ويژه نامه ورزشي، دوره 10، شماره 7، 1393:875-95

الگوی راه رفتن در بیماران مبتلا به مولتیپل اسکلروزیس و اثر توانبخشی بر آن

مهرداد عنبريان, محمد تقي کريمي, مهناز مروي اصفهاني, سيد محمد مرندي, مسعود اعتمادي فر

DOI: 10.22122/jrrs.v10i7.1809

چکیده


مقدمه: اختلال در الگوي راه رفتن بيماران مبتلا به مولتیپل اسکلروزیس (MS) بسیار شايع است. با وجود تحقیقات زیاد در این زمینه، نتایج متناقض است و هنوز پروتکل درمانی موثر بر بهبود الگوی راه رفتن این بیماران ارائه نشده است. هدف از اجرای این تحقیق ارائه ویژگی ها و الگوهای مختلف راه رفتن در بیماران مبتلا به MS و بررسی پروتکل های درمانی و ارائه یک پروتکل درمانی مناسب برای بهبود الگوی راه رفتن این بیماران بود.

روش اجرا: یک جستجوی الکترونیکی در وب سایت هایPubMed, Embase, and ISI Web of Knowledge انجام و تحقیقات منتشر شده بر ویژگی های الگوی راه رفتن و انواع پروتکل های درمانی مؤثر بر آناز سال های 1990 ـ 2014 استخراج گردید.الگوی راه رفتن بر اساس پارامترهای فضایی ـ مکانی، مقادیر کلینیکی از قبیل سرعت، زمان و مسافت پیموده شده و انواع پروتکل های درمانی مؤثر بر آن مطابق با نتایج پیشینارائه شد.

یافته ها:ویژگی های الگوی راه رفتن بیماران در مقایسه با افراد سالم شامل کاهش در متغیرهای طول گام، طول استراید، کادنس، سرعت، حرکات مفصل، افزايش زمان دبل ساپورت، نامتقارني دردوره هاي زمانی ايستادن بر روي پاي راست و چپ و تغییرپذیری زیاد در اکثر پارامترهای الگوی راه رفتن بود. دامنه حرکتی مفاصل نیز در فازهای مختلف راه رفتن با کاهش و افزایش همراه بود.یک برنامه ی توانبخشی خاص، بر اساس آموزش قدرت می تواند منجر به بهبود عملکرد بیماران در راه رفتن، تعادل، ثبات مفصل زانو و کاهش ناهنجاریهای زانو شود.

نتیجه گیری:انواع الگوهای راه رفتن اسپاستیک و آتاکسی مخچه ایی در این بیماران به وضوح مشاهده می شود. طراحی يك برنامه توانبخشي با توجه به افزایش قدرت عضلات اندام تحتانی بویژه عضله همسترینگ و تصحیح الگوی راه رفتن برای این بیماران توصیه می شود.

کلید واژه ها: الگوی راه رفتن، مولتیپل اسکلروزیس، توانبخشی


تمام متن:

PDF

مراجع


Herrera WG. Vestibular and other balance disorders in multiple sclerosis. Differential diagnosis of disequilibrium and topognostic localization. Neurol Clin 1990; 8(2): 407-20.

Doring A, Pfueller CF, Paul F, Dorr J. Exercise in multiple sclerosis- an integral component of disease management. EPMA J 2011; 3(1): 2.

Cameron MH, Wagner JM. Gait abnormalities in multiple sclerosis: pathogenesis, evaluation, and advances in treatment. Curr Neurol Neurosci Rep 2011; 11(5): 507-15.

Kurtzke JF. Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology 1983; 33(11): 1444-52.

Morris ME, Cantwell C, Vowels L, Dodd K. Changes in gait and fatigue from morning to afternoon in people with multiple sclerosis. J Neurology Neurosurgery Psychiatry 2002 ;72(3): 361-5.

Lassmann H. The pathology of multiple sclerosis and its evolution. Philos Trans R Soc Lond B Biol Sci 1999; 354(1390): 1635-40.

