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

نوع مقاله : مقاله مروری

نویسندگان
مهرداد عنبریان 1
محمد تقی کریمی 2
مهناز مروی اصفهانی 3
سید محمد مرندی 4
مسعود اعتمادی فر 5
1 دکترای بیومکانیک ورزشی، دانشیار، دانشکده تربیت بدنی و علوم ورزشی، دانشگاه بو علی سینا، همدان
2 دکترای ارتوپدی فنی، استادیار، گروه ارتوپدی فنی، دانشکده توانبخشی، دانشگاه علوم پزشکی، اصفهان
3 دانشجوی دکترای بیومکانیک ورزشی، دانشکده تربیت بدنی و علوم ورزشی، دانشگاه بو علی سینا، همدان
4 دکترای فیزیولوژی ورزش، دانشیار، گروه فیزیولوژی ورزش، دانشکده تربیت بدنی و علوم ورزشی، دانشگاه اصفهان، اصفهان
5 استاد، گروه مغز و اعصاب، دانشکده پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان
10.22122/jrrs.v10i7.1809
چکیده
مقدمه: اختلال در الگوی راه رفتن بیماران مبتلا به مولتیپل اسکلروزیس (MS) بسیار شایع 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، افزایش زمان دبل ساپورت، نامتقارنی دردوره های زمانی ایستادن بر روی پای 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 یک برنامه توانبخشی 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
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