تأثیر هشت هفته تمرینات توپی در آب و پیلاتس بر سلامت روان و برخی شاخصهای عملکرد عضلانی زنان مبتلا به MS

نوع مقاله : اصیل پژوهشی

نویسنده

کارشناس ارشد فیزیولوژی ورزشی، دانشگاه علوم کشاورزی و منابع طبیعی خوزستان، خوزستان، ایران.

چکیده

مقدمه: بیماری مولتیپل اسکلروزیس (MS)، بیماری مزمن تخریب میلین سیستم اعصاب مرکزی است که به‌وسیله اختلال در انتقال در تکانه­های عصبی مشخص می‌شود. با توجه به تأثیر تمرینات ورزشی متفاوت در کمک به کاهش نشانه­های بیماری در بیماران MS، مطالعه حاضر با هدف مقایسه تأثیر دو نوع برنامه تمرینی تمرینات توپی در آب و پیلاتس بر روی سرعت و استقامت راه رفتن، میزان خستگی، تعادل و کیفیت زندگی در زنان مبتلا به بیماری MS انجام شد.
روش‌کار: این مطالعه کاربردی و نیمه تجربی  در پاییز 1395 بر روی 31 نفر از زنان ساکن مشهد و مبتلا به مولتیپل اسکلروزیس با EDSS 4-1 مراجعه‌کننده به انجمن MS شهر مشهد انجام شد. افراد در سه گروه تمرینات توپی در آب، پیلاتس و گروه کنترل قرار گرفتند. آزمودنی‌ها 3 جلسه در هفته و به مدت 8 هفته به تمرین پرداختند. داده‌های آزمون سرعت (آزمون 10 متر راه رفتن) و استقامت راه رفتن (آزمون دو دقیقه) و آزمون تعادلی برگ به‌وسیله زمانسنج و به‌وسیله پرسشنامه (شدت خستگی FFS)، میزان خستگی بیماران اندازه‌گیری شد و همچنین با استفاده از ضربان‌سنج، شدت برنامه­های تمرینی پیلاتس و تمرینات توپی در آب (از 70-40% ضربان قلب بیشینه) مورد سنجش قرار گرفت. تجزیه ‌و تحلیل داده‌ها با استفاده از نرم‌افزار آماری SPSS (نسخه 18) و آزمون‌های تحلیل واریانس چندراهه، تی همبسته و آزمون پیگیری توکی انجام شد. میزان p‌ کمتر از 05/0 معنادار در نظر گرفته شد.
یافته‌ها: سرعت راه رفتن در گروه تمرینات توپی در آب افزایش معنی­داری یافت (001/0>p)، درحالی‌که در گروه پیلاتس این افزایش معنی­دار نبود (132/0=p). استقامت راه رفتن و تعادل در گروه تمرینات توپی در آب (008/0=p، 001/0=p) و گروه پیلاتس (009/0=p، 002/0=p) افزایش معنی­داری یافت. خستگی در گروه تمرینات توپی در آب (004/0=p) و پیلاتس (019/0=p) کاهش معنی­داری یافت. کیفیت زندگی بیماران نیز در دو گروه تمرینات توپی در آب (0001/0=p) و پیلاتس (001/0=p) افزایش معنی­داری یافت، درحالی‌که نسبت به تمام شاخص­ها بین دو گروه آزمودنی تفاوت معنی‌داری مشاهده نشد (05/0p≥). گروه کنترل نیز در هیچ­یک از شاخص­های اندازه­گیری شده تغییری نشان ندادند.
نتیجه­گیری: تمرینات توپی در آب و تمرینات پیلاتس می­تواند در کنار درمان­های دارویی موجب بهبود در شاخص­های تعادل، خستگی، سرعت و استقامت راه رفتن و کیفیت زندگی بیماران مبتلا به MS شود و با افزایش هدفمند شدت و حجم فعالیت، توان جسمانی و سطح کیفیت زندگی بیماران افزایش پیدا کند.

کلیدواژه‌ها


عنوان مقاله [English]

Comparing the effects of eight week ball exercises in water and Pilates on some muscle performance indices and mental health of Women with MS

نویسنده [English]

  • Asieh Sadat Mousavian
M.Sc. of Sport physiology, Agricultural Science and Natural Resources University of Khuzestan, Khuzestan, Iran
چکیده [English]

