نوع مقاله : مقاله پژوهشی Released under CC BY-NC 4.0 license I Open Access I

نویسندگان

1 گروه علوم ورزشی، دانشکده علوم انسانی، دانشگاه شهرکرد ، شهرکرد، ایران .

2 گروه علوم ورزشی، دانشکده علوم انسانی، دانشگاه شهرکرد، شهرکرد، ایران .

3 گروه جراحی مغز و اعصاب، دانشکده پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران.

چکیده

مقدمه: مولتیپل اسکلروزیس (ام‌اس) از شایع‌ترین بیماری‌های خودایمنی التهابی مزمن سیستم عصبی مرکزی است که بر سیستم‌های حرکتی و حسی پایه برای کنترل تعادل در هنگام ایستادن و راه رفتن تأثیرگذار است. هدف پژوهش حاضر بررسی اثر هشت هفته تمرینات حس عمقی بر تعادل، خستگی و کیفیت زندگی زنان مبتلا به ام‌اس بود.
روش پژوهش: جامعة آماری پژوهش شامل زنان 20 تا 50 سالۀ مبتلا به ام‌اس با نمرۀ مقیاس وضعیت شدت ناتوانی 1تا 4 و عضو انجمن ام‌اس‌شهر اصفهان بودند. از بین بیماران 30 داوطلب به ‌روش نمونه‌گیری در دسترس انتخاب و در دو گروه تجربی و کنترل تقسیم شدند. آزمودنی‌های هر دو گروه پیش از شروع برنامۀ تمرینی پرسشنامه‌های شدت خستگی و کیفیت زندگی بیماران ام‌اس را تکمیل و در آزمون مقیاس تعادل برگ شرکت کردند. گروه تجربی به مدت هشت هفته تمرینات حس عمقی را سه جلسه در هفته و به مدت60 دقیقه اجرا کردند و گروه کنترل در این مدت فعالیت‌های روزمره خود را انجام دادند. در پایان برنامه، آزمون‌های قبل تکرار شد. داده‌ها از طریق آزمون‌هایt مستقل و t زوجی و در سطح خطای 0/05 تحلیل شد.
یافته‌ها: نتایج نشان‌ داد در گروه تجربی پیش‌آزمون و پس‌آزمون تعادل، خستگی و کیفیت‌ زندگی تفاوت معناداری داشت. همچنین مقایسة نتایج پس‌آزمون دو گروه تجربی و کنترل نشان‌داد تعادل و کیفیت زندگی تفاوت معناداری داشت.
نتیجه‌گیری: در مجموع هشت هفته تمرینات حس عمقی تعادل بیماران ام‌اس را بهبود بخشید و کیفیت زندگی آنان را ارتقا داد، ولی بر کاهش میزان خستگی آنان مؤثر نبود. بنابراین استفاده از تمرینات حس عمقی برای بهزیستی بیماران ام‌اس توصیه می‌شود.

کلیدواژه‌ها

عنوان مقاله [English]

The Effect of Proprioceptive Training on Balance, Fatigue, and Quality of Life of Women With Multiple Sclerosis

نویسندگان [English]

  • Niloufar Emamian 1
  • Ali Shafizadeh 2
  • Masoud Etemadifar 3

1 Department of sports sciences, Faculty of Humanities, Shahrekord University, Shahrekord, Iran.

2 Department of sports sciences, Faculty of Humanities, Shahrekord University, Shahrekord, Iran .

3 Department of Neurosurgery, School of Medicine, Isfahan University of Medical Science, Isfahan, Iran.

چکیده [English]

Introduction: Multiple­ sclerosis (MS) is one of the most common chronic inflammatory autoimmune diseases of the central nervous system that affects the motor and sensory systems to control balance while standing and walking. This study aimed to investigate the effect of eight weeks of proprioceptive training on balance, fatigue, and quality of life of women with MS.
Methods: The statistical population of this research included 20- to 50-year-old women with MS and a total score of 1 to 4 on the Expanded Disability Status Scale (EDSS) that are members of the Isfahan MS Association. From this population, 30 volunteers were selected conveniently and assigned to experimental and control groups. Participants of both groups completed the Fatigue Severity Scale (FSS), Multiple Sclerosis Quality of Life-54 (MSQOL-54), and Berg Balance Scale (BBS) tests before starting the training program. The experimental group performed 60-minute proprioceptive training for eight weeks and three sessions a week, and the control group performed their daily activities during this period. After 8 weeks of training, both experimental and control groups repeated the previous tests. The data were analyzed using independent and paired t-tests at the significant level of 0.05.
Results: The results showed that there was a significant difference in balance, fatigue, and quality of life of the experimental group in the post-test compared with the pre-test (P<0.05). Also, the comparison of the post-test results of the two experimental and control groups showed a significant difference in the balance and quality of life of MS patients (P<0.05).
Conclusion: Overall, eight weeks of proprioceptive training improved the balance and quality of life of MS patients, but it was not effective in reducing their fatigue. Therefore, the use of proprioceptive training is recommended for the well-being of MS patients.