Weinshenker BG, Bass B, Rice GP, Noseworthy J, Carriere W, Baskerville J, et al. The natural history of multiple sclerosis: a geographically based study. I. Clinical course and disability. Brain 1989; 112 (Pt 1): 133-46.

Weinshenker BG. The natural history of multiple sclerosis. Neurol clin 1995; 13(1): 119-46.

Downs SH, Black N. The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non- randomised studies of health care interventions. J Epidemiol Community Health 1998; 52: 377–84.

Kaufman M, Moyer D, Norton J. The significant change for the Timed 25-foot Walk in the multiple sclerosis functional composite. Mult Sclerosis J 2000; 6(4): 286-90.

Benedetti MG, Piperno R, Simoncini L, Bonato P, Tonini A, Giannini S. Gait abnormalities in minimally impaired multiple sclerosis patients. Mult Sclero 1999; 5(5): 363-8.

Kelleher KJ, Spence W, Solomonidis S, Apatsidis D. The characterisation of gait patterns of people with multiple sclerosis. Disabil Rehabil 2010;32(15): 1242-50.

Sacco R, Bussman R, Oesch P, Kesselring J, Beer S. Assessment of gait parameters and fatigue in MS patients during inpatient rehabilitation: a pilot trial. J Neurol 2011; 258(5): 889-94.

Givon U, Zeilig G, Achiron A. Gait analysis in multiple sclerosis: characterization of temporal-spatial parameters using GAITRite functional ambulation system. Gait Posture 2009; 29(1): 138-42.

Martin CL, Phillips BA, Kilpatrick TJ, Butzkueven H, Tubridy N, McDonald E, et al. Gait and balance impairment in early multiple sclerosis in the absence of clinical disability. Mult Scler 2006; 12(5): 620-8.

Thoumie P, Lamotte D, Cantalloube S, Faucher M, Amarenco G. Motor determinants of gait in 100 ambulatory patients with multiple sclerosis. Mult Scler 2005; 11(4): 485-91.

Gehlsen G, Beekman K, Assmann N, Winant D, Seidle M, Carter A. Gait characteristics in multiple sclerosis: progressive changes and effects of exercise on parameters. Arch Phys Med Rehabil 1986; 67(8): 536-9.

Crenshaw SJ, Royer TD, Richards JG, Hudson DJ. Gait variability in people with multiple sclerosis. Mult Scler 2006; 12(5): 613-9.

Remelius JG, Hamill J, Kent-Braun J, Van Emmerik RE. Gait initiation in multiple sclerosis. Motor Control 2008; 12(2): 93-108.

Savci S, Inal-Ince D, Arikan H, Guclu-Gunduz A, Cetisli-Korkmaz N, Armutlu K, et al. Six-minute walk distance as a measure of functional exercise capacity in multiple sclerosis. Disabil Rehabil 2005; 27(22): 1365-71.

Franceschini M, Rampello A, Bovolenta F, Aiello M, Tzani P, Chetta A. Cost of walking, exertional dyspnoea and fatigue in individuals with multiple sclerosis not requiring assistive devices. J Rehabil Med 2010; 42(8): 719-23.

Gijbels D, Alders G, Van Hoof E, Charlier C, Roelants M, Broekmans T, et al. Predicting habitual walking performance in multiple sclerosis: relevance of capacity and self-report measures. Mult Sclerosis 2010; 16(5): 618-26.

Hamilton F, Rochester L, Paul L, Rafferty D, O'Leary CP, Evans JJ. Walking and talking: an investigation of cognitive-motor dual tasking in multiple sclerosis. Mult Scler 2009; 15(10): 1215-27.

Ng AV, Miller RG, Gelinas D, Kent-Braun JA. Functional relationships of central and peripheral muscle alterations in multiple sclerosis. Muscle Nerve 2004; 29(6): 843-52.