Introduction: Multiple Sclerosis (MS) is a chronic disease of the demyelination of central nervous system which is characterized in the nerve by the disruption in the transmission. Considering to the effects of different exercises to help in decreasing the disease' symptoms in MS patients, this study was performed with aim to compare the effects of ball exercises in water and Pilates on the speed and endurance of walking, balance, fatigue and quality of life in women with MS.
Methods: This applied and semi-experimental study was performed on 31 MS women with EDSS£4 who were resident in Mashhad and had referred to MS institute of Mashhad in 2016. The subjects were placed in three groups of ball exercises, Pilates, and control. The participants exercised three times a week for 8 weeks. Speed test data (10m walk test), walking durability (2-minute test), and Equilibrium test (BBS) were measured by time-meter. Fatigue test (FFS) questionnaire was used to measure the fatigue of patients and also pulsometer was used to measure the intensity of Pilates training programs and ball exercises in water (from 40-70% of maximum heart rate). Data was analyzed by SPSS software (version 18) and multivariate analysis of variance analysis, dependent-t, and Tukey follow-up test. P< 0.05 was considered significant.
Results: Speed of walking was significantly increased in the group of ball exercises in water (P<0.001), while this increase was not significant in Pilates group (P=0.132). Endurance of walking and balance were significantly increased in the groups of ball exercises in water (P= 0.008, P-0.001) and Pilates (P= 0.009, P=0.002). Fatigue was significantly decreased in the groups of ball exercised in water (P= 0.004) and Pilates (P= 0.019). Quality of life was significantly increased in the groups of ball exercised in water (P= 0.000) and Pilates (P= 0.001). However, there was no significant difference between the two groups in all the indices. The control group didn’t show changes in any indices.
Conclusion: In terms of the measured indices, no changes have been observed in control group (P≥0.05). The information can be helpful and useful in designing the exercise programs for he patients with MS.
Conclusion: Ball exercises in water and Pilates exercises along with drug therapies can improve the balance indexes, fatigue, speed and endurance of walking and quality of life in patients with MS, and with a targeted increase in the intensity and volume of activity, physical capacity, and quality of life of patients will increase.

کلیدواژه‌ها [English]

