﻲ ﺑﻮﺩ. ﻣﻮﺍﺩ ﻭ ﺭﻭﺵﻫﺎ: 10 ﺑﻴﻤﺎﺭ ﻣﺒﺘﻼ ﺑﻪ ﻓﻠﺞ ﻣﻐﺰﻱ ﻭ 10 ﻧﻔﺮ ﺁﺯﻣﻮﺩﻧﻲ ﺳﺎﻟﻢ ﻫﻤﮕﻦ ﺑﻪﺻﻮﺭﺕ ﺩﺍﻭﻃﻠﺒﺎﻧﻪ ﺩﺭ ﺍﻳﻦ ﺗﺤﻘﻴﻖ ﺷﺮﮐﺖ ﮐﺮﺩﻧﺪ. ﺑﺎ ﺍﺳﺘﻔﺎﺩﻩ ﺍﺯ ﺩﺳﺘﮕﺎﻩ ﺍﻟﮑﺘﺮﻭﻣﻴﻮﮔﺮﺍﻓﻲ +EMG USB2 ﻭ ﺍﻟﮑﺘﺮﻭﺩﻫﺎﻱ ﺳﻄﺤﻲ ﺩﻭﻗﻄﺒﻲ، ﺷﺪﺕ ﻓﻌﺎﻟﻴﺖ ﻋﻀﻼﺕ RF ،ES ﻭ BF ﻫﻨﮕﺎﻡ ﺭﺍﻩ ﺭﻓﺘﻦ ﻋﺎﺩﻱ ﻭ ﺭﺍﻩ ﺭﻓﺘﻦ ﺑﺎ ﺗﮑﻠﻴﻒ ﺩﻭﮔﺎﻧﻪ ﺣﺮﮐﺘﻲ )ﺭﺍﻩ ﺭﻓﺘﻦ ﻫﻤﺮﺍﻩ ﺑﺎ ﺣﻤﻞ ﺑﺎﺭ( ﺛﺒﺖ ﮔﺮﺩﻳﺪ. ﭘﺲ ﺍﺯ ﺛﺒﺖ ﻓﻌﺎﻟﻴﺖ ﺍﻟﮑﺘﺮﻳﮑﻲ ﻋﻀﻼﺕ، ﺳﻴﮕﻨﺎﻝﻫﺎﻱ ﺑﻪﺩﺳﺖﺁﻣﺪﻩ ﺑﺎ ﺍﺳﺘﻔﺎﺩﻩ ﺍﺯ ﻧﺮﻡﺍﻓﺰﺍﺭ OT Biolab ﭘﺮﺩﺍﺯﺵ ﺷﺪﻧﺪ. ﺩﺍﺩﻩﻫﺎﻱ ﺑﻪﺩﺳﺖﺁﻣﺪﻩ ﺑﺎ ﻧﺮﻡﺍﻓﺰﺍﺭ SPSS22 ﻭ ﺭﻭﺵﻫﺎﻱ ﺁﻣﺎﺭﻱ ANOVA ﻭﻳﮋﻩ ﺩﺍﺩﻩﻫﺎﻱ ﺗﮑﺮﺍﺭﻱ ﺩﺭ ﺳﻄﺢ ﻣﻌﻨﻲﺩﺍﺭﻱ 0/05 ﺗﺠﺰﻳﻪﻭﺗﺤﻠﻴﻞ ﺷﺪﻧﺪ. ﻳﺎﻓﺘﻪﻫﺎ: ﻧﺘﺎﻳﺞ ﻧﺸﺎﻥ ﺩﺍﺩ ﺷﺪﺕ ﻓﻌﺎﻟﻴﺖ ﻋﻀﻼﺕ BF ،L3 ﻭ RF ﺳﻤﺖ ﭼﭗ )ﺑﻪ ﺗﺮﺗﻴﺐ 0/001= p =0/041 ،p ﻭ 0/022= p( ﻭ ﻋﻀﻠﻪ L3 ﺳﻤﺖ ﺭﺍﺳﺖ )0/027= p( ﺑﻴﻤﺎﺭﺍﻥ ﻓﻠﺞ ﻣﻐﺰﻱ ﺑﻪﻃﻮﺭ ﻣﻌﻨﻲﺩﺍﺭﻱ ﺑﻴﺸﺘﺮ ﺍﺯ ﺍﻓﺮﺍﺩ ﺳﺎﻟﻢ ﺑﻮﺩ. ﻭﻇﻴﻔﻪ ﺩﻭﮔﺎﻧﻪ ﺣﺮﮐﺘﻲ ﻫﻨﮕﺎﻡ ﺭﺍﻩ ﺭﻓﺘﻦ ﻓﻌﺎﻟﻴﺖ ﻋﻀﻼﺕ ﺳﻤﺖ ﺭﺍﺳﺖ ﻭ ﭼﭗ ﺍﻓﺮﺍﺩ ﺳﺎﻟﻢ ﺭﺍ ﺗﻘﺮﻳﺒﺎﹰ ﺑﻪﻃﻮﺭ ﻣﺸﺎﺑﻬﻲ ﺍﻓﺰﺍﻳﺶ ﺩﺍﺩ )0/001 = p(. ﺍﻣﺎ ﺩﺭ ﺍﻓﺮﺍﺩ ﻓﻠﺞ ﻣﻐﺰﻱ ﻭﻇﻴﻔﻪ ﺩﻭﮔﺎﻧﻪ ﺑﺎﻋﺚ ﺍﻓﺰﺍﻳﺶ ﺑﻴﺸﺘﺮﻱ ﺩﺭ ﻋﻀﻼﺕ ﺳﻤﺖ ﭼﭗ ﮔﺮﺩﻳﺪ )0/010 = p(. ﺑﺤﺚ ﻭ ﻧﺘﻴﺠﻪﮔﻴﺮﻱ: ﺑﻴﻤﺎﺭﺍﻥ ﻓﻠﺞ ﻣﻐﺰﻱ ﻫﻨﮕﺎﻡ ﺭﺍﻩ ﺭﻓﺘﻦ ﻋﺎﺩﻱ ﻭ ﺭﺍﻩ ﺭﻓﺘﻦ ﺑﺎ ﺗﮑﻠﻴﻒ ﺩﻭﮔﺎﻧﻪ ﻓﻌﺎﻟﻴﺖ ﻋﻀﻼﻧﻲ ﺑﻴﺸﺘﺮﻱ ﺍﺯ ﺍﻓﺮﺍﺩ ﺳﺎﻟﻢ ﺩﺍﺭﻧﺪ. ﻭﻇﻴﻔﻪ ﺩﻭﮔﺎﻧﻪ ﺣﺮﮐﺘﻲ ﻓﻌﺎﻟﻴﺖ ﻋﻀﻼﺕ L3 ﻭ BF ﺍﻓﺮﺍﺩ ﻓﻠﺞ ﻣﻐﺰﻱ ﺭﺍ ﺑﻴﺸﺘﺮ ﺍﺯ ﺍﻓﺮﺍﺩ ﺳﺎﻟﻢ ﺍﻓﺰﺍﻳﺶ ﻣﻲﺩﻫﺪ ﮐﻪ ﺍﻳﻦ ﺍﻓﺰﺍﻳﺶ ﻣﻲﺗﻮﺍﻧﺪ ﺑﻪ ﺗﻼﺵ ﻓﺮﺩ ﺑﺮﺍﻱ ﺣﻔﻆ ﻭﺿﻌﻴﺖ ﺑﺪﻥ ﻭ ﺗﻌﺎﺩﻝ ﭘﻮﻳﺎ ﺩﺭ ﺁﻥﻫﺎ ﻧﺴﺒﺖ ﺩﺍﺩﻩ ﺷﻮﺩ. ﺩﺭ ﺍﺭﺯﻳﺎﺑﻲ ﻭ ﻃﺮﺍﺣﻲ ﺑﺮﻧﺎﻣﻪﻫﺎﻱ ﺗﻤﺮﻳﻨﻲ ﻭﻳﮋﻩ ﺍﻓﺮﺍﺩ ﻓﻠﺞ ﻣﻐﺰﻱ، ﺗﻮﺟﻪ ﺑﻪ ﺗﮑﻠﻴﻒ ﺩﻭﮔﺎﻧﻪ ﺗﻮﺻﻴﻪ ﻣﻲﺷﻮﺩ.

Background & Aims: This study aimed to investigate the effect of motor dual task on the electromyographic activity of lower limb and trunk muscles during gait in cerebral palsy (CP) and healthy subjects. Materials & Methods: 10 patients with CP and 10 healthy matched subjects participated in this study voluntarily. Using an EMG USB2+ system and bipolar electrodes, the electromiyographic activity of biceps femoris (BF), rectus femoris (RF), and erector spinea at L3 level (L3) was recorded during gait with and without motor dual task. The gathered signals were processed using OT Biolab software. SPSS 22 software and ANOVA with significance level of 0.05 were used for statistical analysis. Results: Results showed that CP patients had greater normalized EMG of right and left L3 and left BF and RF muscle than control group. Motor dual task increased muscle activity in both groups (p=0.001) and had the same effect on the EMG of both right and left sides of healthy subjects. However, in the CP patients, motor dual task resulted in a higher muscle activity on the left side than the right side (p=0.01). Conclusion: Motor dual task increases EMG activity of RF, BF, and L3 muscle of CP patient's more than healthy subjects. This increase can be attributed to the greater attempt of these subjects to maintain body posture and dynamic balance. So, focus on the motor dual task can be recommended in evaluating and designing an appropriate exercise program for CP patients.