Multipl Skleroz'lu bireylerde ikili görev eğitiminin denge, yürüme, ikili görev performansı, kognitif fonksiyon ve yorgunluk üzerindeki etkileri
Küçük Resim Yok
Tarih
2024
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Ege Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Multipl Skleroz(MS)'li bireylerde ikili görev eğitiminin denge, yürüme, ikili görev performansı, kognitif fonksiyon ve yorgunluk üzerindeki etkilerinin araştırılmasıdır. Yöntem: Randomize kontrollü çalışmamız 22.08.2022-23.01.2023 arasında, dahil etme kriterlerimizi karşılayan MS'li bireyler ile tamamlanmıştır. Katılımcılar randomize bir şekilde İkili-Görev Grubu (İGG) (n=13) ve Kontrol Grubu (KG) (n=19) atanmıştır. Kontrol grubuna alt ekstremite, kor stabilizasyonu ve dengeye yönelik ev egzersizlerini içeren bir egzersiz programı sunulmuştur. İkili görev grubuna ise aynı ev egzersiz programına ek olarak haftada 2 gün, 8 hafta boyunca yüz yüze fizyoterapist eşliğinde ikili görev eğitimi verilmiştir. İGG ve KG grupları tedavi öncesi ve 8 haftalık tedavi sonrası değerlendirilmiştir. Bireyler, MS Yürüme Skalası-12 (MSWS-12), 10 Metre Yürüme Testi (10MYT), Zamanlı Kalk Yürü Testi (ZKYT), ZKYT ve 10MYT'nin ikili görev versiyonları, İkili Görev Anketi (İGA), Yorgunluk Şiddet Ölçeği (YŞÖ), Berg Denge Ölçeği (BDÖ) ve Tetrax Bilgisayarlı Postürografi Cihazı ile değerlendirilmiştir. Veri analizi SPSS 25.0 paket programı ile yapılmıştır.İstatiksel analizler uygulanırken kullanılan hesaplamalar ve testler arasında sayı, yüzdelik, ortalama ± standart sapma, ortanca hesaplamaları, One-Sample Kolmogorow-Smirnow Testi, Bağımsız Örneklem t Testi Mann-Whitney U testi, ki-kare analizi, Eşleştirilmiş t Testi ve Wilcoxon işaretli sıralar testi bulunmaktadır. İstatistiksel anlamlılık için sınır p<0,05 olarak belirlenmiştir. Bulgular: Toplam 32 hastanın yaş ortalamaları 46,75±9,16 yıl (29 kadın, 3 erkek) olarak belirlendi. Grupların başlangıçtaki demografik ve klinik özellikler bakımından benzerdi. Tedavi sürecinde 5 katılımcı çalışmadan ayrıldı ve son değerlendirmelerde İGG (n=13), KG (n=14) olarak yapıldı. BDÖ, FSS ve BICAMS puanlarında, ayrıca 10MYT ve çift görevli 10MYT performansında DTTG lehine anlamlı iyileşme gözlemlenmiştir (p<0.05). TUG, DTQ, DTC puanları ve çift görevli TUG performansında iki müdahale birbirine üstün değildi. FI puanları DTTG ve CG'de önemli bir iyileşme göstermedi (p>0.05). Sonuç: MS'li bireylerde ev programına ek olarak verilen ikili görev eğitimi kognisyon, yorgunluk ve yürüme hızı parametrelerinde yalnızca ev programına göre daha üstün bulundu. Postüral stabilite, ikili görev performansının 10MYT-İkili görev dışındaki parametrelerinde, dengeyi ölçen ZKYT değerleri açısından ise ev programı ve ev programına ek olarak verilen ikili görev eğitimi birbirine üstünlük oluşturmamaktadır. Anahtar Kelimeler; Multipl Skleroz; Denge; Yürüme; Fonksiyonel Mobilite; Kognitif Motor İkili görev; Günlük Yaşam Aktiviteleri
Aim: The objective of this research is to examine the impact of dual-task training on balance, walking, dual-task performance, cognitive function, and fatigue among individuals diagnosed with Multiple Sclerosis (MS). Method: Our randomized controlled trial was conducted between August 22, 2022, and January 23, 2023, and involved individuals with MS who met inclusion criteria. Subjects were randomly assigned to two groups: the Dual-Task Group (DTG) with 13 participants and the Control Group (CG) with 19 participants. The control group received home exercises focusing on lower extremity, core stabilization, and balance. Alongside the same home exercise program, the dual-task group underwent in-person dual-task training with a physiotherapist twice weekly for a duration of 8 weeks. Both groups underwent assessment before and after the 8-week treatment duration. Evaluation methods included the Multiple Sclerosis Walking Scale-12 (MSWS-12), 10-Meter Walk Test (10MWT), Timed Up and Go Test (TUGT), dual-task versions of TUGT and 10MWT, Dual-Task Questionnaire (DTQ), Dual-Task Cost (DTC), Fatigue Severity Scale (FSS), Berg Balance Scale (BBS), and Tetrax Computerized Posturography