اثرات یک دوره تمرینات اصلاحی برروی شاخص عدم تقارن مولفه‌های نیروی عکس‌العمل زمین طی حرکت فرود در مردان سالمند دارای ژنووالگوم

نوع مقاله: مقاله پژوهشی

نویسندگان

1 استادیار گروه تربیت بدنی و علوم ورزشی، دانشکده علوم تربیتی و روانشناسی، دانشگاه محقق اردبیلی، اردبیل، ایران

2 کارشناس ارشد تربیت بدنی، دانشکده علوم ورزشی، دانشگاه تهران، تهران، ایران

چکیده

سابقه و هدف: افرادی که دچار ناهنجاری­ به ویژه در اندام تحتانی هستند، علاوه­بر استراتژی فرود مناسب نیاز به اصلاح راستای قامتی می­باشند. هدف این مطالعه بررسی اثرات برنامه تمرین اصلاحی بر شاخص عدم تقارن مولفه­های نیروی عکس­العمل زمین در افراد سالمند دارای ژنووالگوس طی حرکت فرود دو پا بود.
مواد و روش­ها: 13 مرد سالمند دارای ژنووالگوس (میانگین سنی: 21/2±92/63 سال؛ قد: 04/0±69/1 متر؛ جرم: 59/4±15/71 کیلوگرم) جهت شرکت در این پژوهش داوطلب شدند. داده­های نیروی عکس­العمل طی حرکت فرود دوپا توسط دو دستگاه صفحه­نیرو کیستلر (1000 هرتز) طی پیش‌آزمون و پس­آزمون جمع­آوری شد. مدت اجرای برنامه تمرینی اصلاحی (شامل تمرینات کششی و تمرینات مقاومتی به وسیله تراباند) 35 تا 40 دقیقه در هر جلسه، سه جلسه در هفته، و به مدت 16 هفته بود. متغیرهای وابسته شامل شاخص عدم تقارن مربوط به اوج نیروهای عکس العمل زمین، زمان رسیدن به اوج نیروها، نرخ بارگذاری، ضربه و گشتاور آزاد بود. جهت مقایسه آماری نتایج در پیش و پس­آزمون از آزمون تی زوجی استفاده شد.
یافته­ ها: شاخص عدم تقارن ضربه عمودی (9/1 درصد؛ 047/0=p) و قدامی-خلفی (8/26 درصد؛ 026/0=p) طی پس­آزمون کمتر از پیش­آزمون بود. با وجود این ختلاف معناداری بین شاخص تقارن سایر متغیرهای نیروی عکس‌العمل زمین (نیروهای عکس­العمل زمین و زمان رسیدن این نیروها به اوج، نرخ بارگذاری عمودی (97/0=p)، گشتاور آزاد (76/0=p) و ضربه داخلی-خارجی (14/0=p)) در پیش‌آزمون و پس‌آزمون مشاهده نشد.
نتیجه­ گیری: به طور کلی می‌توان گفت که تمرینات اصلاحی مورد استفاده در پژوهش حاضر بر عدم تقارن مولفه‌های نیروی عکس‌العمل اثر نداشته­اند. با وجود این، برنامه تمرینات اصلاحی احتمالا می­تواند مداخله‌ای مناسب جهت بهبود شاخص عدم تقارن ایمپالس در دو راستای عمودی و قدامی­-خلفی در مردان سالمندان دارای ژنووالگوس طی حرکت فرود دوپا باشد. بنابراین استفاده از این تمرینات برای بهبود تقارن در متغیر ضربه طی انجام فعالیت­ها در این افراد توصیه می­گردد. 

تازه های تحقیق

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کلیدواژه‌ها


عنوان مقاله [English]

Effects of Genu Valgus Corrective Training on Asymmetry Index of Ground Reaction Force Characteristics During Bilateral Drop Landing

نویسندگان [English]

  • Mohsen Barghamadi 1
  • Amirali Jafarnezhad 1
  • Mehri Gomar 2
1 Department of Physical Education and Sport Sciences, University of Mohaghegh Ardabili, Ardabil, IRAN.
2 Exercise physiology department, Faculty of Physical Education and Sports Sciences ,Tehran University, Tehran, Iran
چکیده [English]

