بررسی تأثیر آرامسازی عضلانی بر میزان فشار خون در بارداری

نوع مقاله: اصیل پژوهشی

نویسندگان

1 کارشناس ارشد مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

2 کارشناسی ارشد مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

3 استاد زنان و زایمان، مرکز تحقیقات سلامت زنان، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

4 استادیار روانشناسی بالینی، مرکز تحقیقات روانپزشکی و علوم رفتاری،دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

5 کارشناس ارشد آمار، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی مشهد، مشهد، ایران

چکیده

مقدمه: فشار خون یکی از اختلالات شایع در دوران بارداری و علت عمده مرگ و میر و ناخوشی های مادری و جنینی می باشد که درمان مؤثری ندارد. یکی از روش های اساسی در درمان فشار خون، کاهش استرس نظیر آرامسازی عضلانی است. با توجه به احتمال نقش استرس در ایجاد اختلالات فشار خون در دوران بارداری، مطالعه حاضر با هدف تعیین تأثیر آرامسازی عضلانی بر کنترل فشار خون در بارداری انجام شد.
 
روش‌کار: در این مطالعه کارآزمایی بالینی که طی سالهای 89- 1388 در مراکز بهداشتی درمانی شهر مشهد انجام شد، 20 زن باردار با فشار خون سیستول مساوی یا بیشتر از 135 میلی متر جیوه یا دیاستول مساوی یا بیشتر از 85 میلی متر جیوه به عنوان گروه کنترل و مداخله وارد مطالعه شدند. در گروه مداخله آرامسازی عضلانی به روش جکوبسون به مدت 4 هفته که یک جلسه در هفته بصورت حضوری و در بقیه روزهای هفته با راهنمایی سی دی در منزل، انجام می شد. فشار خون قبل و بعد از انجام تمرین در جلسات حضوری و در گروه کنترل قبل و بعد از 15 دقیقه انتظار، بدون مداخله خاصی اندازه گیری می شد. تجزیه و تحلیل داده ها با استفاده از نرم افزار SPSS (نسخه 5/11) انجام شد.
 
یافته‌ها: آرامسازی عضلانی، فشار خون سیستول و دیاستول گروه مداخله را نسبت به گروه کنترل بطور معنی داری، کاهش می دهد (001/0=p).
 
نتیجه‌گیری: آرامسازی عضلانی در کاهش فشار خون سیستول و دیاستول و درمان فشار خون بالا در دوران بارداری مؤثر است.

کلیدواژه‌ها


عنوان مقاله [English]

Study of Effectiveness of Muscle Relaxation on Blood Pressure in Pregnancy

نویسندگان [English]

  • Farzaneh Jafarnejad 1
  • Mahboobeh Aalami 2
  • Monireh Pourjavad 3
  • Morteza Modrres Gharavi 4
  • Saeed Ebrahim zadeh 5
1 M.Sc. of Midwifery, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
2 M.Sc. of Midwifery, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
3 Professor of Obstetrics and Gynecology, Women’s Health Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
4 Assistant professor of psychology, Psychiatry and Behavioral Sciences Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
5 M.Sc. of Statistics, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
چکیده [English]

Introduction: Hypertension disorders are common in pregnancy and are major cause of maternity and neonatal mortality and morbidity. Although these disorders are accompanied by many difficulties in pregnancy, but not found effective therapy for those. There are hypothesises about role of stress in creation of hypertension disorders in pregnancy. From stress reduction programs such as muscle relaxation, Can used in care of essential hypertension. This study was done with purpose of determination of effectiveness Muscle relaxation on blood pressure in pregnancy.




Methods: This clinical trial was done in Mashhad community health cares in 2010. Pregnant women with systolic blood pressure≥ 135 mmHg or diastolic blood pressure≥ 85 mmHg, with simple method of sampling, entered in the study. Patients were divided in case and control groups randomly. Each group included 20 patients. In intervention group, muscle relaxation according to the Jacobson's technique, was performed one session in week personally, and in other days of week done with compact disk guidance, for 4 weeks. Blood pressure was controlled before and after the intervention in personal session in case group and before and after 15 minutes wait without special intervention in control group. Data was analyzed with SPSS software (version 11/5).




