مقایسه اثربخشی تمرینات نوروفیدبک و فراهم‌سازهای محیط تمرین بر تعادل ایستا در مردان ساکن سرای سالمندان مقالة

توانایی تعادل یکی از اجزای حیاتی فعالیت‌‌های مستقل روزانه در میان سالمندان است. اختلال تعادل یکی از عوامل خطر عمده برای زمین خوردن و عوارض مربوط به آن است. بنابراین هدف از پژوهش حاضر، مقایسه اثربخشی تمرینات نوروفیدبک و فراهم‌سازهای محیط تمرین بر تعادل ایستا مردان ساکن سرای سالمندان بود. پژوهش حاضر از نوع نیمه‌تجربی با طرح پیش‌آزمون-پس‌آزمون با گروه کنترل بود. جامعه آماری پژوهش حاضر شامل مردان سالمند مقیم سرای سالمندان شهر ایلام با دامنه سنی 60 تا 80 سال بود که تعداد 36 شرکت‌کننده با نمونه‌‌گیری در دسترس و با در نظر گرفتن معیارهای ورود و خروج انتخاب شدند، و به سه گروه 12 نفری نوروفیدبک، آموزش فراهم‌‌سازی‌‌های محیط تمرینی و کنترل تقسیم شدند. شرکت‌‌کنندگان در مرحله پیش‌آزمون در سه کوشش اقدام به انجام تکلیف تعادل ایستا نمودند. در مرحله مداخله (تمرین)، که به مدت هشت هفته به طول انجامید و شامل سه جلسه 30 دقیقه‌ای در هفته بود، دو گروه‌ آزمایشی به تمرینات مربوطه پرداختند. لازم به ذکر است که در این مدت گروه کنترل به اجرای فعالیت‌‌های معمول و روزانه خود پرداختند. مرحله پس‌آزمون دقیقا پس از آخرین جلسه تمرینی اجرا شد. داده‌‌ها به روش تحلیل کوواریانس تک‌متغیری (آنکوا) تحلیل شد که نتایج آن نشان داد که آموزش نوروفیدبک بر بهبود تعادل ایستای (جابجایی قدامی-خلفی و جابجایی مرکزی-جانبی مرکز فشار) مردان سالمند تاثیر معنی‌‌داری دارد (01/0>P). همچنین آموزش فراهم‌‌سازی محیط تمرین نیز بر بهبود تعادل ایستای (جابجایی قدامی-خلفی و جابجایی مرکزی-جانبی مرکز فشار) سالمندان مرد تاثیر معنی‌‌داری دارد (01/0>P). نتایج آزمون تعقیبی LSD نشان داد که آموزش فراهم‌‌سازی‌های محیط تمرینی در مقایسه با آموزش نوروفیدبک اثر بیشتری در بهبودی تعادل ایستای مردان سالمند داشت (01/0>P). با توجه به نتایج پژوهش حاضر به مربیان و متخصصان سالمندی پیشنهاد می‌‌شود که بر غنی‌‌سازی محیط برای بهبود تعادل سالمندان توجه نمایند.

Balance ability is a crucial component of the independent daily activities among older adults. Balance impairment is one of the significant risk factors for falls and its related complications. Therefore, the purpose of the current study was to compare the effectiveness of neurofeedback training and training environment affordance on static balance in the elderly ‎men. This was a quasi-experimental study with a pretest-posttest control group design. The statistical population of the present study included the elderly men with an age range of 60 to 80 years living in nursing homes in Ilam, Iran, among whom 36 participants were selected using convenience sampling along with considering the inclusion and exclusion criteria, and assigned into three groups of neurofeedback, training environment affordance and control, each of which had 12 members. Participants performed a static balance task in three attempts in the pretest phase. In the intervention phase (practice), which lasted for eight weeks and included three 30-minute sessions per week, the member of two experimental groups performed the relevant exercises. It should be noted that during this period, the control group performed their usual daily activities. The posttest phase was conducted exactly after the last training session. Data were analyzed by univariate analysis of covariance (ANCOVA), the results of which indicated that neurofeedback training has a significant effect on improving static balance (anterior-posterior displacement and central-lateral displacement of the center of pressure) in the elderly men (PReferences Aranda-Gallardo, M., Morales-Asencio, J. M., de Luna-Rodriguez, M. E., Vazquez-Blanco, M. J., Morilla-Herrera, J. C., Rivas-Ruiz, F., Toribio-Montero, J. C., & Canca-Sanchez, J. C. (2018). Characteristics, consequences and prevention of falls in institutionalized older adults in the province of Malaga (Spain): A prospective, cohort, multicentre study. BMJ Open, 8(2), Article e020039. Azarpaikan, A., & Taheri Torbati, H. (2018). Effect of somatosensory and neurofeedback training on balance in older healthy adults: A preliminary investigation. Aging Clinical and Experimental Research, 30(7), 745-753. Azarpaikan, A., Torbati, H. T., & Sohrabi, M. (2014). Neurofeedback and physical balance in Parkinson's patients. Gait & Posture, 40(1), 177-181. Chippendale, T., & Boltz, M. (2015). The neighborhood environment: perceived fall risk, resources, and strategies for fall prevention. The Gerontologist, 55(4), 575-583. Clemson, L., Stark, S., Pighills, A. C., Torgerson, D. J., Sherrington, C., & Lamb, S. E. (2019). Environmental interventions for preventing falls in older people living in the community. The Cochrane Database of Systematic Reviews, 2, Article