Dalgas U, Stenager E, Ingemann-Hansen T. Multiple sclerosis and physical exercise: recommendations for the application of resistance-, endurance- and combined training. Mult Scler 2008; 14(1): 35-53.

Larocca NG. Impact of walking impairment in multiple sclerosis: perspectives of patients and care partners. Patient 2011; 4(3): 189-201.

Rodgers MM, Mulcare JA, King DL, Mathews T, Gupta SC, Glaser RM. Gait characteristics of individuals with multiple sclerosis before and after a 6-month aerobic training program. J Rehabil Res Devel 1999; 36(3): 183-8.

Kalron A, Dvir Z, Givon U, Baransi H, Achiron A. Gait and jogging parameters in people with minimally impaired multiple sclerosis. Gait Posture 2014; 39(1): 297-302.

Socie MJ, Motl RW, Pula JH, Sandroff BM, Sosnoff JJ. Gait variability and multiple sclerosis. Gait Posture 2013; 38(1): 51-5.

Socie MJ, Motl RW, Pula JH, Sandroff BM, Sosnoff JJ. Gait variability and disability in multiple sclerosis. Gait Posture 2013; 38(1): 51-5.

Huisinga JM, Schmid KK, Filipi ML, Stergiou N. Gait mechanics are different between healthy controls and patients with multiple sclerosis. J App Biomech 2013; 29(3): 303-11.

Wurdeman SR, Huisinga JM, Filipi M, Stergiou N. Multiple sclerosis alters the mechanical work performed on the body's center of mass during gait. J Appl Biomech 2013; 29(4): 435-42.

Scott SM, van der Linden ML, Hooper JE, Cowan P, Mercer TH. Quantification of gait kinematics and walking ability of people with multiple sclerosis who are new users of functional electrical stimulation. J Rehabil Med 2013; 45(4): 364-9.

Pilutti LA, Dlugonski D, Sandroff BM, Suh Y, Pula JH, Sosnoff JJ, et al. Gait and six-minute walk performance in persons with multiple sclerosis. J Neurol Sci 2013; 334(1-2): 72-6.

Pilutti LA, Dlugonski D, Sandroff BM, Suh Y, Pula JH, Sosnoff JJ, et al. Further validation of multiple sclerosis walking scale-12 scores based on spatiotemporal gait parameters. Arch Phys Med Rehabil 2013; 94(3): 575-8.

Sosnoff JJ, Sandroff BM, Motl RW. Quantifying gait abnormalities in persons with multiple sclerosis with minimal disability. Gait Posture 2012; 36(1): 154-6.

Remelius JG, Jones SL, House JD, Busa MA, Averill JL, Sugumaran K, et al. Gait impairments in persons with multiple sclerosis across preferred and fixed walking speeds. Arch Phys Med Rehabil 2012; 93(9): 1637-42.

Spain RI, St George RJ, Salarian A, Mancini M, Wagner JM, Horak FB, et al. Body-worn motion sensors detect balance and gait deficits in people with multiple sclerosis who have normal walking speed. Gait Posture 2012; 35(4): 573-8.

D'Orio VL, Foley FW, Armentano F, Picone MA, Kim S, Holtzer R. Cognitive and motor functioning in patients with multiple sclerosis: neuropsychological predictors of walking speed and falls. J Neurol Sci 2012; 316(1-2): 42-6.

Weikert M, Suh Y, Lane A, Sandroff B, Dlugonski D, Fernhall B, et al. Accelerometry is associated with walking mobility, not physical activity, in persons with multiple sclerosis. Med Eng Phys 2012; 34(5): 590-7.

Motl RW, Sandroff BM, Suh Y, Sosnoff JJ. Energy cost of walking and its association with gait parameters, daily activity, and fatigue in persons with mild multiple sclerosis. Neurorehabil Neural Repair 2012; 26(8): 1015-21.

Kempen JC, de Groot V, Knol DL, Polman CH, Lankhorst GJ, Beckerman H. Community walking can be assessed using a 10-metre timed walk test. Mult Scler 2011; 17(8): 980-90.