کلیدواژه‌ها [English]

  • Balance
  • Fatigue
  • Multiple Sclerosis
  • Proprioception
  • Quality of Life
 
Ahmadi, A., Haghighi, A. H., Nikkhah, K & ,.Askari, R. (2018). The effect of eight weeks combined
exercise training and coenzyme Q10 supplementation on motor function in patients with multiple
sclerosis. medical journal of mashhad university of medical sciences, 61(2), 958-970.
htts//doi.org/10.22038/MJMS.2018.11564 .(In Persian)
Aman JE, Elangovan N, Yeh IL, & Konczak J. (2015). The effectiveness of proprioceptive training for improving motor function: a systematic review. Frontiers in human neuroscience, 8, 1075. htts//doi.org/10.3389/fnhum.2014.01075
Amico AP, Nisi M, Covelli I, Polito AM, Damiani S, et al. (2014) Efficacy of Proprioceptive Training with Prokin System in Balance Disorders from Multiple Sclerosis. J Mult Scler 1: 110. htts//doi.org/10.4172/jmso.1000110
Azimian, M., Farahani, A. S., Dadkhah, A., Fallahpour, M., & Karimlu, M. (2009). Fatigue severity scale:
the psychometric properties of the persian-version in patients with multiple sclerosis. Res J Biol Sci, 4(9),
974-977. htts//doi.org/rjbsci.2009.974.977 (In Persian)
Bayat F, Khanjani Z, Babapour J. Bakhshipour Roudsari A. (2021). Modeling Multiple Sclerosis Based on Sensory Processing Sensitivity by Mediation of Risk Full Decision Making. Res Behav Sci 19(2), 317-327. htts//doi.org/0.29252/rbs.19.2.317
Bayramoglu, M., Toprak, R., & Sozay, S. (2007). Effects of osteoarthritis and fatigue on proprioception of the knee joint. Archives of Physical Medicine and Rehabilitation, 88(3), 346-350 .
https://doi.org/10.1016/j.apmr.2006.12.024.
Bernier, J. N., & Perrin, D. H. (1998). Effect of coordination training on proprioception of the functionally unstable ankle. Journal of Orthopaedic & Sports Physical Therapy, 27(4), 264-275 .
https://www.jospt.org/doi/10.2519/jospt.1998.27.4.264
Cameron, M. H., Horak, F. B., Herndon, R. R., & Bourdette, D. (2008). Imbalance in multiple sclerosis: a result of slowed spinal somatosensory conduction. Somatosensory & motor research, 25(2), 113-122 https://doi.org/10.1080/08990220802131127 .
Citaker, S., Gunduz, A. G., Guclu, M. B., Nazliel, B., Irkec, C., & Kaya, D. (2011). Relationship between
foot sensation and standing balance in patients with multiple sclerosis. Gait & posture, 34(2), 275-278 .
https://doi.org/10.1016/j.gaitpost.2011.05.015
Daneshjoo, A., Gheitasi, M., & Jaffari, N. (2020). The effect of six weeks’ massage in water on walking speed, postural control, pain intensity, fatigue and quality of life in women with multiple sclerosis. Anesthesiology and Pain, 11(1), 70-84 .(In Persian)
De Groot MH, Phillips SJ, & Eskes GA. (2003). Fatigue associated with stroke and other neurologic
conditions: Implications for stroke rehabilitation. Arch Phys Med Rehabil, 84(11), 1714-1720 .
https://doi.org/10.1053/S0003-9993(03)00346-0
Dehner, C., Heym, B., Maier, D., Sander, S ,.Arand, M., Elbel, M., . . . Kramer, M. (2008). Postural control
deficit in acute QTF grade II whiplash injuries. Gait & posture, 28(1), 113-119 .https://doi.org/10.1016/j.gaitpost.2007.10.007
Ebrahimi M, Mousavi Sadati SK, Daneshjoo A. (2020). Comparison of the Effect of Proprioceptive Neuromuscular Facilitation Exercises with Mental Imagery and Working Memory on Dynamic Balance, Range of Motion and the Rate of Spasticity in MS Patients. J Clin Physio Res. 5(4): e24. Doi: https://doi.org/10.22037/jcpr.v4i3.29115. (In Persian)
Etemadifar M, Sajjadi S, Nasr Z, Firoozeei TS, Abtahi SH, Akbari M, & al, e. (2013). Epidemiology of Multiple Sclerosis in Iran: A systematic review. European Neurology, 70(5-6), 356-363. htts//doi.org/10.1159/000355140