CD013258. Colom, A., Ruiz, M., Warnberg, J., Compa, M., Muncunill, J., Baron-Lopez, F. J., & Romaguera, D. (2019). Mediterranean built environment and precipitation as modulator factors on physical activity in obese mid-age and old-age adults with metabolic syndrome: Cross-sectional study. International Journal of Environmental Research and Public Health, 16(5), Article 854. Cosio-Lima, L. M., Reynolds, K. L., Winter, C., Paolone, V., & Jones, M. T. (2019). Effects of physioball and conventional floor exercises on early phase adaptations in back and abdominal core stability and balance in women. The Journal of Strength & Conditioning Research, 17(4), 721-725. Davids, K., Araujo, D., & Brymer, E. (2016). Designing affordances for health-enhancing physical activity and exercise in sedentary individuals. Sports Medicine, 46(7), 933-938. Engels, H. J., Drouin, J., Zhu, W., & Kazmierski, J. F. (1998). Effects of low-impact, moderate-intensity exercise training with and without wrist weights on functional capacities and mood states in older adults. Gerontology, 44(4), 239-244. Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). “Mini-mental state”: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12(3), 189-198. Gibson, J. J. (2014). The ecological approach to visual perception: classic edition. Psychology press. Gillespie, L., & Handoll, H. (2009). Prevention of falls and fall-related injuries in older people. Injury Prevention, 15(5), 354-355. Gruzelier, J. H., Foks, M., Steffert, T., Chen, M. L., & Ros, T. (2014). Beneficial outcome from EEG-neurofeedback on creative music performance, attention and well-being in school children. Biological Psychology, 95, 86-95. Hammond, D. C. (2007). What is neurofeedback? Journal of Neurotherapy, 10(4), 25-36. Karlsson, A., & Frykberg, G. (2000). Correlations between force plate measures for assessment of balance. Clinical Biomechanics, 15(5), 365-369. Latash, M. L. (2012). Fundamentals of motor control. Academic Press. Mihara, M., Fujimoto, H., Hattori, N., Otomune, H., Kajiyama, Y., Konaka, K., Watanabe, Y., Hiramatsu, Y., Sunada, Y., Miyai, I., & Mochizuki, H. (2021). Effect of neurofeedback facilitation on poststroke gait and balance recovery: A randomized controlled trial. Neurology, 96(21), 2587-2598. Moshref-Razavi, S., Sohrabi, M., & Sotoodeh, M. S. (2017). Effect of neurofeedback interactions and mental imagery on the elderly’s balance. Iranian Journal of Ageing, 12(3), 288-299. [Persian] Park, J. H. (2017). The effects of eyeball exercise on balance ability and falls efficacy of the elderly who have experienced a fall: A single-blind, randomized controlled trial. Archives of Gerontology and Geriatrics, 68, 181-185. Perez-Elvira, R., Oltra-Cucarella, J., Carrobles, J. A., Molto, J., Florez, M., Parra, S., Agudo, M., Saez, C., Guarino, S., Costea, R.M., & Neamtu, B. (2021). Enhancing the effects of neurofeedback training: The motivational value of the reinforcers. Brain Sciences, 11(4), Article 457. Pighills, A., Ballinger, C., Pickering, R., & Chari, S. (2016). A critical review of the effectiveness of environmental assessment and modification in the prevention of falls amongst community dwelling older people. British Journal of Occupational Therapy, 79(3), 133-143. Province, M. A., Hadley, E. C., Hornbrook, M. C., Lipsitz, L. A., Miller, J. P., Mulrow, C. D., & Weiss, S. (1995). The effects of exercise on falls in elderly patients: a preplanned meta-analysis of the FICSIT trials. Journal of the American Medical Association, 273(17), 1341-1347. Rezaei, K., Nami, M., Sinaei, E., Bagheri, Z., & Yoosefinejad, A. K. (2021). A comparison between effects of neurofeedback and balance exercise on balance of healthy older adults. Journal of Biomedical Physics & Engineering, 11(6), Article 713. Seyedian, M., Falah, M., Nourouzian, M., Nejat, S., Delavar, A., & Ghasemzadeh, H. A. (2008). Validity of the Farsi version of mini-mental state examination. Journal of Medical Council of Iran, 25(4), 408-414. [Persian] Shafizadeh, M., Manson, J., Fowler-Davis, S., Ali, K., Lowe, A. C., Stevenson, J., Parvinpour, S., & Davids, K. (2020). Effects of enriched physical activity environments on balance and fall prevention in older adults: a scoping review. Journal of Aging and Physical Activity, 29(1), 178-191. Shahrbanian, S., Hashemi, A., & Hemayattalab, R. (2021). The comparison of the effects of physical activity and neurofeedback training on postural stability and risk of fall in elderly women: A single-blind randomized controlled trial. Physiotherapy Theory and Practice, 37(2), 271-278.