Wurdeman SR, Huisinga JM, Filipi M, Stergiou N. Multiple sclerosis affects the frequency content in the vertical ground reaction forces during walking. Clin Biomechanics 2011; 26(2): 207-12.

Yahia A, Ghroubi S, Mhiri C, Elleuch MH. Relationship between muscular strength, gait and postural parameters in multiple sclerosis. Ann Phys Rehabil Med 2011; 54(3): 144-55.

Sosnoff JJ, Shin S, Motl RW. Multiple sclerosis and postural control: the role of spasticity. Arch Phys Med Rehabil 2010; 91(1): 93-9.

Kasser SL, Jacobs JV, Foley JT, Cardinal BJ, Maddalozzo GF. A prospective evaluation of balance, gait, and strength to predict falling in women with multiple sclerosis. Arch Phys Med Rehabil 2011;92(11): 1840-6.

Kalron A, Achiron A, Dvir Z. Muscular and gait abnormalities in persons with early onset multiple sclerosis. J Neurol Phys Ther 2011; 35(4): 164-9.

Gianfrancesco MA, Triche EW, Fawcett JA, Labas MP, Patterson TS, Lo AC. Speed- and cane-related alterations in gait parameters in individuals with multiple sclerosis. Gait Posture 2011; 33(1): 140-2.

Kalron A, Dvir Z, Achiron A. Walking while talking- difficulties incurred during the initial stages of multiple sclerosis disease process. Gait Posture 2010; 32(3): 332-5.

Kelleher KJ, Spence WD, Solomonidis S, Apatsidis D. The effect of textured insoles on gait patterns of people with multiple sclerosis. Gait Posture 2010; 32(1): 67-71.

. Mendes A, Sa MJ. Classical immunomodulatory therapy in multiple sclerosis: how it acts, how it works. Arq Neuropsiquiatr 2011; 69(3): 536-43.

Thompson AJ. Neurorehabilitation in multiple sclerosis: foundations, facts and fiction. Curr Opin Neurol 2005; 18(3): 267-71.

. Dalgas U, Stenager E, Jakobsen J, Petersen T, Hansen HJ, Knudsen C, et al. Resistance training improves muscle strength and functional capacity in multiple sclerosis. Neurology 2009; 73(18): 1478-84.

Gutierrez GM, Chow JW, Tillman MD, McCoy SC, Castellano V, White LJ. Resistance training improves gait kinematics in persons with multiple sclerosis. Arch Phys Med Rehabil 2005; 86(9): 1824-9.

Broekmans T, Gijbels D, Eijnde BO, Alders G, Lamers I, Roelants M, et al. The relationship between upper leg muscle strength and walking capacity in persons with multiple sclerosis. Mult Scler 2013; 19(1): 112-9.

.White LJ, Dressendorfer RH. Exercise and multiple sclerosis. Sports Med 2004; 34(15): 1077-100.

.Stroud NM, Minahan CL. The impact of regular physical activity on fatigue, depression and quality of life in persons with multiple sclerosis. Health Qual life Outcomes 2009; 7: 68.

Medina-Perez C, de Souza-Teixeira F, Fernandez-Gonzalo R, de Paz-Fernandez JA. Effects of a resistance training program and subsequent detraining on muscle strength and muscle power in multiple sclerosis patients. Neuro Rehabil 2014; 34(3): 523-30.

Taylor P, Barrett C, Mann G, Wareham W, Swain I. A feasibility study to investigate the effect of functional electrical stimulation and physiotherapy exercise on the quality of gait of people with multiple sclerosis. Neuromodulation 2014;17(1): 75-84.

Baert I, Freeman J, Smedal T, Dalgas U, Romberg A, Kalron A, et al. Responsiveness and clinically meaningful improvement, according to disability level, of five walking measures After Rehabilitation in Multiple Sclerosis: A European Multicenter Study. Neurorehabil Neural Repair 2014; 28(7): 621-31.

