تاثیر تمرینات اصلاحی بر راستای ستون فقرات معلولان ذهنی تربیت‌پذیر مبتلا به اسکولیوزیس

زمینه و هدف: اختلال اسکولیوزیس با درصد شیوع زیادی در معلولان ذهنی مشاهده می‌شود؛ بنابراین هدف از این مطالعه، بررسی اثر تمرینات اصلاحی بر کاهش درجهٔ اسکولیوزیس ستون فقرات در مردان معلول کم‌توان ذهنی تربیت‌پذیر بود. روش‌بررسی: پژوهش حاضر از نوع مطالعات نیمه‌تجربی با طرح پیش‌آزمون-پس‌آزمون بود. جامعهٔ آماری مطالعه را مردان معلول ذهنی تربیت‌پذیر شهرستان گنبدکاووس و حومه با دامنهٔ سنی 25تا40 سال تشکیل دادند. آزمودنی‌ها سی مرد بزرگسال با معلولیت ذهنی تربیت‌پذیر بودند که به ناهنجاری اسکولیوزیس با انحنای جانبی یک‌قوسی در ناحیهٔ توراسیک (با انحنای جانبی کمتر از چهل درجه) مبتلا بودند. این افراد به گروه آزمایش و گروه گواه (هر گروه‌ پانزده نفر) تقسیم شدند. آزمودنی‌های گروه آزمایش به‌مدت هشت هفته، سه جلسه در هفته و هر جلسه 40تا60 دقیقه، تمرینات اصلاحی را اجرا کردند؛ درحالی‌که گروه گواه به انجام فعالیت‌های عادی خود مشغول بود. از روش عکس‌برداری دیجیتال برای تعیین درجهٔ اسکولیوزیس استفاده شد. برای محاسبهٔ تغییرات درون‌گروهی و بین‌گروهی، آزمون‌های تی ‌وابسته و تی ‌مستقل در نرم‌افزار spss به‌کار رفت. سطح معناداری آزمون‌ها 0/05 در نظر گرفته شد. یافته‌ها: نتایج آزمون تی ‌وابسته نشان داد، بین میزان درجهٔ اسکولیوزیس پیش‌آزمون و پس‌آزمون افراد گروه آزمایش تفاوت معناداری وجود داشت (0/018=p)؛ اما چنین تفاوتی در گروه گواه مشاهده نشد (0/34=p). همچنین نتایج آزمون تی ‌مستقل در پس‌آزمون نشان‌دهندهٔ کاهش معنادار درجهٔ اسکولیوزیس گروه آزمایش درمقایسه با گروه گواه بود (0/009=p). نتیجه‌گیری: تمرینات اصلاحی اثربخشی مطلوبی بر کاهش زاویهٔ انحنای جانبی ستون فقرات در مردان معلول ذهنی تربیت‌پذیر مبتلا به ناهنجاری اسکولیوزیس دارند.

the effects of corrective exercises on spinal posture in educable individuals with intellectual disability

background & objectives: intellectual disability (id) is associated with significant limitations in physical function and adaptive behaviors. adults with ids may encounter problems, such as structural, motor, orthopedic, or health issues. posture quality and posture are among the indicators of general health assessment, i.e., limited in individuals with ids. furthermore, the prevalence of chronic diseases and structural disorders of the spine, including scoliosis, is higher in this group, compared to the general population. data on scoliosis disorders among individuals with ids are scarce. due to specific mental conditions, these individuals may present different reactions to corrective exercises (ces). therefore, the present study aimed to investigate the effects of ces on the extent of spinal cord scoliosis in educable males with ids.methods: this was a quasi–experimental research with a pretest–posttest and a control group design. the statistical population of this study consisted of educable male ids in gonbadekavoos city, iran. thirty educable adult males aged 25–40 years with ids and scoliosis anomaly and a pre–diagnosed lateral curvature in the thoracic area were selected by convenience sampling method. the study subjects were divided into the experimental and control groups by simple randomization (n=15/group). the experimental group conducted a researcher–designed ce program for three 40–60–minute weekly sessions in 8 weeks; however, the control group performed their routine activities. we studied and compared between– and within–group changes of spinal lateral curvature on a frontal plate. the ce protocol included 3 steps, in all training sessions; the first step consisted of 5 exercises for symmetrical trunk stretching in standing, sitting, and lying positions, i.e., based on the nature of the disorder and trunk asymmetries. at this stage, we applied exercise equipment, such as swiss balls, training elastic bands, and stick, i.e., already used by participants, to make them more familiar with their practice environment. this equipment was excluded in the next stages. the second step consisted of 5 movements for trunk stretching, including asymmetric and sideway stretches; due to the three–dimensional nature of scoliosis disorder, this step was focused on postural exercises combined with daily living activities, such as standing and sitting on a chair and the ground. the stretches were initiated with 30% of intensity during the first weeks which reached 75% at final weeks. the third step of the protocol included 5 movements of light resistance, active postural, and mirror therapy exercises. the digital imaging method was used to determine the study subjects’ scoliosis degree. in this study, descriptive statistics (mean & sd) were used to analyze the collected data; within–group and between–groups changes were also measured by dependent and independent samples t–tests. the significance level was considered 0.05.results: the present study results suggested that the mean±sd extent of the spine’s lateral curvature in the experimental group reached 20.87±2.98 degrees in the posttest step, while it was 22.42±2.07 in the pretest; thus, it indicated a decrease of 1.55 degrees. the paired samples t–test data also revealed significant differences between the pretest and posttest (after 8 weeks of ces) values in scoliosis degree among the experimental subjects (p=0.018). however, the mean±sd spinal lateral curvature in the control group changed from 22.18±2.54 in the pretest to 22.17±2.70 degrees in the posttest, indicating no significant difference (p=0.34). independent samples t–test data comparing the scores of pretest–posttest also revealed a significant difference between the study groups (p=0.009). the effect size of ces on scoliosis degree was calculated based on cohen’s d, demonstrating that the effect of this training course on the degree of scoliosis was more than moderate and close to a high level (f²=0.28).conclusion: according to the current study findings, ces focused on balanced weight distribution, symmetrical and asymmetrical stretching along with strengthening the deep and superficial muscles of the thorax, pelvis, and thighs can be used as an effective method in reducing the lateral curvature degree of the spine, in the educable individuals with ids and scoliosis.