  • Ball exercises in water
  • Mental health
  • Muscular function
  • MS
  • Pilates
  1. Strober LB, Amett PA. An examination of four models predicting fatigue in multiple sclerosis. Arch Clin Neuropsychol 2005; 20(6):31-46.
  2. Rao SM, Huber SJ, Bornstein RA. Emotional changes with multiple sclerosis and Parkinson’s disease. J Consult Clin Psychol 1992; 60(3):69-78.
  3. Besharat M, Barati N, Lotfi J. Relationship between coping styles and mental health in a sample of multiple sclerosis patients. Res Med 2008; 32(1):27-35. (Persian.(
  4. White LJ, Dressendorfer RH. Exercise and multiple sclerosis. Sports Med 2004; 34(1077):94-100.
  5. Morris ME, Cantwell C, Vowels L, Dodd K. Changes in gait and fatigue from morning to afternoon in people with multiple sclerosis. J Neurol Neurosurg Psychiatry 2002; 72(3):361-5.
  6. Mirshafiee A. Multiple sclerosis disease. Tehran: Hayyan Publications; 2008.
  7. Snook EM, Motl RW. Effect of exercise training on walking mobility in multiple sclerosis: a meta-analysis. Neurorehabil Neural Repair 2009; 23(2):108-16.
  8. Lennon CL, Hoffmeister C, Lake W, Dibble L, Gappmaier ED. A critical analysis of clinical balance tests in people with Multiple sclerosis. Toronto: Comprehensive Approaches to Complex Challenges; 2008. P. 156.
  9. Sharifi Zarchi M, Salimi M, Askarizadeh SE, Khorshidifar A, Pour Mohammadi E, Hosseini M, et al. Provide a boost muscle movement patterns and increasing range of motion in patients with multiple sclerosis. Proceedings of the Fourth International Congress, New Jersey, USA; 2007. P. 121.
  10. Uccelli M. Choosing fitness: exercise and MS. MS Focus 2005; 5:9-11.
  11. Cattaneo D, Jonsdottir J, Zocchi M, Regola A. Effect of balance exercise on people with Multiple sclerosis a pilot study. Clin Rehabil 2007; 21(9):771-881.
  12. Hale L, Schou E, Piggot J, Littman A, Tumilty S. The effect of combined exercise program for people with Multiple sclerosis: a case series. N Zealand J Physiother 2003; 31(3):130-8.
  13. Romberg A, Virtanen A, Ruutiainen T, Aunola S, Karppi SL, Vaara M, et al. Effects of a 6-month exercise program on patients with Multiple sclerosis. Neurology 2004; 63(11):2034-8.
  14. Adamson L, Tombs C. A comparison of two community-based leg strengthening program for person with multiple sclerosis. Mult Scler 2008; 14:S136.
  15. Shumway-Cook A, Woollacott MH. Motor control: theory and practical applications. 2nd ed. Baltimore: Williams and Wilkins; 2001. P. 276-9.
  16. Newman MA, Dawes H, van den Berg M, Wade DT, Burridge J, Izadi H. Can aerobic treadmill training reduce the effort of walking and fatigue in people with multiple sclerosis: a pilot study. Mult Scler 2007; 13(1):113-9.
  17. Grieve FG, Harris DS, Fairbanks SD. Extending the fatigue severity scale to an obese population. Eat Weight Disord 2000; 5(3):161-5.
  18. Azimian M, Shahvarughi F, Fallahpour M, Karimlu M. The Validity and reliability of the Fatigue Severity Scale in Iranians with multiple sclerosis. The 5th International MS Congress of Iran, Tehran; 2008. P. 5.
  19. Atapour M. Effect of exercise on walking speed, fatigue and quality of life of patients with multiple sclerosis. [Master Thesis]. Ahvaz: Ahvaz Jundishapur University of Medical Sciences; 2008. (Persian).
  20. Aprile I, Di Stasio E, Romitelli F, Lancellotti S, Caliandro P, Tonali P, et al. Effects of rehabilitation on quality of life in patients with chronic stroke. Brain Injury 2008; 22(6):451-6.
  21. Moslehi NE, Dabidi RV, Falah MZ, Pouramir M. Effect of short term vitamin e supplementation on lipid peroxidation of healthy man after exhaustive exercise in the sea level and moderate altitude. Olympic 2008; 16(1):47-57. (Persian).
  22. Sultani M, Hejazi SM, Nurian A. Examine the effects of aerobic exercise in water on a scale of disability (EDSS) M.S patients with low-grade. Proceedings of the Fourth International Congress of Iranian MS, Tehran, Iran; 2007. P. 142-5.
  23. Giesser B, Beres-Jones J, Budovitch A, Herlihy E, Harkema S. Locomotor training using body weight support on a treadmill improves mobility in persons with multiple sclerosis: a pilot study. Mult Scler 2008; 13(2):224-31.
  24. Soltani M, Hejazi SM, Noorian A, Zendedel A, Ashkanifar F. The effect of aerobic training on the improvement of expanded disability status scale (EDSS) in multiple sclerosis patients. J Med Sci Islamic Azad Univ Mashhad 2009; 5(1):15-20. (Persian).
  25. Killeff J, Ashburn A. A pilot study of the effect of aerobic exercise on people with moderate disability multiple sclerosis. Clin Rehabil 2005; 19(2):165-9.
  26. Faragoso YD, Santana DL, Pinto RC. The positive effects of a physical activity program for multiple sclerosis patients with fatigue. NeuroRehabilitation 2008; 23(2):153-7.
  27. McCullagh R, Fitzgerald AP, Murphy RP, Cooke G. Long-term benefits of exercising on quality of life and fatigue in multiple sclerosis patients with mild disability: a pilot study. Clin Rehabil 2008; 22(3):206-14.
  28. Moshtagh M, Kooshyar H, Sardar M, Foroughi MA. The effect of water exercise on fatigue in women with multiple sclerosis. Proceedings of the Third International Congress of Iranian MS, Iran; 2006. P. 133-5.
  29. Fayazi B, Parnow A, Ahsan B. Effect aerobic exercises on fatigue and quality of life in women with multiple sclerosis. J Holistic Nurs Midwifery 2016; 25(79):30-40.
  30. Barrett CL, Mann GE, Taylor PN, Strike PA. Randomized trial to investigate the effects functional electrical stimulation and therapeutic exercise on walking performance for people with multiple sclerosis. Mult Scler 2009; 15(4):493-504.
  31. Shanazari Z, Marandi SM, Shayegannejad V. The effect of Pilates exercises and aquatic trainning on walking speed in women with multiple sclerosis. J Res Dev Nurs Midwifery 2014; 17(11):10-7. (Persian).
  32. Rampello A, Franceschini M, Piepoli M, Antenucci R, Lenti G, Olivieri D, et al. Effect of aerobic training on walking capacity and maximal exercise tolerance in patients with multiple sclerosis: a randomized crossover controlled study. Phys Ther 2007; 87(5):545-55.
  33. Debolt LS, McCubbin JA. The effects of home-based resistance exercise on balance, power, and mobility in adults with multiple sclerosis. Arch Phys Med Rehabil 2004; 85(2):290-7.
  34. Ahmadi A, Arastoo AA, Nikbakht M, Zahednejad S, Rajabpour M. Comparison of the effect of 8 weeks aerobic and yoga training on ambulatory function, fatigue and mood status in MS patients. Iran Red Crescent Med J 2013;15(6):449-54.
  35. Eftekhari E, Nikbakht H, Etemadifar M, Rabiei K. The effect of aerobic quality of life in women with multiple sclerosis. Olympic J 2008; 16(1):37-4.