مقایسه متغیرهای کینماتیکی اندام تحتانی در راه رفتن کودکان ناشنوا و شنوا

نوع مقاله: مقاله پژوهشی

نویسندگان

1 دانشجوی کارشناسی ارشد بیومکانیک ورزشی، گروه تربیت‌بدنی و علوم ورزشی، دانشکده علوم تربیتی و روانشناسی، دانشگاه محقق اردبیلی، اردبیل، ایران.

2 استادیار بیومکانیک ورزشی، گروه تربیت‌بدنی و علوم ورزشی، دانشکده علوم انسانی، دانشگاه آزاد اسلامی، واحد همدان، همدان، ایران

3 استادیار بیومکانیک ورزشی، گروه تربیت‌بدنی و علوم ورزشی، دانشکده علوم تربیتی و روانشناسی، دانشگاه محقق اردبیلی، اردبیل، ایران.

چکیده

سابقه و هدف: ارتباط بین کینماتیک راه رفتن و نقص در شنوایی تاکنون به درستی شناخته نشده است. هدف پژوهش حاضر مقایسه متغیرهای کینماتیکی مفاصل اندام تحتانی طی راه رفتن در کودکان ناشنوا در مقایسه با کودکان سالم بود.
روش شناسی:15 کودک ناشنوا با اختلال شنوایی دو طرفه (سن 79/1±26/11 سال) و 15 کودک سالم به‌طور هدفمند به‌عنوان گروه کنترل (سن 55/1±53/10 سال) انتخاب شدند. یک سیستم تحلیل حرکتی با چهار دوربین Vicon­­ (Oxford Metrics, Oxford, UK) جهت ثبت داده­های کینماتیک اندام تحتانی (با فرکانس نمونه‌برداری100 هرتز) استفاده شد. در این پژوهش شاخص عدم تقارن زوایای مفاصل اندام تحتانی طی فاز اتکا و نوسان راه رفتن محاسبه شد. در این مطالعه برای تحلیل آماری از تست تی مستقل استفاده شد و همچنین سطح معناداری برابر 05/0 گرفته شد.
یافته ­ها: نتایج نشان داد که مقادیر پلنتارفلکشن مچ پای سمت راست در مرحله اتکا و نوسان راه رفتن در گروه ناشنوا نسبت به گروه سالم به ترتیب حدود 37 درصد (002/0=P) و حدود 93 درصد (012/0=P) بالاتر بود. همچنین اوج اولیه فلکشن زانو در اندام سمت چپ، طی مرحله اتکا راه رفتن در گروه ناشنوا کاهش معناداری نسبت به گروه سالم داشت (حدود 12 در صد؛ 022/0P=). مقادیر شاخص عدم تقارن اوج زاویه دورسی فلکشن مفصل مچ پا طی دو فاز اتکا (011/0P=) و نوسان (015/0=P) راه رفتن در گروه ناشنوا بزرگ‌تر از گروه سالم بود.
نتیجه­ گیری: کاهش اوج فلکشن زانو در لحظه تماس پاشنه با زمین و افزایش شاخص عدم در کودکان ناشنوا طی راه رفتن می­تواند با نرخ آسیب بیشتر در این افراد مرتبط باشد. از این نتایج می­توان در پروتکل توان‌بخشی کودکان ناشنوا استفاده نمود.

کلیدواژه‌ها


عنوان مقاله [English]

Comparison of Lower Limb Kinematics in Deaf and Hearing Children during Walking

نویسندگان [English]

  • Amirhosein Sadri 1
  • Mahdi Majlesi 2
  • Amir Ali Jafarnezhadgero 3
1 Department of Physical Education and Sport Sciences, Faculty of Educational Science and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran
2 Assistant Professor of Sport Biomechanics, Department of Sport Biomechanics, Faculty of Humanities, Islamic Azad University, Hamedan Branch, Hamedan, Iran.
3 Department of Physical Education and Sport Sciences, Faculty of Educational Science and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran.
چکیده [English]