Fereshtenejad, N., Sadeghi, E., Jamali, A., & Etemadifar, M. (2015). Foot sensory impairment and its relationship with balance and quality of life in people with Multiple sclerosis. Journal of Research in Rehabilitation Sciences, 10(5), 627-636. htts//doi.org/ 10.22122/jrrs.v10i5.2056 (In Persian)
Frzovic, D., Morris, M. E., & Vowels, L. (2000). Clinical tests of standing balance: performance of persons with multiple sclerosis. Archives of Physical Medicine and Rehabilitation, 81(2), 215-221. https://doi.org/10.1016/S0003-9993(00)90144-8
Ganesan M, Kanekar N, & Aruin AS. (2015). Direction-specific impairments of limits of stabiilty in
individuals with multiple sclerosis. Ann Phys Rehabil Med, 58, 145-150.
htts//doi.org/10.1016/j.rehab.2015.04.002.
Ghazavi N, Sadat SJ, & Roustaei N. (2021). Effect of Proprioceptive Exercises on Lower Extremity Propriocepti-on in Patients with Diabetic Neur-opathy. Journal of Clinical Care and Skills., 2(4), 201-205 .(In Persian)
Goble DJ, & Brown SH. (2008). The biological and behavioral basis of upper limb asymmetries in sensorimotor performance. . Neurosci.Biobehav.Rev., 32, 598–610. htts//doi.org/10.1016/j.neubiorev.2007.10.006
Goble DJ, Coxon JP, VanImpe A, Geurts M, Doumas M, Wenderoth N, & etal. (2011). brain activity during ankle proprioceptive stimulation predicts balance performance in young and older adults. B. J. Neurosci, 31, 16344–16352. htts//doi.org/10.1523/JNEUROSCI.4159-11.2011
Goldlist S, Wijeyaratnam DO, Edwards T, Pilutti LA, & Cressman EK. (2022). Assessing proprioceptive
acuity in people with multiple sclerosis. Mult Scler J Exp Transl Clin., 8(3), 20552173221111761.
htts//doi.org/10.1177/20552173221111761
Grueva-Pancheva, T. (2021). Effect of proprioceptive training on postural balance in patients with chronic
ankle instability. Journal of Physical Education and Sport, 21(1), 3-11 .
htts//doi.org/10.7752/jpes.2021.01001
Ghaem, H., Borhani Haghighi, A., Jafari, P., & Nikseresht, A. R. (2007). Validity and reliability of the Persian version of the multiple sclerosis quality of life questionnaire. Neurology India, 55(4), 369–375. https://doi.org/10.4103/0028-3886.33316
Jamali, A., Sadeghi-Demneh, E., Fereshtenajad, N., & Hillier, S. (2017). Somatosensory impairment and its association with balance limitation in people with multiple sclerosis. Gait & posture, 57, 224-229. https://doi.org/10.1016/j.gaitpost.2017.06.020 .(In Persian)
Karakaya, M. G. r., Rutbil, H., Akpinar, E., Yildirim, A., & Karakaya, İ. C. i. (2015). Effect of ankle proprioceptive training on static body balance. Journal of physical therapy science, 27(10), 3299-3302 .
https://doi.org/10.1589/jpts.27.3299
Kargarfard, M., Shariat, A., Ingle, L., Cleland, J. A., & Kargarfard, M. (2018). Randomized Controlled Trial to Examine the Impact of Aquatic Exercise Training on Functional Capacity, Balance, and Perceptions of Fatigue in Female Patients With Multiple Sclerosis. Archives of Physical Medicine and Rehabilitation, 99(2), 234-241. htts//doi.org/10.1016/j.apmr.2017.06.015
Kiran, D., Carlson, M., Medrano, D., & Smith, D. R. (2010). Correlation of three different knee joint position sense measures. Physical Therapy in Sport, 11(3), 81-85 .https://doi.org/10.1016/j.ptsp.2010.06.002
Kos, D., Kerckhofs, E., Nagels, G., D'hooghe, M., & Ilsbroukx, S. (2008). Origin of fatigue in multiple sclerosis: review of the literature. Neurorehabilitation and neural repair, 22(1), 91-100 htts//doi.org/10.1177/1545968306298934
Lee, H., Kim, H., Ahn, M., & You, Y. (2015). Effects of proprioception training with exercise imagery on
