مجله دانشکده پزشکی اصفهان

مجله دانشکده پزشکی اصفهان

مقایسه‌ی ‌اثر تمرین در آب و خشکی بر تعادل و کیفیت زندگی مبتلایان به پارکینسون

نوع مقاله : مقاله های پژوهشی

نویسندگان
ابراهیم صادقی 1
غلامرضا شریفی 2
احمد چیت‌ساز 3
رضا شاه‌محمدی 4
1 استادیار، مرکز تحقیقات اختلالات اسکلتی و عضلانی، دانشکده‌ی علوم توان‌بخشی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران
2 استادیار، گروه فیزیولوژی ورزشی، دانشگاه آزاد اسلامی واحد اصفهان (خوراسگان)، اصفهان، ایران
3 استاد، مرکز تحقیقات علوم اعصاب و گروه مغز و اعصاب، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران
4 کارشناس ارشد، گروه فیزیولوژی ورزشی، دانشگاه آزاد اسلامی واحد اصفهان (خوراسگان)، اصفهان، ایران
چکیده
مقدمه: بی‌ثباتی وضعیتی، یکی از پیامدهای مهم بیماری پارکینسون است که موجب کاهش تحرک و کیفیت زندگی مبتلایان به این عارضه می‌شود. انجام تمرین و فعالیت بدنی، جزیی از برنامه‌ی درمانی برای کاهش عوارض پارکینسون محسوب می‌شود. در سال‌های اخیر، انجام تمرین در آب برای افراد دارای سطح تحرک پایین توصیه می‌شود. هدف این مطالعه، مقایسه‌ی تأثیر یک برنامه‌ی تمرین درمانی در دو محیط آب و خشکی بود.روش‌ها: 20 مرد مبتلا به پارکینسون ایدیوپاتیک بر اساس شدت بیماری و طبق تشخیص پزشک متخصص، در دو گروه 10 نفری تمرین در آب و تمرین در خشکی تقسیم شدند. هر دو گروه به مدت 8 هفته و هر هفته 3 جلسه، برنامه‌ی تمرین درمانی را زیر نظر یک مربی انجام دادند. ثبات قامتی و کیفیت زندگی شرکت کنندگان به ترتیب توسط صفحه‌ی نیرو و پرسش‌نامه در دو مرحله‌ی قبل و بعد از مداخله سنجیده شد. با استفاده از نرم‌افزار SPSS و آزمون‌های آماری Repeated-measures ANCOVA، Shapiro-Wilk و t مستقل داده‌های ثبت شده تجزیه و تحلیل و مقایسه گردید.یافته‌ها: هر دو دسته از متغیرهای ثبات وضعیت بدن و کیفیت زندگی افراد، در پس آزمون بهبود معنی‌داری نسبت به پیش آزمون نشان دادند. همچنین، میانگین بهبود متغیرها در گروه تمرین در آب به صورت معنی‌داری بیش از گروه خشکی بود.نتیجه‌گیری: تمرین درمانی در محیط آب، روش مفیدتری نسبت به خشکی، جهت افزایش تعادل و کیفیت زندگی مبتلایان به پارکینسون است.
کلیدواژه‌ها
پارکینسون
تمرین
ثبات وضعیت
کیفیت زندگی

عنوان مقاله English

Evaluating the Effect of Water- versus Land-Based Exercise Therapy in the Balance and Quality of Life of Patients with Parkinson’s Disease

نویسندگان English

Ebrahim Sadeghi 1
Gholam-Reza Sharifi 2
Ahmad Chitsaz 3
Reza Shahmohamadi 4
1 Assistant Professor, Musculoskeletal Research Center, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
2 Assistant Professor, Department of Exercise Physiology, School of Physical Education and Sport Sciences, Khorasgan Branch, Islamic Azad University, Isfahan, Iran
3 Professor, Isfahan Neuroscience Research Center AND Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
4 Department of Exercise Physiology, School of Physical Education and Sport Sciences, Khorasgan Branch, Islamic Azad University, Isfahan, Iran
چکیده English

Background: Postural instability is a major complication of Parkinson’s disease (PD) leads to the reduced mobility and poor quality of life in patients. Physical activity and exercise is a part of treatment plan to reduce the symptoms of the disease. Water-based exercise is recommended for patients with a lower level of mobility. This study aimed to compare the effects of water- and land-based exercises on patients with Parkinson’s disease.Methods: 20 patients who were diagnosed to have idiopathic Parkinson’s disease by a neurologist were equally divided into two 10-people groups based on their severity of complications. Both groups completed an 8-weeks (3 sessions per week) exercise program. Postural stability and quality of life (QoL) parameters were recorded using a force-plate and questionnaire in pre- and post-test sessions. Recorded outcomes were analyzed and compared using analysis of covariance statistical test.Findings: Postural stability and quality of life parameters improved at the post-test session compared to pre-test in both groups. The improvement of these outcomes was significantly greater in the water-based group.Conclusion: Water-based exercises can be more beneficial to improve the balance ability and quality of life in patients with Parkinson’s disease.