Background & Purpose: The link between gait kinematics and hearing loss is not well understood. The aim of this study was to compare lower limb kinematics during walking in children with hearing loss compared with healthy control ones.
Methodology: Fifteen deaf children with bilateral hearing impairment and fifteen matched healthy control children, were purposefully selected. A four camera Vicon system (Oxford Metrics,UK) was used to record lower-body kinematic data. In this study, the asymmetric index of lower limb kinematics was calculated during the stance and swing phases of walking. In this study, independent t-test was used for statistical analysis. The significance level was set at P Results: The results showed that the values of the right ankle plantar flexion angle in the stance and swing phases of walking in the deaf group were higher than that the healthy group by 37% (P=0.002) and 93%, respectively. Also, the initial peak of the left knee flexion angle during stance phase of walking in the deaf group was lower than that in the healthy group. The values of the ankle dorsiflexion asymmetric index in the deaf group were greater than that in the healthy group during both stance (P=0.11) and swing (P=0.015) phases of the walking.
Conclusion: Lower initial peak knee flexion and higher asymmetry index during walking in children with hearing loss could be associated with increased the rate of injuries in these individuals. These results could be used in the rehabilitation protocol of children with hearing loss.

کلیدواژه‌ها [English]

  • Walking
  • Kinematics
  • Deaf
  • Asymmetry
##Wiener-Vacher SR. 2008. Vestibular disorders in children. International journal of audiology. 47(9):578-83.##Effgen SK. 1981. Effect of an exercise program on the static balance of deaf children. Physical therapy. 61(6):873-7.##Cruickshanks KJ, Wiley TL, Tweed TS, Klein BE, Klein R, Mares-Perlman JA, et al. 1998. Prevalence of hearing loss in older adults in Beaver Dam, Wisconsin: The epidemiology of hearing loss study. American journal of epidemiology. 148(9):879-86.##DAvIs AC. 1989. The prevalence of hearing impairment and reported hearing disability among adults in Great Britain. International Journal of Epidemiology. 18(4):911-7.##Carvill S. 2001. Sensory impairments, intellectual disability and psychiatry. Journal of Intellectual Disability Research. 45(6):467-83.##Mohr PE, Feldman JJ, Dunbar JL, McConkey-Robbins A, Niparko JK, Rittenhouse RK, et al. 2000. The societal costs of severe to profound hearing loss in the United States. International journal of technology assessment in health care. 16(04):1120-35.##         Koffler T, Ushakov K, Avraham KB. 2015. Genetics of hearing loss: syndromic. Otolaryngologic clinics of North America. 48(6):1041-61.##Siegel JC, Marchetti M, Tecklin JS. 1991. Age-related balance changes in hearing-impaired children. Physical therapy. 71(3):183-9.##Jafari Z, Malayeri SA. 2011. The effect of saccular function on static balance ability of profound hearing-impaired children. International journal of pediatric otorhinolaryngology. 75(7):919-24.##Potter CN, Silverman LN. 1984. Characteristics of vestibular function and static balance skills in deaf children. Physical therapy. 64(7):1071-5.##Rajendran V, Roy FG. 2011. An overview of motor skill performance and balance in hearing impaired children. Italian journal of pediatrics. 37(1):33.##De Kegel A, Dhooge I, Cambier D, Baetens T, Palmans T, Van Waelvelde H. 2011. Test–retest reliability of the assessment of postural stability in typically developing children and in hearing impaired children. Gait & posture. 1;33(4):679-85.##de Sousa AMM, de França Barros J, de Sousa Neto BM. 2012. Postural control in children with typical development and children with profound hearing loss. International journal of general medicine. 5:433.##Pavao SL, dos Santos AN, de Oliveira AB, Rocha NACF. 2014. Functionality level and its relation to postural control during sitting-to-stand movement in children with cerebral palsy. Research in developmental disabilities. 35(2):506-11.