تاثیر برنامهٔ ترکیبی تمرین-بانداژ بر زاویهٔ شست کج زنان دارای ناهنجاری شست کج

زمینه و هدف: مطالعات در زمینهٔ تاثیر روش‌های محافظتی بر ناهنجاری شست کج کم و در عین حال متناقض است؛ بنابراین تحقیق حاضر با هدف بررسی تاثیر پروتکل ترکیبی تمرین-بانداژ بر اصلاح زاویهٔ ناهنجاری شست کج در زنان انجام شد. روش‌بررسی: روش تحقیق نیمه‌تجربی و طرح آن به‌صورت پیش‌آزمون‌پس‌آزمون با گروه تجربی و گواه بود. جامعهٔ آماری را زنان 18تا45 سال مراجعه‌کننده به کلینیک حرکات اصلاحی توان شهرستان بانه تشکیل دادند. در این پژوهش سی زن دارای شست کج خفیف و متوسط (15تا30 درجه) با میانگین و انحراف معیار سن 8٫26 ± 30٫83 به‌طور هدف‌مند انتخاب شده و به‌صورت تصادفی در دو گروه تمرین-بانداژ و گروه گواه تقسیم شدند. گروه تمرین–بانداژ به‌مدت هشت هفته و 24ساعته از بانداژ کینزیولوژی استفاده کرده و روزانه دو نوبت تمرینات اصلاحی شست کج را انجام داد؛ درحالی‌که گروه گواه مداخله‌ای دریافت نکرد. میزان زاویهٔ شست در هر دو گروه در ابتدا و پایان هفتهٔ هشتم و ازطریق رادیوگرافی تعیین شد. آزمون‌های تی‌وابسته (مقایسهٔ درون‌گروهی) و تی‌مستقل (مقایسهٔ بین‌گروهی) برای مقایسهٔ نتایج به‌دست‌آمده در سطح معناداری 95درصد و میزان آلفا کوچکتر یا مساوی با 0٫05، به‌کار رفت. تجزیه‌وتحلیل داده‌ها با نرم‌افزار spss نسخهٔ 20 صورت گرفت. یافته‌ها: یافته‌ها نشان داد که بین نمرات پیش‌آزمون و پس‌آزمون زاویهٔ شست در گروه تمرین-بانداژ تفاوت معنا‌داری وجود دارد (0٫001> p)؛ درحالی‌که چنین تفاوتی در گروه گواه مشاهده نمی‌شود. همچنین تفاوت نمرات پس از آزمون گروه تمرین-بانداژ با گروه گواه معنادار است (0٫001> p). نتیجه‌گیری: به‌نظر می‌رسد که جهت اصلاح ناهنجاری زاویهٔ شست کج در زنان می‌توان از برنامهٔ ترکیبی تمرین-بانداژ استفاده کرد. 

Combined Exercise-Bandage Protocol on Hallux Valgus Angle in Women with Hallux Valgus Deformity

Background & Objectives: Hallux valgus is a common disorder, leading to the external deflection of the first bone of the foot and internal thumb displacement with its external rotation, which highlights the first the metatarsophalangeal joints (MTP joint). This abnormality is more common in women and causes the formation of a hallux valgus to interfere with the first MTP joint and muscle imbalance between the adductor and the abdomen of the thumb. The main reasons for the development of the hallux valgus can divide into two categories; A) The underlying causes include: flat foot, which can be effective in creating a hallux valgus; and foot pronation introduced as the main agent;  B) Outer causes that include: wearing inappropriate footwear, which is one of the main factors in the creation of a hallux valgus; in the case of muscle weakness its destructive effects will be greater; inheritance; other factors including fracture, discontinuation of the second finger, gout, rheumatism, and infection. Studies on the effect of protective methods on the crooked thumb are scant and at the same time, contradictory. Therefore, the aim of this study was the effect of a combined exercise–bandage protocol on the hallux valgus angle in women with hallux valgus deformity.Methods: The research was semi–experimental and the research design was a pretest–posttest with the experimental and control group. The statistical population of the study consisted of women aged 18 to 45 years old who referred to the Baneh city (Kurdistan province, Iran) school of rehabilitation. In this study, 30 women with mild and moderate toes (15 to 30 degrees) with a mean and standard deviation of age: 30.83±8.26, 161.63±4.41, 61.77±5.47, the target group was selected and randomly divided into two groups: training–bandages and control group. First, the angle of the shoulder was determined using radiographs. The training group–bonding for 8 weeks and 24 hours with Kinesio tape and daily two repetitive exercises of the thumb. The control group did not receive intervention. After 8 weeks, radiography was performed using the angle of hallux valgus. The training group –Bondage used a Kinesio tape for 8 weeks and 24 hours, and twice–daily exercises were performed on the hallux valgus, while the control group did not receive the intervention. The exercises include seven exercises, which should be performed for 8 weeks and twice daily. Between each repetition, 5 seconds rest and each move are restrained for 20 seconds. Experimental group exercises included mobility, stretching, tensile strength, strength, tensile strength, strength, strength, strength in each session. When exercising, the subjects were asked to use the muscles of the shoulder and to prevent the creation and production of force by the muscles of the wrists or legs. The angle of hallux valgus was measured in both groups at the beginning and end of the eighth week by radiography. Independent t–test (intra–group comparison) and independent t–test (inter–group comparison) were used to compare the results at 95% significance level and the alpha value smaller or equal to 0.05. Data were analyzed using SPSS version 22 software.Results: The results showed that there was a significant difference between the pre–test and post–test scales angle in the training group (p<0.001). However, there was no difference between the scores of pre–test and post–test of angle of thumb in the control group. In addition, the difference in post–test scores between test–band and control group was significant (p<0.001). In other words, the combined exercise–bandage program can reduce the angle of the thumb.Conclusion: It seems that in order to correct hallux valgus in women, we can use the training program–bandage program. Results showed that practicing lumbar spine could have a positive effect on the improvement of angles and in women with hallux valgus.