Results: Muscle relaxation significantly decreased systolic (p=0.001) and diastolic (p=0.001) blood pressure after 4 weeks of intervention in compare with control group.




Conclusion: According to the results, muscle relaxation can consider in decrease of systolic and diastolic blood pressure and care of gestational hypertension.

کلیدواژه‌ها [English]

  • Muscle Relaxation
  • blood pressure
  • Hypertension
  • pregnancy
1. James PR, Nelson-Piercy C. Management of hypertension before, during, and after pregnancy. Heart 2004
Dec;90(12):1499–504.
2. Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Gilstrap III L, Wenstrom KD. Williams obstetrics. 22nd
ed. New York:McGraw-Hill;2005;883-935.
3. Amira OC, Okubadejo NU. Frequency of complementary and alternative medicine utilization in
hypertensive patients attending an urban tertiary care centre in Nigeria. BMC Complement Altern Med
2007 Sep;28(7):30.
4. Roberts JM, Pearson G, Cutler J, Lindheimer M; NHLBI Working Group on Research on Hypertension
During Pregnancy. Summary of the NHLBI Working Group on Research on Hypertension During
Pregnancy. Hypertension 2003 Mar;41(3):437-45.
5. Mugo M, Govindardjan G, Kurukulasuriya LR, Sowers JR, McFarlane SI. Hypertension in pregnancy. Curr
Hypertens Rep 2005 Oct;7(5):348–54
6. Keshtkar A, majdzadeh S, mohommad K, Ramezanzadeh F, Borna S, Azemikhah A, et al. [Determination
effective factors on preeclampsia severity, performance of regression tree]. J Gorgan Univ Med Sci 2007;
8(2): 47-54.[Article in Persian].
7. Chen XK, Wen SW, Smith G, Yang Q, Walkera M. Pregnancy-induced hypertension is associated with
lower infant mortality in preterm singletons. BJOG 2006 May;113(5):544-51.
8. Zhang J, Cai WW, Lee DJ. Pregnancy-induced hypertension and early neonatal death: a case-control study.
Am J Perinatol 1993 Sep;10(5):401-3.
9. Gabbe SG, Niebyl JR, Simpson JL. Obstetrics: normal and problem pregnancies. 5th ed.
Philadelphia:Churchill Livingstone;2007.
10. Madadzadeh M, Feizi Z, Hagikazemi E, Haghani H. [Mothers' hypertension and neonatal birth weight].
Iranian J Neonatal 2005;18(41-42):17-26.[Article in Persian].
11. Miranda ML, Swamy GK, Edwards S, Maxson P, Gelfand A, James S. Disparities in maternal hypertension
and pregnancy outcomes: evidence from North Carolina, 1994-2003. Public Health Rep 2010JulAug;125(4):579-87.
12. Chen XK, Wen SW, Smith GN, Yang Q, Walker MC. New-onset hypertension in late pregnancy and fetal
growth: different associations between singletons and twins. Hypertens Pregnancy 2007;26(3):259-72.
13. Huang Y.[Incidence of pregnancy induced hypertension and the effects on mother and fetus in Shanghai
during 1989-1998]. [Article in Chinese]. Zhonghua Fu Chan Ke Za Zhi 2001 Mar;36(3):137-9.
14. James DK, Steer PJ, Weiner CP, Gonik B,Mordechai H.Hypertension in pregnancy. High risk pregnancy
management options. 2nd ed. London:W.B. Saunders;2000:639-63
15. Hernández-Díaz S, Werler MM, Mitchell AA. Gestational hypertension in pregnancies supported by
infertility treatments: role of infertility, treatments, and multiple gestations. Fertil Steril 2007
Aug;88(2):438-45.
16. Mikolajczyk RT, Zhang J, Ford J, Grewal J. Effects of interpregnancy interval on blood pressure in
consecutive pregnancies. Am J Epidemiol 2008 Aug;168(4):422–6.
17. Vahid Roudsari F, Ayati S, Ebrahimi Monfared M, Esmaeili Habib E, SHahabian M. [The effect of
prepregnancy body mass index on the development of gestational hypertension and preeclampsia] [Article
in Persian]. JBUMS 2009;11(51):49-53. 
 