Tarakci E, Yeldan I, Huseyinsinoglu BE, Zenginler Y, Eraksoy M. Group exercise training for balance, functional status, spasticity, fatigue and quality of life in multiple sclerosis: a randomized controlled trial. Clin Rehabil 2013; 27(9): 813-22.

Straudi S, Benedetti MG, Venturini E, Manca M, Foti C, Basaglia N. Does robot-assisted gait training ameliorate gait abnormalities in multiple sclerosis? A pilot randomized-control trial. Neuro Rehabil 2013; 33(4): 555-63.

Latimer-Cheung AE, Pilutti LA, Hicks AL, Martin Ginis KA, Fenuta AM, MacKibbon KA, et al. Effects of exercise training on fitness, mobility, fatigue, and health-related quality of life among adults with multiple sclerosis: a systematic review to inform guideline development. Arch Phys Med Rehabil 2013; 94(9): 1800-28.

Ruiz J, Labas MP, Triche EW, Lo AC. Combination of robot-assisted and conventional body-weight-supported treadmill training improves gait in persons with multiple sclerosis: a pilot study. J Neurol Phys Ther 2013; 37(4): 187-93.

Hilgers C, Mundermann A, Riehle H, Dettmers C. Effects of whole-body vibration training on physical function in patients with multiple sclerosis. Neuro Rehabil 2013; 32(3): 655-63.

Shafizadeh M, Platt GK, Mohammadi B. Effects of different focus of attention rehabilitative training on gait performance in Multiple Sclerosis patients. J Body W Mov Ther 2013; 17(1): 28-34.

Learmonth YC, Paul L, Miller L, Mattison P, McFadyen AK. The effects of a 12-week leisure centre-based, group exercise intervention for people moderately affected with multiple sclerosis: a randomized controlled pilot study. Clin Rehabil 2012; 26(7): 579-93.

Silva KM, Tucano SJ, Kumpel C, Castro AA, Porto EF. Effect of hydrotherapy on quality of life, functional capacity and sleep quality in patients with fibromyalgia. Rev Bras Reumatol 2012; 52(6): 851-7.

Freeman JA, Gear M, Pauli A, Cowan P, Finnigan C, Hunter H, et al. The effect of core stability training on balance and mobility in ambulant individuals with multiple sclerosis: a multi-centre series of single case studies. Mult Scler 2010; 16(11): 1377-84.

Sheffler LR, Hennessey MT, Knutson JS, Chae J. Neuroprosthetic effect of peroneal nerve stimulation in multiple sclerosis: a preliminary study. Arch Phys Med Rehabil 2009; 90(2): 362-5.

Sheffler LR, Bailey SN, Chae J. Spatiotemporal and kinematic effect of peroneal nerve stimulation versus an ankle-foot orthosis in patients with multiple sclerosis: a case series. PM R 2009; 1(7): 604-11.

Baram Y, Miller A. Auditory feedback control for improvement of gait in patients with Multiple Sclerosis. J Neurological Sci 2007; 254(1-2): 90-4.

Newman MA, Dawes H, van den Berg M, Wade DT, Burridge J, Izadi H. Can aerobic treadmill training reduce the effort of walking and fatigue in people with multiple sclerosis: a pilot study. Mult Scler 2007; 13(1): 113-9.

Rampello A, Franceschini M, Piepoli M, Antenucci R, Lenti G, Olivieri D, et al. Effect of aerobic training on walking capacity and maximal exercise tolerance in patients with multiple sclerosis: a randomized crossover controlled study. Phys Therapy 2007; 87(5): 545-55.

van den Berg M, Dawes H, Wade DT, Newman M, Burridge J, Izadi H et al. Treadmill training for individuals with multiple sclerosis: a pilot randomised trial. J Neurol Neurosurg Psychiatry 2006; 77(4):531–33.

Dodd KJ, Taylor NF, Denisenko S, Prasad D. A qualitative analysis of a progressive resistance exercise programme for people with multiple sclerosis. Disabil Rehabil 2006; 28(18):1127-34.

