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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

Year 2022, , 20 - 29, 29.04.2022
https://doi.org/10.15437/jetr.836058

Abstract

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.

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References

  • 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

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

Year 2022, , 20 - 29, 29.04.2022
https://doi.org/10.15437/jetr.836058

Abstract

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.

Project Number

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References

  • 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
There are 31 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Articles
Authors

Taşkın Özkan 0000-0001-9448-0516

Nezehat Özgül Ünlüer 0000-0001-9448-0516

Project Number -
Publication Date April 29, 2022
Submission Date December 4, 2020
Published in Issue Year 2022

Cite

Vancouver Özkan T, Ünlüer NÖ. 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. JETR. 2022;9(1):20-9.