Device. Statistical analysis was conducted using SPSS version 25.0, including descriptive statistics, One-Sample Kolmogorov-Smirnov Test, Independent Samples t-test, Mann-Whitney U test, chi-square analysis, Paired t-test, and Wilcoxon signed-rank test. Statistical significance was considered at p<0.05. Results: The mean age of all 32 participants was 46.75±9.16 (29 females, 3 males). The groups exhibited similar demographic and clinical characteristics at the beginning of the study. During the treatment process, 5 participants dropped out, and the final evaluations were conducted with total of 27 participants (DTG (N=13) and CG (N=14)). Significant improvements in BBS, FSS and BICAMS scores as well as 10MYT and dual-task 10MYT performance (p<0.05) in favor of the DTTG was demonstrated. In TUG, DTQ, DTC scores and dual-task TUG performance two interventions were not superior to each other. FI scores showed no significant improvements in DTTG and CG (p>0.05). Conclusion: DT training, in addition to a home exercise program is superior to the just home program in terms of BBS, BICAMS, FSS and 10MWT values. However, for FSS, TUG, TUG-Dual Task, and 10MWT-Dual Task, home exercise program and the DT training in addition to home exercise program do not show superiority over each other. Keywords; Multiple Sclerosis; Balance; Gait; Functional Mobility; Cognitive Motor Dual-Task; Activities of Daily Living
Aim: The objective of this research is to examine the impact of dual-task training on balance, walking, dual-task performance, cognitive function, and fatigue among individuals diagnosed with Multiple Sclerosis (MS). Method: Our randomized controlled trial was conducted between August 22, 2022, and January 23, 2023, and involved individuals with MS who met inclusion criteria. Subjects were randomly assigned to two groups: the Dual-Task Group (DTG) with 13 participants and the Control Group (CG) with 19 participants. The control group received home exercises focusing on lower extremity, core stabilization, and balance. Alongside the same home exercise program, the dual-task group underwent in-person dual-task training with a physiotherapist twice weekly for a duration of 8 weeks. Both groups underwent assessment before and after the 8-week treatment duration. Evaluation methods included the Multiple Sclerosis Walking Scale-12 (MSWS-12), 10-Meter Walk Test (10MWT), Timed Up and Go Test (TUGT), dual-task versions of TUGT and 10MWT, Dual-Task Questionnaire (DTQ), Dual-Task Cost (DTC), Fatigue Severity Scale (FSS), Berg Balance Scale (BBS), and Tetrax Computerized Posturography Device. Statistical analysis was conducted using SPSS version 25.0, including descriptive statistics, One-Sample Kolmogorov-Smirnov Test, Independent Samples t-test, Mann-Whitney U test, chi-square analysis, Paired t-test, and Wilcoxon signed-rank test. Statistical significance was considered at p<0.05. Results: The mean age of all 32 participants was 46.75±9.16 (29 females, 3 males). The groups exhibited similar demographic and clinical characteristics at the beginning of the study. During the treatment process, 5 participants dropped out, and the final evaluations were conducted with total of 27 participants (DTG (N=13) and CG (N=14)). Significant improvements in BBS, FSS and BICAMS scores as well as 10MYT and dual-task 10MYT performance (p<0.05) in favor of the DTTG was demonstrated. In TUG, DTQ, DTC scores and dual-task TUG performance two interventions were not superior to each other. FI scores showed no significant improvements in DTTG and CG (p>0.05). Conclusion: DT training, in addition to a home exercise program is superior to the just home program in terms of BBS, BICAMS, FSS and 10MWT values. However, for FSS, TUG, TUG-Dual Task, and 10MWT-Dual Task, home exercise program and the DT training in addition to home exercise program do not show superiority over each other. Keywords; Multiple Sclerosis; Balance; Gait; Functional Mobility; Cognitive Motor Dual-Task; Activities of Daily Living
Açıklama
Anahtar Kelimeler
Fizyoterapi ve Rehabilitasyon, Physiotherapy and Rehabilitation
