تأثیر پروتکل تعدیل‌شده درمان اغتشاشی بر الگوی فعالیت عضلانی و عملکرد بیماران مبتلا به پارگی لیگامان متقاطع قدامی

نوع مقاله: مقاله پژوهشی

نویسندگان

1 گروه آموزشی فیزیوتراپی، دانشکدة توانبخشی، دانشگاه علوم پزشکی جندی‌شاپور اهواز، ایران.

2 گروه آموزشی فیزیوتراپی، دانشکدة علوم توانبخشی، دانشگاه علوم پزشکی تهران، ایران.

3 گروه آمار و اطلاع‌رسانی، مرکز تحقیقات، دانشکدة علوم توانبخشی، دانشگاه علوم پزشکی تهران، ایران.

10.22118/jsmj.2012.55112

چکیده

زمینه و هدف: پارگی لیگامان متقاطع قدامی (ACL) از عمده آسیب­های مفصل زانو است. کنترل عصبی- عضلانی فاکتور حیاتی در ثبات دینامیکی مفصل زانوی بیماران دارای پارگی لیگامان متقاطع قدامی (ACLD)، می­باشد. آموزش      عصبی- عضلانی (به­ویژه اغتشاش درمانی) در تمرین درمانی و توانبخشی آسیب ACL افزایش یافته است. هدف از این تحقیق بررسی تأثیر پروتکل تعدیل­شدۀ اغتشاش درمانی بر سیستم کنترل عصبی- عضلانی و بهبود عملکرد بیماران ACLD می­باشد.
روش بررسی: 10 ورزشکار حرفه­ای مرد، با میانگین گذشت 19/3 ±7/6 ماه از پارگی یک­طرفه ACL شرکت داده شدند. اطلاعات الکترومایوگرافی سطحی(EMG) از عضلات رکتوس فموریس، واستوس مدیالیس، مدیال گاستروکنمیوس، لترال همسترینگ و گلتئوس ماگزیموس، طی انجام پرش متقاطع، جمع­آوری شد. الگوی فعالیت عضلات قبل و بعد از 10 جلسه اغتشاش درمانی مقایسه شد. نتیجة درمان از نمرات پرسش­نامه­ها و  آزمون­های عملکردی مشخص شد.
یافته­ها: نمرات پرسش­نامه IKDC و آزمون­های عملکردی بهبود معناداری داشتند(05/0>P). الگوی فعالیت عضلات تعدیل گردید. عضلة رکتوس فموریس در هر دو اندام درگیر و غیردرگیر، از یک سو شروع فعالیت زود هنگام­تر و از سوی دیگر زمان به قله رسیدن دیرتر و در مجموع فاصلة زمانی وارد عمل شدن تا رسیدن به قلة فعالیت طولانی­تری را نشان داد (05/0>P ).
نتیجه­گیری: اغتشاش درمانی تأثیر مرکزی بر سیستم کنترل عصبی-عضلانی داشته و با تغییر در کنترل فیدفوروارد (feedforward) این سیستم، سبب تعدیل آن در بیماران ACLD می­شود. فعالیت عضلة رکتوس فموریس، نه تنها به زیان ACL نیست، بلکه نقش حمایتی دارد. فعالیت بهینة این عضله در پیش­گیری و توانبخشی آسیب  ACLمهم می باشد.
م ع پ 1390؛‌10(6): 615- 627

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