چكيده لاتين
Multiple sclerosis is an autoimmune, chronic and progressive disease of the nervous system that causes disturbances in balance, coordination, increased risk of falls and muscle weakness in individuals. In recent years, sports science studies have emphasized the use of exercise to improve the disorders of this disease. The aim of the present study was to study the effect of Otago exercises on some functional characteristics, fear of falling and quality of life of female patients with MS. Methods: In this semi-experimental study, 28 women with multiple sclerosis referring to the Isfahan MS Association were selected to participate in the study through convenience and purpose. The mean and standard deviation of the subjectsʹ age was 70.57±42.70, the Expanded Disability Status Scale was 0.84±2.23, the height was 162.85±33.5, and the weight was 64.92±43.9. They were randomly assigned (EDSS score) to two control (n=14) and experimental (n=14) groups. The experimental group performed the Otago exercise program (for the whole body, with four levels of difficulty from easy to difficult) for 8 weeks, 3 sessions per week for 30 to 45 minutes. While the control group received their usual care and daily activities. Before and after the training intervention, the variables of static balance, dynamic balance, cardiorespiratory endurance, neuromuscular function, range of motion, proprioception, muscle strength, quality of life, fatigue, fear of falling, and fear of movement were evaluated through the functional access test, time to get up and go, 6-minute walk, and 30-second sit-to-stand from a chair, goniometer, dynamometer, 54-question quality of life questionnaire, MFIS questionnaire, FSI questionnaire, and Tampa questionnaire for patients with multiple sclerosis, respectively. The combined analysis of variance (Repeated Measure) test was used to analyze the data. Also, the significance level was determined at the 95% confidence level (P≤0.05).
Results: The functional capacity of the experimental group was significantly improved compared to the control group in the time to get up and go, 6-minute walk, 30-second sit-to-stand from a chair, and functional access tests at the post-test (P≤0.05). There was a significant difference in the range of motion only in the left hip joint, but no significant difference was seen in the other joints (P≥0.05). There was no significant difference in the reconstruction error at angles of 60 degrees and 30 degrees in either leg (P≥0.05). However, a decrease in the reconstruction error at 60 degrees and 30 degrees was observed in the experimental group compared to the control group. In the variable of muscle strength, a significant difference was seen in some muscles of the lower extremities (P≤0.05), but no significant difference was seen in some other muscles (P≥0.05). Also, a significant improvement was seen in the quality of life of the experimental group compared to the control group at the post-test (P≤0.05). There was no significant difference in the fear of falling (P≥0.05). In the fear of movement, a significant difference was seen only in the fall variable of the fear of movement questionnaire (P≤0.05), and no significant difference was seen in the other variables (P≥0.05). There was no significant difference in the fatigue factor (P≥0/05).
Conclusion: Otago exercises are a multifaceted, safe, and low-cost intervention that can significantly improve functional capacity and quality of life in patients with MS in a short period of time.