balance ability of stroke patients. Journal of physical therapy science, 27(1), 1-4 .https://doi.org/10.1589/jpts.27.1
Mahdizadeh, A., Lokzadeh, S., Riyahi, A., Hosseini, S. A., & Jalili, N. (2019). The Investigation of Factors Affecting the Gait of the Patients Suffering From Multiple Sclerosis. Archives of Rehabilitation, 20(1), 64-73. htts//doi.org/10.32598/rj.20.1.64.(In Persian)
Matuska, K., Mathiowetz, V., & Finlayson, M. (2007). Use and perceived effectiveness of energy
conservation strategies for managing multiple sclerosis fatigue .American Journal of Occupational
Therapy, 61(1), 62-69. htts//doi.org/10.5014/ajot.61.1.62.
Marjani F, Rahnama N, Etemadifar M. (2022). Comparison of the Effect of Selected Exercises with TRX and Aerofitness on Balance and Proprioception in Patients with Multiple sclerosis. Journal of Ilam University of Medical Sciences, 30(1), 42-54. htts//doi.org/10.52547/sjimu.30.1.42
Moghadas tabrizi, Y., Rajabi , R., Sabzi, K., Nabavi , M., & Rostami , R. (2017). the effects of neurofeedback training on balance,fatigue and quality of life in pationts with multiple sclerosis. Applied psychololgical reserch quarterly, 7(4 ), 89-100. htts//doi.org/10.22059/JAPR.2017.61082.(In Persian)
Mohammad K, Rimaz, S., Dastoorpour M, Sadeghi M, & Majdzadeh S R. (2014). Quality of Life and
Related Factors among multiple sclerosis patients. Journal of School of Public Health and Institute of
Public Health Research, 11(4), 1-14.(In Persian)
Moradi, B., Shojaeddin, S. S., & Hadanezad, M. (2017). Effect of Eight Week Theraband Resistance Training on the Fatigue Severity, the Quality of life, and the Muscular Strength of the Lower Extremity in Men with Multiple Sclerosis. The Scientific Journal of Rehabilitation Medicine (SJRM), 5(4), 146-15.(In Persian)
Motahari Nejad F, Parvaneh SH, & Ghahari S. (2016). fatigue in peopel with multiple sclerosis :cause,
evaluation and treatment. journal of paramedical and Rehabilitaion(JPSR), 5(1), 73-80
htts//doi.org/10.22038/JPSR.2016.6386.(In Persian)
Negaresh, R., Motl, R., Mokhtarzade, M., Ranjbar, R., Majdinasab, N., Khodadoost, M., . . . Patel, D. (2019).
Effect of Short-Term Interval Exercise Training on Fatigue, Depression, and Fitness in Normal Weight
vs. Overweight Person With Multiple Sclerosis. EXPLORE, 15(2), 134-141.
https://doi.org/10.1016/j.explore.2018.07.007
Newman, M., Dawes, H., van den Berg, M., Wade, D., Burridge, J., & Izadi, H. (2007). Can aerobic treadmill training reduce the effort of walking and fatigue in people with multiple sclerosis: a pilot study. Multiple Sclerosis Journal, 13(1), 113-119 .https://doi.org/10.1177/1352458506071169
Olek MJ. (2021). Multiple Sclerosis. Ann Intern Med, 174(6), 81-96. doi:10.7326/AITC202106150
Proia P, Amato A, Puleo R, Arnet F, Rizzo F, Di Grigoli L, . . . Messina G. (2019). Efficacy of 12 weeks of proprioceptive training in patients with multiple sclerosis. Journal of Human Sport and Exercise, 14(5), 1986-1992 .http://hdl.handle.net/10045/100235
Razazian N, Kazeminia M, Moayedi H, Daneshkhah A, Shohaimi S, Mohammadi M, . . . Salari N. (2020 ). The impact of physical exercise on the fatigue symptoms in patients with multiple sclerosis: a systematic review and meta-analysis. BMC Neurol, 13 20(1), 93. htts//doi.org/ 10.1186/s12883-020-01654-y
Romberg A, Virtanen A, & Ruutiainen J. (2005). Long-term exercise improves functional impairment but
not quality of life in multiple sclerosis. Neurol, 252(7), 839-845 .DOI 10.1007/s00415-005-0759-2