Taylor NF, Dodd KJ, Prasad D, Denisenko S. Progressive resistance exercise for people with multiple sclerosis. Disabil Rehabil 2006; 28(18): 1119-26.

White LJ, McCoy SC, Castellano V, Ferguson MA, Hou W, Dressendorfer RH. Effect of resistance training on risk of coronary artery disease in women with multiple sclerosis. Scand J Clin lab Invest 2006; 66(4): 351-5.

White LJ, Castellano V, Mc Coy SC. Cytokine responses to resistance training in people with multiple sclerosis. J sports sci 2006; 24(8): 911-4.

Robineau S, Nicolas B, Gallien P, Petrilli S, Durufle A, Edan G, et al. Eccentric isokinetic strengthening in hamstrings of patients with multiple sclerosis. Ann Readapt Med Phys 200; 48(1): 29-33.

Kileff J, Ashburn A. A pilot study of the effect of aerobic exercise on people with moderate disability multiple sclerosis. Clin Rehabil 2005; 19(2): 165-9.

Koudouni A OA. Contribution of aerobic exercise to the improvement of quality of life in persons suffering from multiple sclerosis. Multiple sclerosis international. 2004; 10(S132).

Schulz KH, Gold SM, Witte J, Bartsch K, Lang UE, Hellweg R, et al. Impact of aerobic training on immune-endocrine parameters, neurotrophic factors, quality of life and coordinative function in multiple sclerosis. J Neurol Sci 2004; 225(1-2): 11-8.

Heesen C, Gold SM, Hartmann S, Mladek M, Reer R, Braumann KM, et al. Endocrine and cytokine responses to standardized physical stress in multiple sclerosis. Brain Behav Immu 2003; 17(6): 473-81.

O’Connell R, Murphy RM, Hutchinson M, Cooke G, Coote S. A controlled study to assess the effects of aerobic training on patients with multiple sclerosis. Proceedings of 14th International World Confederation for Physical Therapy; 2003; June 7-12; Barcelona, Spain, 2003, RR-PL-2105.

Husted C, Pham L, Hekking A, Niederman R. Improving quality of life for people with chronic conditions: the example of t'ai chi and multiple sclerosis. Altern Ther Health Med 1999; 5(5): 70-4.

Harvey L SA, Jones R. The effect of weighted leg raises on quadriceps strength, EMG parameters and functional activities in people with multiple sclerosis. Physiotherapy 1999; 85(3): 154–61.

Kraft GH,Alguist AD,de Lateur BJ. Effects of resistive exercise on function in multiple sclerosis (MS). Vet Aff Rehabil Res Dev Prog Rep 1996; 33: 328–9.

Mevellec E, Lamotte D, Cantalloube S, Amarenco G, Thoumie P. Relationship between gait speed and strength parameters in multiple sclerosis .Ann Readapt Phys 2003; 46(2): 85-90.

Bickley L. Bate's guide to physical examination and history taking. Trans. Gheiratian MM, Motaghed M, Yazdinejad A. Tehran: Andishe Rafie; 2009. p. 673.

Cantalloube S, Monteil I, Lamotte D, Mailhan L, Thoumie P. Strength, postural and gait changes following rehabilitation in multiple sclerosis. Ann Readapt Med Phys 2006; 49(4): 143-9.

de Sa JC, Airas L, Bartholome E, Grigoriadis N, Mattle H, Oreja-Guevara C, et al. Symptomatic therapy in multiple sclerosis: a review for a multimodal approach in clinical practice. Ther Adv Neurol Dis 2011; 4(3): 139-68.

Petajan JH, White AT. Recommendations for physical activity in patients with multiple sclerosis. Sports Med 1999; 27(3): 179-91.


ارجاعات

  • در حال حاضر ارجاعی نیست.


Creative Commons Attribution-NonCommercial 4.0

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 Unported License which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.