کلیدواژه‌ها English

Parkinson’s disease
Exercise Therapy
Postural stability
Quality of Life
  1. Jankovic J. Parkinson's disease: clinical features and diagnosis. J Neurol Neurosurg Psychiatry 2008; 79(4): 368-76.
  2. Kerr GK, Worringham CJ, Cole MH, Lacherez PF, Wood JM, Silburn PA. Predictors of future falls in Parkinson disease. Neurology 2010; 75(2): 116-24.
  3. Calandra-Buonaura G, Guaraldi P, Sambati L, Lopane G, Cecere A, Barletta G, et al. Multiple system atrophy with prolonged survival: is late onset of dysautonomia the clue? Neurol Sci 2013; 34(10): 1875-8.
  4. Ashburn A, Stack E, Pickering RM, Ward CD. A community-dwelling sample of people with Parkinson's disease: characteristics of fallers and non-fallers. Age Ageing 2001; 30(1): 47-52.
  5. Schapira AHV, Olanow CW. The medical management of Parkinson's disease. In: Olanow AHV, editor. Principles of treatment in Parkinson's disease. Philadelphia, PA: Butterworth-Heinemann; 2005. p. 119-43.
  6. Goodwin VA, Richards SH, Taylor RS, Taylor AH, Campbell JL. The effectiveness of exercise interventions for people with Parkinson's disease: a systematic review and meta-analysis. Mov Disord 2008; 23(5): 631-40.
  7. Dibble LE, Addison O, Papa E. The effects of exercise on balance in persons with Parkinson's disease: a systematic review across the disability spectrum. J Neurol Phys Ther 2009; 33(1): 14-26.
  8. Zigmond MJ, Cameron JL, Hoffer BJ, Smeyne RJ. Neurorestoration by physical exercise: moving forward. Parkinsonism Relat Disord 2012; 18(Suppl 1): S147-S150.
  9. Wood BH, Bilclough JA, Bowron A, Walker RW. Incidence and prediction of falls in Parkinson's disease: a prospective multidisciplinary study. J Neurol Neurosurg Psychiatry 2002; 72(6): 721-5.
  10. Quittenbaum BH, Grahn B. Quality of life and pain in Parkinson's disease: a controlled cross-sectional study. Parkinsonism Relat Disord 2004; 10(3): 129-36.
  11. Fox SH, Katzenschlager R, Lim SY, Ravina B, Seppi K, Coelho M, et al. The Movement Disorder Society Evidence-Based Medicine Review Update: Treatments for the motor symptoms of Parkinson's disease. Mov Disord 2011; 26(Suppl 3): S2-41.
  12. Crizzle AM, Newhouse IJ. Is physical exercise beneficial for persons with Parkinson's disease? Clin J Sport Med 2006; 16(5): 422-5.
  13. Tuon T, Valvassori SS, Dal Pont GC, Paganini CS, Pozzi BG, Luciano TF, et al. Physical training prevents depressive symptoms and a decrease in brain-derived neurotrophic factor in Parkinson's disease. Brain Res Bull 2014; 108: 106-12.
  14. Morris DM. Aquatic therapy to improve balance dysfunction in older adults. Topics in Geriatric Rehabilitation 2010; 26(2): 104-19.
  15. Kim YM, Lee DK. Comparison between aquatic and ground environments of rhythmic initiation for postural control. J Phys Ther Sci 2012; 24(12): 1269-71.
  16. Elbar O, Tzedek I, Vered E, Shvarth G, Friger M, Melzer I. A water-based training program that includes perturbation exercises improves speed of voluntary stepping in older adults: a randomized controlled cross-over trial. Arch Gerontol Geriatr 2013; 56(1): 134-40.
  17. Perez CA, Cancela JM. Effectiveness of water-based exercise in people living with Parkinson's disease: a systematic review. European Review of Aging and Physical Activity 2013; 11(2): 1-12.
  18. Vivas J, Arias P, Cudeiro J. Aquatic therapy versus conventional land-based therapy for Parkinson's disease: an open-label pilot study. Arch Phys Med Rehabil 2011; 92(8): 1202-10.
  19. Kargarfard M, Chitsaz A, Azizi S. Effects of an 8-week aquatic exercise training on balance in patients with Parkinson's disease. J Isfahan Med Sch 2012; 30(178): 141-50. [In Persian].
  20. Shumway-Cook A, Woollacott M. Clinical management of the patient with a postural control disorder. In: Shumway-Cook A, Woollacott M, editors. Motor control. Philadelphia, PA: Lippincott Williams and Wilkins; 2011. p. 257-98.
  21. Hoehn MM, Yahr MD. Parkinsonism: onset, progression, and mortality. 1967. Neurology 2001; 57(10 Suppl 3): S11-S26.
