ﺗﺎﺛﯿﺮ ﭘﺮوﺗﮑﻞ درﻣﺎﻧﺪه ﺳﺎز ﺑﺮ ﻫﻢ اﻧﻘﺒﺎﻇﯽ ﻋﻀﻼت زاﻧﻮ در اﻓﺮاد ﺳﺎﻟﻢ و ﺑﺎ ﭘﺎي ﭘﺮوﻧﯿﺖ ﻃﯽ دوﯾﺪن

The Effect of Exhaustive Protocol on Knee Muscle Co-contraction in Healthy People and with a Pronated Foot during Running

ﺧﺴﺘﮕﯽ و ﻧﺎﻫﻨﺠﺎري در اﻧﺪام ﺗﺤﺘﺎﻧﯽ ﻣﺎﻧﻨﺪ ﭘﺎي ﭘﺮوﻧﯿﺖ ﻣﯽﺗﻮاﻧﺪ ﺑﺮ ﺑﯿﻮﻣﮑﺎﻧﯿﮏ ﺣﺮﮐﺎت اﻧﺴﺎن ﻣﺎﻧﻨﺪ دوﯾﺪن، ﺗﺄﺛﯿﺮ ﻣﻨﻔﯽ ﺑﮕﺬارد و ﻣﻨﺠﺮ ﺑﻪ ﺑﺮوز ﻋﺪم ﻫﻢاﻧﻘﺒﺎﺿﯽ ﻋﻀﻼﻧﯽ و ﻋﻼﺋﻢ ﻧﺎﭘﺎﯾﺪار در ﻣﻔﺎﺻﻞ اﻧﺪام ﺗﺤﺘﺎﻧﯽ )زاﻧﻮ( ﺷﻮد. ﺑﻨﺎﺑﺮاﯾﻦ ﻫﺪف اﺻﻠﯽ اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﺑﺮرﺳﯽ ﺗﺎﺛﯿﺮ ﭘﺮوﺗﮑﻞ درﻣﺎﻧﺪه ﺳﺎز ﺑﺮ ﻫﻢاﻧﻘﺒﺎﺿﯽ ﻋﻀﻼت زاﻧﻮ در اﻓﺮاد ﭘﺎي ﭘﺮوﻧﯿﺖ و ﺳﺎﻟﻢ ﻃﯽ دوﯾﺪن ﺑﻮد. روشﻫﺎ: ﺗﻌﺪاد ﭼﻬﺎرده ﻧﻔﺮ ﻣﺮد ﺟﻮان ﺑﺎ ﭘﺎي ﭘﺮوﻧﯿﺖ و 14 ﻧﻔﺮ ﺑﺎ ﭘﺎي ﺳﺎﻟﻢ در اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﺷﺮﮐﺖ ﮐﺮدﻧﺪ. ﻓﻌﺎﻟﯿﺖ اﻟﮑﺘﺮوﻣﺎﯾﻮﮔﺮاﻓﯽ ﻋﻀﻼت ﻣﻨﺘﺨﺐ ﻗﺒﻞ و ﺑﻌﺪ از اﺟﺮاي ﭘﺮوﺗﮑﻞ ﺛﺒﺖ ﮔﺮدﯾﺪ. دادهﻫﺎ ﺑﺎ اﺳﺘﻔﺎده از ﻧﺮماﻓﺰار SPSS و آزﻣﻮن ﺗﺤﻠﯿﻞ وارﯾﺎﻧﺲ ﺑﺎ اﻧﺪازهﮔﯿﺮي ﻫﺎي ﻣﮑﺮر ﻣﻮرد ﺗﺠﺰﯾﻪ و ﺗﺤﻠﯿﻞ ﻗﺮار ﮔﺮﻓﺖ )0/05 ≤ P(. ﯾﺎﻓﺘﻪﻫﺎ: ﯾﺎﻓﺘﻪﻫﺎ در ﮔﺮوه ﭘﺎي ﭘﺮوﻧﯿﺖ در ﻣﻘﺎﯾﺴﻪ ﺑﺎ ﭘﺎي ﺳﺎﻟﻢ ﻧﺸﺎن داد ﮐﻪ ﻫﻢاﻧﻘﺒﺎﺿﯽ ﻋﻤﻮﻣﯽ زاﻧﻮ ﻃﯽ ﻓﺎز ﻣﯿﺎﻧﻪ اﺳﺘﻘﺮار )0/026 = P ،0/928 = d( و ﻧﻮﺳﺎن )0/046 = d = 0/820 ،P( و ﻫﻢاﻧﻘﺒﺎﺿﯽ ﺟﻬﺖ دار ﭘﻬﻦ داﺧﻠﯽ/ ﭘﻬﻦ ﺧﺎرﺟﯽ ﻃﯽ ﻓﺎز ﺗﻤﺎس ﭘﺎﺷﻨﻪ )0/049 = P ،0/810= d( ﺑﻪ ﻃﻮر ﻣﻌﻨﯽداري ﮐﻤﺘﺮ ﺑﻮد. ﻫﻢاﻧﻘﺒﺎﺿﯽ ﺟﻬﺖدار ﻓﻠﮑﺴﻮري/ اﮐﺴﺘﻨﺴﻮري در ﻣﻘﺎﯾﺴﻪ ﭘﯿﺶ آزﻣﻮن ﻧﺴﺒﺖ ﺑﻪ ﭘﺲ آزﻣﻮن ﻃﯽ ﻓﺎز ﺟﺪا ﺷﺪن ﭘﺎﺷﻨﻪ در ﻫﺮ دو ﮔﺮوه ﭘﺎي ﭘﺮوﻧﯿﺖ )0/037 = d =0/81 ،P( و ﭘﺎي ﺳﺎﻟﻢ )0/037 = d = 0/81 ،P( ﺑﻪ ﻃﻮر ﻣﻌﻨﯽداري ﮐﺎﻫﺶ ﯾﺎﻓﺖ. ﺳﺎﯾﺮ ﻣﺆﻟﻔﻪﻫﺎ ﻫﯿﭻﮔﻮﻧﻪ اﺧﺘﻼف ﻣﻌﻨﯽداري را ﻧﺸﺎن ﻧﺪاﻧﺪ. ﻧﺘﯿﺠﻪﮔﯿﺮي: ﻫﻢ اﻧﻘﺒﺎﺿﯽ ﻋﻀﻼت ﻣﻮرد ﺑﺮرﺳﯽ در ﻣﻔﺼﻞ زاﻧﻮ در اﻓﺮاد ﭘﺎي ﭘﺮوﻧﯿﺖ در ﻣﺮاﺣﻞ ﻣﺨﺘﻠﻒ اﺳﺘﺎﻧﺲ ﻧﺴﺒﺖ ﺑﻪ ﮔﺮوه ﭘﺎي ﺳﺎﻟﻢ ﮐﺎﻫﺶ ﯾﺎﻓﺘﻪ اﺳﺖ. ﺷﺎﯾﺪ ﺑﻪ ﻋﻠﺖ ﻓﻌﺎﻟﯿﺖ اﺿﺎﻓﯽ ﮔﺮوﻫﯽ از ﻋﻀﻼت ﺟﻬﺖ ﻏﻠﺒﻪ ﺑﺮ ﺑﯽ ﺛﺒﺎﺗﯽ زاﻧﻮ و ﺟﻠﻮﮔﯿﺮي از ﺣﺮﮐﺎت اﺿﺎﻓﯽ اﯾﻦ ﻣﻔﺼﻞ ﺑﻪ ﻫﻨﮕﺎم ﺑﺮوز ﺧﺴﺘﮕﯽ ﺑﺎﺷﺪ، و اﯾﻦ اﺣﺘﻤﺎل وﺟﻮد دارد ﮐﻪ اﯾﻦ ﻓﻌﺎﻟﯿﺖ اﺿﺎﻓﯽ ﮔﺮوﻫﯽ از ﻋﻀﻼت ﺑﺮ ﻣﮑﺎﻧﯿﮏ دوﯾﺪن اﻓﺮاد ﭘﺎي ﭘﺮوﻧﯿﺖ ﺗﺎﺛﯿﺮ ﮔﺬاﺷﺘﻪ و در ﻣﺮاﺣﻞ ﻣﺨﺘﻠﻔﯽ از ﺳﯿﮑﻞ دوﯾﺪن ﺑﺎﻋﺚ وارد آﻣﺪن ﻓﺸﺎر اﺿﺎﻓﯽ ﺑﻪ ﻣﻔﺼﻞ زاﻧﻮ ﺷﺪه و ﺳﯿﺴﺘﻢ اﺳﮑﻠﺘﯽ ﻋﻀﻼﻧﯽ در ﻣﻔﺼﻞ زاﻧﻮ ﺗﻮاﻧﺎﯾﯽ ﺧﻮد در ﺟﺬب ﻣﻨﺎﺳﺐ ﺷﻮك ﻫﻨﮕﺎم دوﯾﺪن را از دﺳﺖ داده و ﺑﺎﻋﺚ اﻓﺰاﯾﺶ ﻟﻘﯽ ﻣﻔﺼﻞ ﺷﺪه و ﺧﻄﺮ اﺑﺘﻼ ﺑﻪ آﺳﯿﺐﻫﺎي ﻣﻔﺼﻠﯽ ﻧﺎﺷﯽ از ﺧﺴﺘﮕﯽ اﻓﺰاﯾﺶ ﯾﺎﺑﺪ.

