Multipl Skleroz hastalarında aerobik eğitim ile kombine gövde stabilizasyon eğitiminin denge, alt ekstremite kas kuvveti ve kor stabilite üzerine etkilerinin incelenmesi: randomize kontrollü bir çalışma

Yıl 2022, Cilt: 9 Sayı: 1, 20 - 29, 29.04.2022

Taşkın Özkan , Nezehat Özgül Ünlüer

https://doi.org/10.15437/jetr.836058

Öz

Amaç: Çalışmanın amacı, Multipl Skleroz (MS) hastalarında aerobik eğitim ile kombine gövde stabilizasyon eğitiminin denge, alt ekstremite kas kuvveti ve kor stabilite üzerine etkilerinin incelenmesiydi.
Yöntem: Çalışmaya relapsing remitting tip MS tanısı alan 16 birey dahil edildi. MS-egzersiz grubuna (6’sı kadın, 2’si erkek) aerobik eğitim ile kombine gövde stabilizasyon eğitimi, MS-aktif kontrol grubuna (5’i kadın, 3’ü erkek) aerobik eğitim verildi. Haftada 2 gün ve toplam 8 hafta olmak üzere egzersiz eğitimi uygulandı. Denge, alt ekstremite kas kuvveti ve kor endurans tedavi öncesi ve sonrası değerlendirildi.
Bulgular: Çalışma sonucunda MS-egzersiz grubunda dengenin alt parametreleri olan postüral stabilite ve stabilite limitinde, alt ekstremite kas kuvveti ve kor enduransta anlamlı gelişme olduğu (p<0,05), MS-aktif kontrol grubunda postüral stabilite ve alt ekstremite kas kuvvetinde anlamlı gelişme olduğu (p<0,05), stabilite limiti ve kor endurans değerlerlerinde ise anlamlı bir değişim olmadığı belirlendi (p>0,05). MS-egzersiz ve MS-aktif kontrol gruplarının eğitim öncesi ve sonrası stabilite limitleri ve kor endurans test sonuçlarının farkları arasında anlamlı bir değişim olduğu (p<0,05), postüral stabilite ve alt ekstremite kas kuvveti test sonuçlarının farkları arasında ise anlamlı bir değişim olmadığı gözlemlendi (p>0,05).
Sonuç: Aerobik eğitim ile kombine gövde stabilizasyon eğitimi denge, alt ekstremite kas kuvveti ve kor endurans üzerine etkilidir. Aerobik eğitim ile kombine gövde stabilizasyon eğitiminin daha ileri özür düzeyindeki relapsing-remitting tip MS hastalarında daha uzun süreli etkilerinin araştırılacağı çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

Denge, Egzersiz, Multipl Skleroz, Kas kuvveti

Destekleyen Kurum

-

Proje Numarası

-

Teşekkür

-

Investigation of the effects of trunk stabilization training combined with aerobic training on balance, lower limb muscle strength, and core stability in patients with Multiple Sclerosis: a randomized controlled study

Öz

Purpose: To examine the effects of trunk stabilization training combined with aerobic training on balance, lower extremity muscle strength, and core stability in patients with Multiple Sclerosis (MS).
Methods: Sixteen individuals diagnosed with relapsing-remitting MS were included in the study. Trunk stabilization training combined with aerobic training was given to the MS-exercise group (6 women, 2 men), and aerobic group was given to the MS-active control group (5 women, 3 men). Exercise training was applied 2 days a week for 8 weeks. Balance, lower extremity muscle strength and core endurance were assessed before and after the training.
Results: There was a significant improvement in postural stability and stability limit, which are sub-parameters of balance, lower extremity muscle strength and core endurance in MS-exercise group (p<0.05), there was a significant improvement in postural stability and lower extremity muscle strength (p<0.05), and there was no significant change in stability limits and core endurance (p>0.05) in MS-active control group. There was a significant change between the stability limits and core endurance test results differences before and after the training of MS-exercise and MS-active control groups (p<0.05), but there was no significant change between the differences in postural stability and lower extremity muscle strength test results (p>0.05).
Conclusion: Trunk stabilization training combined with aerobic training is effective on balance, lower extremity muscle strength and core endurance. There is a need for studies to investigate the longer-term effects of trunk stabilization training combined with aerobic training in relapsing-remitting MS patients with more severe disability.