##Pollock AS, Durward BR, Rowe PJ, Paul JP. 2000. What is balance? Clinical rehabilitation. 14(4):402-6.##Dutt-Mazumder A, Challis J, Newell K. 2016. Maintenance of postural stability as a function of tilted base of support. Human movement science. 48:91-101.##Jafarnezhadgero AA, Majlesi M, Azadian E. 2017. Gait ground reaction force characteristics in deaf and hearing children. Gait & posture. 53:236-40.##Majlesi M, Azadian E, Farahpour N, Jafarnezhad AA, Rashedi H. 2017. Lower limb muscle activity during gait in individuals with hearing loss. Australasian physical & engineering sciences in medicine. 40(3):659-65.##Melo RdS, Silva PWAd, Tassitano RM, Macky CFS, Silva LVCd. 2012. Balance and gait evaluation: comparative study between deaf and hearing students. Revista Paulista de Pediatria. 30(3):385-91.##Li L, Simonsick EM, Ferrucci L, Lin FR. 2013. Hearing loss and gait speed among older adults in the United States. Gait & posture. 38(1):25-9.##Majlesi M, Farahpour N, Azadian E, Amini M. 2014. The effect of interventional proprioceptive training on static balance and gait in deaf children. Research in developmental disabilities. 35(12):3562-7.##Heiderscheit B. Gait retraining for runners: in search of the ideal. JOSPT, Inc. JOSPT, 1033 North Fairfax Street, Suite 304, Alexandria, VA 22134-1540;2011.##Noehren B, Scholz J, Davis I. 2010. The effect of real-time gait retraining on hip kinematics, pain and function in subjects with patellofemoral pain syndrome. British journal of sports medicine. bjsports69112.##Willy RW, Scholz JP, Davis IS. 2012. Mirror gait retraining for the treatment of patellofemoral pain in female runners. Clinical Biomechanics. 27(10):1045-51. ##Crowell HP, Davis IS. 2011. Gait retraining to reduce lower extremity loading in runners. Clinical biomechanics. 26(1):78-83.##Tucker CA, Ramirez J, Krebs DE, Riley PO. 1998. Center of gravity dynamic stability in normal and vestibulopathic gait. Gait & posture. 8(2):117-23.##Herzog W, Nigg BM, Read LJ, Olsson E. 1989. Asymmetries in ground reaction force patterns in normal human gait. Med Sci Sports Exerc. 21(1):110-4.##Sadeghi H, Allard P, Prince F, Labelle H. 2000. Symmetry and limb dominance in able-bodied gait: a review. Gait & posture. 12(1):34-45.##Sadeghi H, Allard P, Duhaime M. 1997. Functional gait asymmetry in able-bodied subjects. Human Movement Science. 16(2-3):243-58.##Nasirzade A, Sadeghi H, Mokhtarinia HR, Rahimi A. 2017. Gait symmetry and its evaluation’s methods: A review. Scientific Journal of Rehabilitation Medicine. 6(2):283-97.##Bartsch R, Plotnik M, Kantelhardt JW, Havlin S, Giladi N, Hausdorff JM. 2007. Fluctuation and synchronization of gait intervals and gait force profiles distinguish stages of Parkinson's disease. Physica A: Statistical Mechanics and its Applications. 383(2):455-65.##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.##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.##Jafarnezhadgero A, Madadi-Shad M, Esker FS, Robertson D. 2017. Do different methods for measuring joint moment asymmetry give the same results? Journal of Bodywork and Movement Therapies.##Faul F, Erdfelder E, Lang A-G, Buchner A. 2007. G* Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior research methods. 39(2):175-91.##Meyns P, Van Gestel L, Bruijn SM, Desloovere K, Swinnen SP, Duysens J. 2012. Is interlimb coordination during walking preserved in children with cerebral palsy? Research in developmental disabilities. 33(5):1418-28.##Kadaba MP, Ramakrishnan H, Wootten M. 1990. Measurement of lower extremity kinematics during level walking. Journal of orthopaedic research. 8(3):383-92.##Yoon J-y, Hwang Y-i, An D-h, Oh J-s. 2014. Changes in kinetic, kinematic, and temporal parameters of walking in people with limited ankle dorsiflexion: pre-post application of modified mobilization with movement using talus glide taping. Journal of manipulative and physiological therapeutics. 37(5):320-5.##Grieve R, Barnett S, Coghill N, Cramp F. 2013. Myofascial trigger point therapy for triceps surae dysfunction: a case series. Manual therapy. 18(6):519-25.