Fatigue and abnormalities in the lower extremities, such as the pronated foot, can adversely affect the biomechanics of human movements such as running, leading to a lack of muscle contraction and unstable symptoms in the joints of the lower extremities (knees). Therefore, the main purpose of this study was to investigate the effect of exhaustive protocol on knee muscle co-contraction in pronated and healthy individuals while running. Methods: Fourteen young men with pronated feet and 14 healthy feet participated in the study. Electromyography activities of the selected muscles before and after fatigue protocol were recorded. The statistical analysis was performed using the SPSS software and repeated measures analysis of variance (ANOVA) (P ≤0.05). Results: Findings in the pronated foot compared with the healthy foot group showed that the knee general cocontraction during the mid-stance phase (P = 0.026, d = 0.81) and swing (P = 0.046, d = 0.81) and Vastuslateralis/vastusmedialis directed co-contraction of the knee was significantly lower during the heel contact phase (P = 0.049, d = 0.81). Flexural/extensor directed co-contraction in comparison of pretest to posttest during heel propulsion phase in both groups of pronated foot (P = 0.037, d = 0.81) and healthy foot (P = 0.037, 0.81 = d) decreased significantly. The other components did not show any significant differences. Conclusion: The co-contraction of the examined muscles in the knee joint has decreased in pronated foot in different stages of stance compared to the healthy foot group. This may be due to the over-activity of a group of muscles to overcome the instability of the knee and to prevent the extra movements of this joint when fatigue occurs, and it is also possible that this over-activity of a group of muscles has affected the running mechanics of individual with pronated foot and at different stages of the running cycle caused additional pressure on the knee joint and the musculoskeletal system in the knee joint loses its ability to properly absorb shock when running, increasing joint looseness and the risk of joint damage due to fatigue Increase.