Anahtar Kelimeler

Balance, Exercise, Multiple Sclerosis, Muscle strength

Proje Numarası

-

Kaynakça

• 1. Hunter SF. Overview and diagnosis of multiple sclerosis. Am J Manag Care. 2016;22:141-150.
• 2. Jacobs JV, Kasser SL. Balance impairment in people with multiple sclerosis: preliminary evidence for the Balance Evaluation Systems Test. Gait Posture. 2012;36:414-418.
• 3. Cameron MH, Lord S. Postural control in multiple sclerosis: implications for fall prevention. Curr Neurol Neurosci. 2010;10:407-412.
• 4. Preuss R, Fung J. Musculature and biomechanics of the trunk in the maintenance of upright posture. J Electromyogr Kinesiol. 2008;18:815-828.
• 5. Yoosefinejad AK, Motealleh A, Khademi S, et al. Lower endurance and strength of core muscles in patients with multiple sclerosis. Int J MS Care. 2017;19:100-104.
• 6. Jørgensen MLK, Dalgas U, Wens I, et al. Muscle strength and power in persons with multiple sclerosis - a systematic review and meta-analysis. J Neurol Sci. 2017;376:225-241.
• 7. Motl RW, Pilutti LA. The benefits of exercise training in multiple sclerosis. Nat Rev Neurol. 2012;8:487-497.
• 8. Latimer-Cheung AE, Pilutti LA, Hicks AL, 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;94:1800-1828.
• 9. Edwards T, Pilutti LA. The effect of exercise training in adults with multiple sclerosis with severe mobility disability: a systematic review and future research directions. Mult Scler Relat Disord. 2017;16:31-39.
• 10. Halabchi F, Alizadeh Z, Sahraian MA, et al. Exercise prescription for patients with multiple sclerosis; potential benefits and practical recommendations. BMC Neurol. 2017;17:185.
• 11. Latimer-Cheung AE, Ginis KAM, Hicks AL, et al. Development of evidence-informed physical activity guidelines for adults with multiple sclerosis. Archives of physical medicine and rehabilitation. 2013;94(9):1829-36. e7.
• 12. Freeman J, Gear M, Pauli A, 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 J. 2010;16:1377-1384.
• 13. Arntzen EC, Straume BK, Odeh F, et al. Group-based individualized comprehensive core stability intervention improves balance in persons with multiple sclerosis: A randomized controlled trial. Phys Ther. 2019;99:1027-1038.
• 14. Amiri B, Sahebozamani M, Sedighi B. The effects of 10-week core stability training on balance in women with multiple sclerosis according to Expanded Disability Status Scale: a single-blinded randomized controlled trial. Eur J Phys Rehabil Med. 2019;55:199-208. 15. Novak CB. Upper extremity work-related musculoskeletal disorders: a treatment perspective. J Orthop Sports Phys Ther. 2004;34:628-637.
• 16. Kara B, Küçük F, Tomruk MS, et al. Different types of exercise in multiple sclerosis: aerobic exercise or pilates, a single-blind clinical study. J Back Musculoskelet Rehabil. 2017;30:565-573.
• 17. Benedetti M, Gasparroni V, Stecchi S, et al. Treadmill exercise in early mutiple sclerosis: a case series study. Eur J Phys Rehabil Med. 2009;45:53-59.
• 18. Kurtzke JF. Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology. 1983;33:1444-1452.
• 19. Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12:189-198.
• 20. Tombaugh TN, McIntyre NJ. The mini‐mental state examination: a comprehensive review. J Am Geriat Soc. 1992;40:922-935.
• 21. Fletcher GF, Balady GJ, Amsterdam EA, et al. Exercise standards for testing and training: a statement for healthcare professionals from the American Heart Association. Circulation. 2001;104:1694-1740.
• 22. Jemmett R. Spinal stabilization: The new science of back pain. 2nd ed. Halifax: Novont Health Publishing, 2003.
• 23. Hinman MR. Factors affecting reliability of the Biodex Balance System: a summary of four studies. J Sport Rehabil. 2000;9:240-252.
• 24. Cachupe WJ, Shifflett B, Kahanov L, et al. Reliability of biodex balance system measures. Meas Phys Educ Exerc Sci. 2001;5:97-108.
• 25. Dvir Z. Isokinetics: Muscle Testing, Interpretation, and Clinical Applications. New York: Elsevier Health Sciences, 2004.
• 26. Sole G, Hamrén J, Milosavljevic S, et al. Test-retest reliability of isokinetic knee extension and flexion. Arch Phys Med Rehabil. 2007;88:626-631.
• 27. McGill SM, Childs A, Liebenson C. Endurance times for low back stabilization exercises: clinical targets for testing and training from a normal database. Arch Phys Med Rehabil. 1999;80:941-944.
• 28. Edwards LK. Applied Analysis of Variance in the Behavior Sciences. New York: Marcel Dekker;1993.
• 29. Mueller KE, LaVange LE, Ramey SL, et al. 'Power Calculations for General Linear Multivariate Models Including Repeated Measures Applications.' J Am Stat Assoc. 1992;87:1209-1226. 30. Sangelaji B, Kordi M, Banihashemi F, et al. A combined exercise model for improving muscle strength, balance, walking distance, and motor agility in multiple sclerosis patients: A randomized clinical trial. Iranian J Neurol. 2016;15(3):111-120.
• 31. Petajan JH, Gappmaier E, White AT, et al. Impact of aerobic training on fitness and quality of life in multiple sclerosis. Ann Neurol. 1996;39:432-441.
• 32. Guclu-Gunduz A, Citaker S, Irkec C, et al. The effects of pilates on balance, mobility and strength in patients with multiple sclerosis. NeuroRehabilitation. 2014;34:337-342.
• 33. Shahtahmassebi B, Hebert JJ, Stomski NJ, et al. The effect of exercise training on lower trunk muscle morphology. Sports Med. 2014;44:1439-1458