##Kobayashi T, Singer ML, Orendurff MS, Gao F, Daly WK, Foreman KB. 2015. The effect of changing plantarflexion resistive moment of an articulated ankle–foot orthosis on ankle and knee joint angles and moments while walking in patients post stroke. Clinical Biomechanics. 30(8):775-80.##Page P, Frank C, Lardner R. 2010. Assessment and treatment of muscle imbalance: the Janda approach: Human kinetics.##Tabrizi P, McIntyre W, Quesnel M, Howard A. 2000. Limited dorsiflexion predisposes to injuries of the ankle in children. Bone & Joint Journal. 82(8):1103-6.##Fong C-M, Blackburn JT, Norcross MF, McGrath M, Padua DA. 2011. Ankle-dorsiflexion range of motion and landing biomechanics. Journal of athletic training. 46(1):5-10.##Malliaras P, Cook JL, Kent P. 2006. Reduced ankle dorsiflexion range may increase the risk of patellar tendon injury among volleyball players. Journal of science and medicine in sport. 9(4):304-9.##Bell-Jenje T, Olivier B, Wood W, Rogers S, Green A, McKinon W. 2016. The association between loss of ankle dorsiflexion range of movement, and hip adduction and internal rotation during a step down test. Manual therapy. 21:256-61.##Vesci B, Padua D, Bell D, Strickland L, Guskiewicz K, Hirth C. 2007. Influence of hip muscle strength, flexibility of hip and ankle musculature, and hip muscle activation on dynamic knee valgus motion during a double-legged squat. Journal of Athletic Training. 42(2 Suppl):83.##Piva SR, Goodnite EA, Childs JD. 2005 .Strength around the hip and flexibility of soft tissues in individuals with and without patellofemoral pain syndrome. Journal of orthopaedic & sports physical therapy. 35(12):793-801.##Jordan R, Cooper M, Schuster R. 1979 .Ankle dorsiflexion at the heel-off phase of gait: a photokinegraphic study. Journal of the American Podiatric Medical Association. 69(1):40-6.##Mueller MJ, Minor SD, Schaaf JA, Strube MJ, Sahrmann SA. 1995 .Relationship of plantar-flexor peak torque and dorsiflexion range of motion to kinetic variables during walking. Physical therapy. 75(8):684-93.##Liikavainio T, Isolehto J, Helminen HJ, Perttunen J, Lepola V, Kiviranta I, et al. 2007. Loading and gait symmetry during level and stair walking in asymptomatic subjects with knee osteoarthritis: importance of quadriceps femoris in reducing impact force during heel strike? The Knee. 14(3):231-8.##Delfico AJ, Garrett WE. 1998 .Mechanisms of injury of the anterior cruciate ligament in soccer players. Clinics in sports medicine. 17(4):779-85.##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.##Yu B, Lin C-F, Garrett WE. 2006 .Lower extremity biomechanics during the landing of a stop-jump task. Clinical Biomechanics. 21(3):297-305.##Decker MJ, Torry MR, Wyland DJ, Sterett WI, Steadman JR  .2003 .Gender differences in lower extremity kinematics, kinetics and energy absorption during landing. Clinical biomechanics. 18(7):662-9.##Neumann DA. 2013 .Kinesiology of the Musculoskeletal System-E-Book: Foundations for Rehabilitation: Elsevier Health Sciences.##Knutsson E, Mårtensson A. 1971 .Quantitative effects of L-dopa on different types of movements and muscle tone in Parkinsonian patients. Scandinavian journal of rehabilitation medicine. 3(3):121-30.##Chiu M-C, Wang M-J. 2007 .The effect of gait speed and gender on perceived exertion, muscle activity, joint motion of lower extremity, ground reaction force and heart rate during normal walking. Gait & posture. 25(3):385-92.##Keller TS, Weisberger A, Ray J, Hasan S, Shiavi R, Spengler D .1996 .Relationship between vertical ground reaction force and speed during walking, slow jogging, and running. Clinical biomechanics. 11(5):253-9.##Ellis RG, Howard KC, Kram R. 2013. The metabolic and mechanical costs of step time asymmetry in walking. Proceedings of the Royal Society of London B: Biological Sciences. 280(1756):20122784.##Hodt-Billington C, Helbostad JL, Vervaat W, Rognsvåg T, Moe-Nilssen R. 2012. Criteria of gait asymmetry in patients with hip osteoarthritis. Physiotherapy theory and practice. 28(2):134-41.##Durham S, Eve L, Stevens C, Ewins D. 2004. Effect of functional electrical stimulation on asymmetries in gait of children with hemiplegic cerebral palsy. Physiotherapy. 90(2):82-90.##