اثر تکلیف شناختی بر زمان‌بندی مرحلۀ استانس راه‌رفتن بیماران مولتیپل اسکلروزیس

هدف: مولتیپل اسکلروزیس از شایع ترین بیماری های عصبی پیش رونده در بین بزرگ سالان جوان است. هدف از پژوهش حاضر، بررسی اثربار شناختی تکلیف بر زمان بندی مرحلۀ استانس راه رفتن بیماران مولتیپل اسکلروزیس بود.روش بررسی: روش مطالعۀ حاضر، از نوع نیمه تجربی با طرح پیش آزمون پس آزمون بود. بیست بیمار مبتلا به مولتیپل اسکلروزیس از انجمن ام اس ایران (با دامنۀ سنی 41٫85±12٫59 سال و نمرۀ مقیاس پیشرفت ناتوانی صفر تا 5) به صورت داوطلبانه در این تحقیق شرکت کردند. آزمودنی ها سه تکلیف شناختی مختلف را هم زمان با راه رفتن بر روی دستگاه فوت مدیسنس اجرا کردند و زمان مرحلۀ استانس آزمودنی ها با دستگاه فوت مدیسنس اندازه گیری شد. برای تحلیل نتایج، از آزمون تحلیل واریانس با اندازه گیری های مکرر و آزمون تعقیبی بونفرونی در سطح معناداری 0٫05 استفاده شد. داده ها با استفاده از نرم افزار spss نسخۀ 21 تحلیل شد.یافته ها: یافته های به دست آمده از تحقیق نشان داد تکلیف شناختی اثر معناداری بر افزایش زمان استانس راه رفتن در هر دو پا داشت (0٫001>p) و بین زمان استانس راه رفتن در تمامی مراحل تکلیف شناختی، به جز مرحلۀ 2 در برابر 3، در پای چپ تفاوت معناداری وجود داشت (0٫05≥p.نتیجه گیری: نتایج تحقیق نشان داد زمان مرحلۀ استانس گام برداری در بیماران مولتیپل اسکلروزیس هنگام اجرای تکلیف شناختی افزایش داشته است و بیماران مولتیپل اسکلروزیس هنگام اجرای تکلیف شناختی سرعت گام برداری کمتری دارند.

Cognitive task on Stance phase timing of walking in Multiple Sclerosis patients

Background & Objective: Multiple sclerosis (MS) disease is one of the common diseases of central nervous system. In the disease white blood cells attack to the sheath of the central nervous system, which is called myelin. The amount of MS infection in women is two or three times more men and infecting age range is between 1550 years old that its peak is in 30 years. Multiple sclerosis can result in variable neuromuscular deficit including muscle weakness, spasticity, balance impairment and sensory disturbance. Walking difficulties and cognitive impairments are clinical hallmarks of people with multiple sclerosis. Among symptoms of the disease, growing attention has focused on cognitive functions. Cognitive deficit have been reported in 4570% of people affected by this disease. Cognitive impairments can play a significant role in memory, attention, learning, performance, information processing ability and speed of information processing. One of the most important problems in MS patients is memory impairment. This memory involves the process of temporary storage of information and its application in the process of processing information and complex cognitive skills such as reasoning and learning; in other words, working memory is the result of controlling attention and maintaining concentration in a particular mental activity. In many daily activities, people often require performing an additional cognitive demanding task while walking. Therefore, purpose of this study was to evaluate the effect of cognitive task on stance phase timing of walking in multiple sclerosis patients.Methods: The current study design was a quasiexperimental with pre and posttest. Twenty volunteer men and women with multiple sclerosis (mean±SD age: 41.85± 12.59 years old and EDSS score 05) from Tehran (capital city of Iran) multiple sclerosis association were participated in this study and stance phase timing of walking measured in 3 different level by foot Medisense. Analysis of variance with repeated measurement test and Bonferroni post Hoc tests were used for statistical analysis (p<0.05).Result: Performance cognitive task had a significant effect on increased time of hill strike phase, foot flat phase, mid stance phase, hill off phase and toe off phase in right leg (p<0.001) and in left leg. In addition, performance of cognitive task had a significant effect on increased time of hill strike phase, foot flat phase, mid stance phase, hill off phase and toe off phase (p<0.001). Except for stage 2 versus stage 3 in left leg, there was a significant difference between the time of walking stance phase in all level in the left leg (stage 1 versus stage 2, stage 1 versus stage 3, stage 1 versus stage 4, stage 2 versus stage 3, stage 2 versus stage 4 and stage 3 versus stage 4) and right leg (stage 1 versus stage 2, stage 1 versus stage 3, stage 1 versus stage 4, stage 2 versus stage 4 and stage 3 versus stage 4).Conclusion: Stance phase time in multiple sclerosis patients increased during cognitive task and multiple sclerosis patient walk slower during cognitive task.