Background & Purpose: Individuals with malalignment (especially in lower limb) in addition to suitable landing strategy need to correct postural alignment. The purpose of this study was to identify the effects of the correction exercise program on asymmetry index of landing ground reaction force characteristics in elderly individuals with genu valgus during bilateral drop landing.
Material and Methods: Thirteen elderly males with genu valgus (mean age: 63.92±2.21 years; height: 1.69±0.04 m; mass: 71.15±4.59 kg) were volunteered to participate in this study. The ground reaction forces and kinematic data of bilateral drop landing were measured by two Kistler Force Platforms (1000 Hz) during pre and posttests. The subjects conducted corrective exercise program (including both flexibility and resistance training by Thera band) for 35-40 minutes at each session, 3 times a week, for 16 weeks. Dependent variables were included: asymmetry indices of ground reaction force characteristics, their time to peak, loading rate, impulse, and free moment. Paired sample T test was used for statistical analysis.
Results: Asymmetry indices of vertical (by 1.9 %; p=0.047) and anterior-posterior (by 26.8 %; p=0.026) impulses during posttest were lower than that pretest. However, asymmetry indices of other ground reaction force variables (ground reaction forces and their time to peaks in all axes, vertical loading rate (p=0.978), free moment (p=0.763), and medio-lateral impulse (p=0.149)) between pre and posttest were not statistically different.
Conclusion: Overall, corrective exercise program did not show significant effect on asymmetry indices of ground reaction forces. However, corrective exercise program may be suitable intervention to improve asymmetry indices of vertical and anterior-posterior impulses in elderly males with genu valgus during bilateral drop landing. Therefore, using of these trainings for improvement of symmetry index of impulse during daily activities was recommended.

کلیدواژه‌ها [English]

