تاثیر هشت هفته تمرینات تعدیل‌شدهٔ هاتایوگا بر قدرت عضلات اکستنسوری کودکان فلج مغزی اسپاستیک دایپلژیک

زمینه و هدف: فلج‌ مغزی ناهنجاری غیرپیشرونده در مغز است که نقایص وضعیتی و حرکتی در رشد کودک ایجاد می‌کند و شیوع آن بیش از ناهنجاری‌های دیگر است. هدف از تحقیق حاضر تعیین میزان تاثیر هشت هفته تمرینات تعدیل‌شدهٔ هاتایوگا بر قدرت کودکان فلج‌ مغزی اسپاستیک دایپلژیک بود.روش‌بررسی: این تحقیق نیمه‌تجربی روی دوازده نفر از دانش‌آموزان 7تا14 سال دختر و پسر مبتلا به فلج مغزی اسپاستیک دا‌یپلژیک، مشغول به تحصیل در سال 98-1397 در مدارس استثنایی جسمی-حرکتی شهر اصفهان انجام شد. آزمودنی‌ها در دو گروه گواه (پنج نفر) و تجربی (هفت نفر) قرار داشتند. جهت اندازه‌گیری قدرت در عضلات اکستنسور تنه، دستگاه دینامومتر دیجیتالی به‌کار رفت. محقق قبل و بعد از شروع برنامهٔ تمرینی از هر دو گروه پیش‌آزمون و پس‌آزمون گرفت. سپس به گروه تجربی به‌مدت هشت هفته تمرین داده شد. در طی این مدت گروه گواه در هیچ برنامهٔ منظم بدنی شرکت نداشت. داده‌های جمع‌آوری‌شده در پیش‌آزمون و پس‌آزمون، توسط آمار توصیفی خلاصه‌سازی و مرتب شد. تجزیه‌وتحلیل داده‌ها با استفاده از آمار استنباطی و روش آماری آنالیز واریانس با اندازهٔ مکرر صورت گرفت. سطح معناداری آزمون‌ها برابر با 0٫05=α بود و داده‌ها نیز با استفاده از نرم‌افزار spss نسخهٔ 23 تحلیل شد.یافته‌ها: تغییرات قدرت اکستنسورهای تنه، طی دو مرتبه اندازه‌گیری نشان داد که بین گروه‌های گواه و تجربی تفاوت معناداری وجود دارد و براساس نتایج آزمون تی‌همبسته قدرت اکستنسورهای تنه‌ٔ گروه تجربی به‌طور معناداری بیشتر از گروه گواه است (0٫020=p).نتیجه‌گیری: براساس یافته‌های این پژوهش، تمرینات هشت‌هفته‌ای تعدیل‌شدهٔ هاتایوگا می‌تواند برنامهٔ تمرینی مناسبی جهت افزایش قدرت عضلات اکستنسوری تنه‌ٔ کودکان فلج‌ مغزی اسپاستیک دایپلژیک باشد.

Effects of an Eight-Week Moderated Hatha Yoga Training on Extensor Muscles in Children with Spastic Diplegic Cerebral Palsy

Background & Objectives: Cerebral Palsy (CP) is a non–progressive disability in the brain that generates motor deficits and conditions in the development of children. Moreover, CP has various types, among which spastic diplegia is more prevalent. The present study aimed to determine the effect of eight–week modified Hatha yoga exercises on the extensor muscle strength of spastic diplegia CP children.Methods: This quasi–experimental study was performed on 12 students aged 7 to 14 years with spastic diplegia CP and the Gross Motor Function Classification System (GMFCS) classification of one to three. The study subjects were studying at the exceptional physical–motor schools of Isfahan city, Iran. The research initiated by obtaining the relevant permission from the General Directorate of Education and the Exceptional Education Administration of Isfahan and receiving consent from the parents of students in two schools of Shahid Ahmad Hur and Nafisi. The study subjects were divided into two groups of control (n=5) and experimental (n=7). Then, we conducted the two stages of pretest and posttest in both study groups, using a US–made digital mouse dynamometer device; it was applied for measuring power in the extensor muscles of the trunk. Before conducting the research, a briefing session was held with the experimental group participants to familiarize students and teachers with the sessions’ instructions and estimating the students’ abilities level. The experimental group exercised for three sessions of 45–60 minutes per week for 8 weeks. The researcher, by adjusting each asana based on the characteristics of each study subject as well as a predetermined schedule, trained and adjusted the breaths in each asana. Accordingly, the researcher instructed each asana under the pain threshold of the study subjects. The exercise program was performed and instructed with increasing load and the training time. During this period, the control group received no regular physical activity programs. Two subjects in the control group were excluded from the study because of the need for attending rehabilitation programs. At each stage of the measurement, each study participant was sampled three times. Then, the mean value of the data was individually obtained for each subject. Finally, after data collection in the posttest using the digital mouse dynamometer, the obtained information was analyzed using a Shapiro–Wilks test to verify the normal distribution of data. Independent Samples t–test was used to compare the strength of trunk extensors between the two groups in pretest and posttest phases. To evaluate the effect of training on the strength of trunk extensors between two groups, the repeated–measures Analysis of Variance (ANOVA) was used. Finally, the Paired Samples t–test was implemented to examine the effect of exercise on the strength of trunk extensors (comparing pretest and posttest scores between the study groups). All analyzes were performed in SPSS23. The significance level was set at p=0.05.Results: The present study findings revealed that moderated training of Hatha yoga provided a significant difference in the strength of extensor muscles in the pretest and posttest phases between the experimental and control groups. Additionally, the Shapiro–Wilk test results suggested that the distribution of trunk extensors power in the two groups in the pretest was normal (p <0.05). There was no significant difference between the two groups in the strength of extensor strength at the pretest. The repeated–measures ANOVA data indicated that the effects of time (p=0.023) and measurement time were significant in the study groups (p =0.043). Thus, the time factor (exercise in the experimental group) caused a difference between the two research groups. Furthermore, t–test results demonstrated that in the experimental group, the strength of extensor strength significantly increased in the subjects (p =0.020); however, in the control group, it provided no change. Accordingly, in the posttest, the two research groups had a significant difference in the strength of trunk extensors (p =0.026).Conclusion: The provided training program of this study is suitable for increasing the strength of trunk extensor muscles in children with spasmodic diplegia CP.