  22. Nelson ME, Rejeski WJ, Blair SN, Duncan PW, Judge JO, King AC, et al. Physical activity and public health in older adults: recommendation from the American College of Sports Medicine and the American Heart Association. Circulation 2007; 116(9): 1094-105.
  23. Maurer C, Peterka RJ. A new interpretation of spontaneous sway measures based on a simple model of human postural control. J Neurophysiol 2005; 93(1): 189-200.
  24. Lin D, Seol H, Nussbaum MA, Madigan ML. Reliability of COP-based postural sway measures and age-related differences. Gait Posture 2008; 28(2): 337-42.
  25. Muslimovic D, Post B, Speelman JD, Schmand B, de Haan RJ. Determinants of disability and quality of life in mild to moderate Parkinson disease. Neurology 2008; 70(23): 2241-7.
  26. Vu TC, Nutt JG, Holford NH. Progression of motor and nonmotor features of Parkinson's disease and their response to treatment. Br J Clin Pharmacol 2012; 74(2): 267-83.
  27. Wright WG, Gurfinkel VS, King LA, Nutt JG, Cordo PJ, Horak FB. Axial kinesthesia is impaired in Parkinson's disease: effects of levodopa. Exp Neurol 2010; 225(1): 202-9.
  28. Brienesse LA, Emerson MN. Effects of resistance training for people with Parkinson's disease: a systematic review. J Am Med Dir Assoc 2013; 14(4): 236-41.
  29. Craig P, Dieppe P, Macintyre S, Michie S, Nazareth I, Petticrew M. Developing and evaluating complex interventions: the new Medical Research Council guidance. BMJ 2008; 337: a1655.
  30. van der Kolk NM, King LA. Effects of exercise on mobility in people with Parkinson's disease. Mov Disord 2013; 28(11): 1587-96.
  31. Allen NE, Canning CG, Sherrington C, Fung VS. Bradykinesia, muscle weakness and reduced muscle power in Parkinson's disease. Mov Disord 2009; 24(9): 1344-51.
  32. Allen NE, Sherrington C, Canning CG, Fung VS. Reduced muscle power is associated with slower walking velocity and falls in people with Parkinson's disease. Parkinsonism Relat Disord 2010; 16(4): 261-4.
  33. Nallegowda M, Singh U, Handa G, Khanna M, Wadhwa S, Yadav SL, et al. Role of sensory input and muscle strength in maintenance of balance, gait, and posture in Parkinson's disease: a pilot study. Am J Phys Med Rehabil 2004; 83(12): 898-908.
  34. Schenkman ML, Clark K, Xie T, Kuchibhatla M, Shinberg M, Ray L. Spinal movement and performance of a standing reach task in participants with and without Parkinson disease. Phys Ther 2001; 81(8): 1400-11.
  35. Morris ME, Martin CL, Schenkman ML. Striding out with Parkinson disease: evidence-based physical therapy for gait disorders. Phys Ther 2010; 90(2): 280-8.
  36. Tomlinson CL, Patel S, Meek C, Clarke CE, Stowe R, Shah L, et al. Physiotherapy versus placebo or no intervention in Parkinson's disease. Cochrane Database Syst Rev 2012; 7: CD002817.
  37. Li F, Harmer P, Fitzgerald K, Eckstrom E, Stock R, Galver J, et al. Tai chi and postural stability in patients with Parkinson's disease. N Engl J Med 2012; 366(6): 511-9.
  38. Hackney ME, Earhart GM. Effects of dance on movement control in Parkinson's disease: a comparison of Argentine tango and American ballroom. J Rehabil Med 2009; 41(6): 475-81.
  39. Sage MD, Johnston RE, Almeida QJ. Comparison of exercise strategies for motor symptom improvement in Parkinson's disease. Neurodegenerative Disease Management 2011; 1(5): 387-95.
  40. Devereux K, Robertson D, Briffa NK. Effects of a water-based program on women 65 years and over: a randomised controlled trial. Aust J Physiother 2005; 51(2): 102-8.
  41. Lord SR, Matters B, St George R, Thomas M, Bindon J, Chan DK, et al. The effects of water exercise on physical functioning in older people. Australas J Ageing 2006; 25(1): 36-41.
  42. Tsourlou T, Benik A, Dipla K, Zafeiridis A, Kellis S. The effects of a twenty-four-week aquatic training program on muscular strength performance in healthy elderly women. J Strength Cond Res 2006; 20(4): 811-8.
مجله دانشکده پزشکی اصفهان
دوره 33، شماره 348 - شماره پیاپی 348
مهر و آبان 1394
صفحه 1391-1402

  • تاریخ دریافت 23 دی 1393
  • تاریخ پذیرش 17 فروردین 1401