  • Corrective training
  • Genu valgus
  • Ground reaction force
  • Impulse
  • Thera band
##Stel VS, Smit JH, Pluijm SM, Lips P. 2004. Consequences of falling in older men and women and risk factors for health service use and functional decline. Age and ageing. 33(1):58-65.##Stevens JA, Corso PS, Finkelstein EA, Miller TR. 2006. The costs of fatal and non-fatal falls among older adults. Injury prevention. 12(5):290-5.##Moon Y, Sosnoff JJ. 2016. Safe Landing Strategies During a Fall: Systematic Review and Meta-Analysis. Archives of physical medicine and rehabilitation.##Buckley JG, Heasley KJ, Twigg P, Elliott DB. 2005. The effects of blurred vision on the mechanics of landing during stepping down by the elderly. Gait & Posture. 21(1):65-71.##Gu Y, Dennis SM. 2016. Are falls prevention programs effective at reducing the risk factors for falls in people with type-2 diabetes mellitus and peripheral neuropathy: a systematic review with narrative synthesis. Journal of Diabetes and its Complications.##DeGoede K, Ashton-Miller J, Schultz A. 2003. Fall-related upper body injuries in the older adult: a review of the biomechanical issues. Journal of biomechanics. 36(7):1043-53.##Gao F, Ma J, Sun W, Guo W, Li Z, Wang W. 2016 .Radiographic assessment of knee–ankle alignment after total knee arthroplasty for varus and valgus knee osteoarthritis. The Knee. ##Smith PD, Mross P, Christopher N. 2017. Development of a Falls Reduction Yoga Program for Older Adults-A Pilot Study. Complementary Therapies in Medicine.##      Pashnameh A, Mirnasouri R, Nikravan M. 2014. Relationship between genu valgum, genu varum and flat food Deformities with Static and Dynamic Balance in Female Students of Dorud Islamic Azad University. Asian Journal Of Multidisciplinary Studies. 2(2).##Weidow J, Tranberg R, Saari T, Kärrholm J. 2006. Hip and knee joint rotations differ between patients with medial and lateral knee osteoarthritis: gait analysis of 30 patients and 15 controls. Journal of Orthopaedic Research. 24(9):1890-9.##Butler RJ, Barrios JA, Royer T, Davis IS. 2011. Frontal-plane gait mechanics in people with medial knee osteoarthritis are different from those in people with lateral knee osteoarthritis. Physical therapy. 91(8):1235-43.## Felson DT, Niu J, Gross KD, Englund M, Sharma L, Cooke TDV, et al. 2013. Valgus malalignment is a risk factor for lateral knee osteoarthritis incidence and progression: findings from the Multicenter Osteoarthritis Study and the Osteoarthritis Initiative. Arthritis & Rheumatism. 65(2):355-62.##Stubbs B, Brefka S, Denkinger MD. 2015. What works to prevent falls in community-dwelling older adults? An umbrella review of meta-analyses of randomized controlled trials. Physical therapy.##Barendrecht M, Lezeman HC, Duysens J, Smits-Engelsman BC. 2011. Neuromuscular training improves knee kinematics, in particular in valgus aligned adolescent team handball players of both sexes. The Journal of Strength & Conditioning Research. 25(3):575-84.##Chang JT, Morton SC, Rubenstein LZ, Mojica WA, Maglione M, Suttorp MJ, et al. 2004. Interventions for the prevention of falls in older adults: systematic review and meta-analysis of randomised clinical trials. Bmj. 328(7441):680.##    Gillespie LD, Gillespie WJ, Robertson MC, Lamb SE, Cumming RG, Rowe BH. 2003. Interventions for preventing falls in elderly people. Cochrane Database Syst Rev. 4.##Park K, Roemmich RT, Elrod JM, Hass CJ, Hsiao-Wecksler ET. 2016. Effects of aging and Parkinson's disease on joint coupling, symmetry, complexity and variability of lower limb movements during gait. Clinical Biomechanics. 33:92-7.##Bautmans I, Jansen B, Van Keymolen B, Mets T. 2011. Reliability and clinical correlates of 3D-accelerometry based gait analysis outcomes according to age and fall-risk. Gait & posture. 33(3):366-72.##Lewek MD, Poole R, Johnson J, Halawa O, Huang X. 2010. Arm swing magnitude and asymmetry during gait in the early stages of Parkinson's disease. Gait & posture. 31(2):256-60.##Hannah R, Morrison J, Chapman A. 1984. Kinematic symmetry of the lower limbs. Archives of physical medicine and rehabilitation. 65(4):155-8.##Hamill J, Bates B, Knutzen K. 1984. Ground reaction force symmetry during walking and running. Research Quarterly for Exercise and Sport. 55(3):289-93.##Burnett DR, Campbell-Kyureghyan NH, Cerrito PB, Quesada PM. 2011. Symmetry of ground reaction forces and muscle activity in asymptomatic subjects during walking, sit-to-stand, and stand-to-sit tasks. Journal of Electromyography and Kinesiology. 21(4):610-5.##Robinson R, Herzog W, Nigg B. 1987. Use of force platform variables to quantify the effects of chiropractic manipulation on gait symmetry. Journal of manipulative and physiological therapeutics. 10(4):172-6.##Schot PK, Bates BT, Dufek JS. 1994. Bilateral performance symmetry during drop landing: a kinetic analysis. Medicine and science in sports and exercise. 26(9):1153-9.##Griffin M, Olney S, McBride I. 1995. Role of symmetry in gait performance of stroke subjects with hemiplegia. Gait & Posture. 3(3):132-42.##Kaufman KR, Miller L, Sutherland D. 1996. Gait asymmetry in patients with limb-length inequality. Journal of Pediatric Orthopaedics. 16(2):144-50.##Doherty C, Bleakley C, Hertel J, Sweeney K, Caulfield B, Ryan J, et al. 2014. Lower extremity coordination and symmetry patterns during a drop vertical jump task following acute ankle sprain. Human movement science. 38:34-46.##Kvist J. 2004. Rehabilitation following anterior cruciate ligament injury. Sports Medicine. 34(4):269-80.##Caplan N, Stewart S, Kashyap S, Banaszkiewicz P, Gibson ASC, Kader D, et al. 2014. The effect of total hip and hip resurfacing arthroplasty on vertical ground reaction force and impulse symmetry during a sit-to-stand task. Clinical Biomechanics. 29(10):1164-9.##Queen RM, Attarian DE, Bolognesi MP, Butler RJ. 2015. Bilateral symmetry in lower extremity mechanics during stair ascent and descent following a total hip arthroplasty: A one-year longitudinal study. Clinical Biomechanics. 