Rougier P, Faucher M, Cantalloube S, Lamotte D, Vinti M, & Thoumie P. (2007). How proprioceptive impairments affect quiet standing in patients with multiple sclerosis. . Somatosens.Mot.Res., 24, 41-51. htts//doi.org/10.1080/08990220701318148
Rozgar, N., Daneshjoo, A., & Divkan, B. (2020). Effect of Eight Weeks of TRX Training on Balance,
Fatigue, Muscle Strength, and Speed in Women with Multiple Sclerosis. The Scientific Journal of
Rehabilitation Medicine, 9(1), 63-73 .htts//doi.org/ 10.22037/jrm.2019.111468.2014 (In Persian)
Saleh, M. S., & Rehab, N. I. (2019). Effect of ankle proprioceptive training on gait and risk of fall in patients with diabetic neuropathy: A randomized controlled trial. International Journal of Diabetes Research, 2(1), 40-45 .
Shahvarughi Farahani A, Azimian M, Fallahpour M, & Karimlou M. (2013). Evaluation of Reliability and Validity of the Persian Version of Fatigue Severity Scale (FSS) among Persons with Multiple Sclerosis. Rehabilitation, 13(4), 84-91 .
Shumway-Cook A, & Woollacott M. (2000). Attentional demands and postural control: the effect of sensory
context. J Gerontol A Biol Sci Med Sci, 55(1), 10-16. htts//doi.org/10.1093/gerona/55
Shumway-Cook, A., & Woollacott, M. (2001). Aging and postural control .motor control: theory and
practical applications, 2nd: Baltimore, Williams & Wilkins.
Singh, S., Handa, A., & Khanna, T. (2016). Comparison of individual and combined effects of ankle
strengthening and proprioception training on balance performance in elderly women. GROUP, 67(5.44),
23.15-21.79 .htts//doi.org/ 10.9790/1959-05125662
Sokhangu, M. K., Rahnama, N., Etemadifar, M., Rafeii, M., & Saberi, A. (2021). Effect of Neuromuscular
Exercises on Strength, Proprioceptive Receptors, and Balance in Females with Multiple Sclerosis.
International Journal of Preventive Medicine, 12 .htts//doi.org/10.4103/ijpvm.IJPVM_525_18
Stillman, B. C. (2002). Making sense of proprioception: the meaning of proprioception, kinaesthesia and
related terms. Physiotherapy, 88(11), 667-676 .https://doi.org/10.1016/S0031-9406(05)60109-5
Surakka, J., Romberg, A., Ruutiainen, J., Aunola, S., Virtanen ,A., Karppi, S.-L., & Mäentaka, K. (2004).
Effects of aerobic and strength exercise on motor fatigue in men and women with multiple sclerosis: a
randomized controlled trial. Clinical rehabilitation, 18(7), 737-746 .
https://doi.org/10.1191/0269215504cr780oa
Van der Esch, M., Steultjens, M., Harlaar, J., Knol, D., Lems, W., & Dekker, J. (2007). Joint proprioception, muscle strength, and functional ability in patients with osteoarthritis of the knee. Arthritis Care & Research: Official Journal of the American College of Rheumatology, 57(5), 787-793 .https://doi.org/10.1002/art.22779
Vuillerme, N., Chenu, O., Pinsault, N., Fleury, A., Demongeot, J., & Payan, Y. (2008). Can a plantar pressure–based tongue-placed electrotactile biofeedback improve postural control under altered vestibular and neck proprioceptive conditions? Neuroscience, 155(1), 291-296 .
https://doi.org/10.1016/j.neuroscience.2008.05.018
Walton C, King R, Rechtman L, Kaye W, Leray E, Marrie RA, & al., e. (2020). Rising prevalence of multiple sclerosis worldwide: Insights from the Atlas of MS, third edition. Mult Scler, 26(14), 1816-1821. htts//doi.org/ 10.1177/1352458520970841
Wijeyaratnam DO, Edwards T, Pilutti LA, & et al. (2022). Assessing visually guided reaching in people with multiple sclerosis with and without self-reported upper limb impairment. PLOS ONE, 17, e0262480 .
https://doi.org/10.1371/journal.pone.0262480.
Zifko UA. (2004). Management of fatigue in patients with multiple sclerosis. Drugs, 64(12), 1295-1304. http://doi.org/:10.2165/00003495-200464120-00003