 
18. Bhattacharya S, Campbell DM, Liston WA, Bhattacharya S. Effect of Body Mass Index on pregnancy
outcomes in nulliparous women delivering singleton babies. BMC Public Health 2007 Jul 24;7:168.
19. Turzanski SR. Modifiable risk factors for hypertensive disorders of pregnancy amoung latina women.
Massachusetts:University of Massachusetts;2009.
20. Tanaka M, Jaamaa G, Kaiser M, Hills E, Soim A, Zhu M, et al. Racial disparity in hypertensive disorders of
pregnancy in New York State: a 10-Year longitudinal population-based study. Am J Public Health 2007
Jan;97(1):
21. Bryson CL, Ioannou GN, Rulyak SJ, Critchlow C. Association between gestational diabetes and pregnancyinduced
hypertension. Am J Epidemiol 2003 Dec;158(12):1148–5.
22. Meher S, Abalos E, Carroli G. Bed rest with or without hospitalisation for hypertension during pregnancy.
Cochrane Database Sys Rev 2005 Oct 19;(4):CD003514.
23. Todros T, Verdiglione P, Oggè G, Paladini D, Vergani P, Cardaropoli S. Low incidence of hypertensive
disorders of pregnancy in women treated with spiramycin for toxoplasma infection. Br J Clin Pharmacol
2005 Mar;61(3):336-40.
24. Takiuti NH, Kahhale S, Zugaib M. Stress-related preeclampsia: an evolutionary aladaptation in exaggerated
stress during pregnancy? Med Hypotheses 2003 Mar;60(3):328–31.
25. Leeners B, Neumaier-Wagner P, Kuse S, Stiller R, Rath W. Emotional stress and the risk to develop
hypertensive diseases in pregnancy. Hypertens Pregnancy 2007;26(2):211-26.
26. Fathi R. [Relax therapy]. Tehran:Shahrab;2000. [In persian]).
27. Jank J. The effect of relaxation therapy on preterm labor outcomes. J Obstet Gynecol Neonatal Nurs 1999
May-Jun;28(3):255-63.
28. NickelI C, Lahmann C, Muehlbacher M, Pedrosa Gil F, Kaplan P, Buschmann W, et al. Pregnant women
with bronchial asthma benefit from progressive muscle relaxation: a randomized, prospective, controlled
triall. Psychother Psychosom 2006;75(4):237-43.
29. Beddoe AE, Lee KA. Mind-body interventions during pregnancy. J Obstet Gynecol Neonatal Nurs 2008
Mar-Apr;37(2):165-75.
30. Little BC, Hayworth J, Benson P, Hall F, Beard RW, Dewhurst J, et al. Treatment of hypertension in
pregnancy by relaxation and biofeedback. Lancet 1984 Apr 21;1(8382):865-7.
31. Urech C, Fink NS, Hoesli I, Wilhelm FH, Bitzer J, Alder J. Effects of relaxation on psychobiological
wellbeing during pregnancy: a randomized controlled trial. Psychoneuroendocrinology 2010
Oct:35(9)1348-55.
32. Everly Jr GS, lating JM. A Clinical Guide to the Treatment of the Human Stress Response. New York,
Boston, Dordrecht, London, Moscow: Kluwer Academic/Plenum Publishers; 2002.
33. Najafian J, Gholestan Hashemi SM. [A study of the effect of relaxation and biofeedbacka assisted
relaxation on patients with mild hypertension] [Article in Persian]. ARYA J 2006;1(3):178-82.