30(1):53-8.##Salvador AF, Schubert KR, de Oliveira Cruz RS, Corvino RB, Pereira KL, Caputo F, et al. 2016. Bilateral muscle strength symmetry and performance are improved following walk training with restricted blood flow in an elite paralympic sprint runner: Case study. Physical Therapy in Sport. 20:1-6.##          Koelewijn AD, Van den Bogert AJ. 2016. Joint contact forces can be reduced by improving joint moment symmetry in below-knee amputee gait simulations. Gait & Posture. 49:219-25.##Becker HP, Rosenbaum D, Kriese T, Gerngro H, Claes L. 1995. Gait asymmetry following successful surgical treatment of ankle fractures in young adults. Clinical orthopaedics and related research. 311:262-9.##Tsai T-Y, Li J-S, Dimitriou D, Kwon Y-M. 2015. Does component alignment affect gait symmetry in unilateral total hip arthroplasty patients? Clinical Biomechanics. 30(8):802-7.##Mikesky AE, Topp R, Wigglesworth JK, Harsha DM, Edwards JE. 1994. Efficacy of a home-based training program for older adults using elastic tubing. European journal of applied physiology and occupational physiology. 69(4):316-20.##McMaster DT, Cronin J, McGuigan M. 2009. Forms of variable resistance training. Strength & Conditioning Journal. 31(1):50-64.##Barrios JA, Heitkamp CA, Smith BP, Sturgeon MM, Suckow DW, Sutton CR. 2016. Three-dimensional hip and knee kinematics during walking, running, and single-limb drop landing in females with and without genu valgum. Clinical Biomechanics. 31:7-11.##Nyland J, Caborn D. 2004. Physiological coxa varus–genu valgus influences internal knee and ankle joint moments in females during crossover cutting. Knee Surgery, Sports Traumatology, Arthroscopy. 12(4):285-93.##Nations U. 2009. World population ageing 2009. Department of Economic and Social Affairs: Population Division. 129.##Magee DJ. 2014. Orthopedic physical assessment: Elsevier Health Sciences.##       Vanwanseele B, Parker D, Coolican M. 2009. Frontal knee alignment: three-dimensional marker positions and clinical assessment. Clinical orthopaedics and related research. 467(2):504-9.##Barrios JA, Higginson JS, Royer TD, Davis IS. 2009. Static and dynamic correlates of the knee adduction moment in healthy knees ranging from normal to varus-aligned. Clinical Biomechanics. 24(10):850-4.##Andersen LL, Andersen CH, Mortensen OS, Poulsen OM, Bjørnlund IBT, Zebis MK. 2010. Muscle activation and perceived loading during rehabilitation exercises: comparison of dumbbells and elastic resistance. Physical therapy. 90(4):538-49.##       Pollock ML, Gaesser GA, Butcher JD, Després J-p, Dishman RK, Franklin BA, et al. 1998. Acsm Position Stand. Medicine & Science in Sports & Exercise. 30(6):975-91.##       Page P, Ellenbecker T. 2005. Strength band training: Human Kinetics.##Lagally KM, Robertson RJ. 2006. Construct validity of the OMNI resistance exercise scale. The Journal of Strength & Conditioning Research. 20(2):252-6.##Clarkson PM, Hubal MJ. 2002. Exercise-induced muscle damage in humans. American journal of physical medicine & rehabilitation. 81(11):S52-S69.##Kamonseki DH, Gonçalves GA, Liu CY, Júnior IL. 2016. Effect of stretching with and without muscle strengthening exercises for the foot and hip in patients with plantar fasciitis: A randomized controlled single-blind clinical trial. Manual therapy. 23:76-82.##Munro CF, Miller DI, Fuglevand AJ. 1987. Ground reaction forces in running: a reexamination. Journal of biomechanics. 20(2):147-55.##Robertson G, Caldwell G, Hamill J, Kamen G, Whittlesey S. 2013. Research methods in biomechanics, 2E: Human Kinetics.##Farahpour N, Jafarnezhad A, Damavandi M, Bakhtiari A, Allard P. 2016. Gait ground reaction force characteristics of low back pain patients with pronated foot and able-bodied individuals with and without foot pronation. Journal of biomechanics. 49(9):1705-10.##     Su B, Song R, Guo L, Yen C. 2015. Characterizing gait asymmetry via frequency sub-band components of the ground reaction force. Biomedical Signal Processing and Control. 18:56-60.##Cohen J. 1988. Statistical power analysis for the behavior science. Lawrance Eribaum Association. ##Andriacchi TP, Mündermann A, Smith RL, Alexander EJ, Dyrby CO, Koo S. 2004. A framework for the in vivo pathomechanics of osteoarthritis at the knee. Annals of biomedical engineering. 32(3):447-57.##Haughom B, Schairer W, Souza RB, Carpenter D, Ma CB, Li X. 2012. Abnormal tibiofemoral kinematics following ACL reconstruction are associated with early cartilage matrix degeneration measured by MRI T1rho. The Knee. 19(4):482-7.##Paterno MV, Schmitt LC, Ford KR, Rauh MJ, Myer GD, Huang B, et al. 2010. Biomechanical measures during landing and postural stability predict second anterior cruciate ligament injury after anterior cruciate ligament reconstruction and return to sport. The American journal of sports medicine. 38(10):1968-78.##    McGinley JL, Baker R, Wolfe R, Morris ME. 2009. The reliability of three-dimensional kinematic gait measurements: a systematic review. Gait & posture. 29(3):360-9.##Zamparo P, Francescato M, Luca G, Lovati L, Prampera P. 1995. The energy cost of level walking in patients with hemiplegia. Scandinavian journal of medicine & science in sports.;5(6):348-52.##           Jørgensen L, Crabtree N, Reeve J, Jacobsen B. 2000. Ambulatory level and asymmetrical weight bearing after stroke affects bone loss in the upper and lower part of the femoral neck differently: bone adaptation after decreased mechanical loading. Bone. 27(5):701-7.##Di Fabio RP, Kurszewski WM, Jorgenson EE, Kunz RC. 2004. Footlift Asymmetry During Obstacle Avoidance in High‐Risk Elderly. Journal of the American Geriatrics Society.52(12):2088-93.##Yen S-C, Schmit BD, Wu M. 2015. Using swing resistance and assistance to improve gait symmetry in individuals post-stroke. Human movement science. 42:212-24.##Uchida MC, Nishida MM, Sampaio RAC, Moritani T, Arai H. 2016. Thera-band® elastic band tension: reference values for physical activity. Journal of physical therapy science. 28(4):1266.##