Journal of Rafsanjan University of Medical Sciences
مجله دانشگاه علوم پزشکی رفسنجان
JRUMS
Medical Sciences
http://journal.rums.ac.ir
69
journal69
1735-3165
2008-7268
10.66224/jrums
fa
jalali
1403
12
1
gregorian
2025
3
1
23
12
online
1
fulltext
fa
تأثیر افزودن آموزش علوم اعصاب درد بر تمرینات کنترل حرکتی در محیط آب و خشکی بر تقارن توزیع فشار کفپایی در زنان مبتلا به کمردرد مزمن غیراختصاصی: یک مطالعه کارآزمایی بالینی
The Effect of Adding Pain Neuroscience Education to Motor Control Exercises in Water and Dry Environments on Plantar Pressure Distribution Symmetry in Women with Non-Specific Chronic Low Back Pain: A Clinical Trial
تربيت بدني
تربيت بدني
پژوهشي
Research
<span style="font-size:10pt"><span style="line-height:119%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman",serif"><b><span lang="AR-SA" style="font-size:11.5pt"><span style="line-height:119%"><span style="font-family:"B Nazanin"">زمینه و هدف:</span></span></span></b> <span lang="FA" style="font-size:11.5pt"><span style="line-height:119%"><span style="font-family:"B Nazanin"">اختلال کنترل حرکتی در بیماران مبتلا به کمردرد مزمن غیراختصاصی (</span></span></span><span dir="LTR" style="font-size:9.5pt"><span style="line-height:119%">NSCLBP</span></span><span lang="FA" style="font-size:11.5pt"><span style="line-height:119%"><span style="font-family:"B Nazanin"">) می­تواند توزیع فشار کف­پایی را دستخوش تغییراتی سازد و بارگذاری ستون فقرات را افزایش و به توسعه </span></span></span><span dir="LTR" style="font-size:9.5pt"><span style="line-height:119%">NSCLBP</span></span><span lang="FA" style="font-size:11.5pt"><span style="line-height:119%"><span style="font-family:"B Nazanin""> منجر ­شود. هدف مطالعه حاضر تعیین تأثیر افزودن آموزش علوم اعصاب درد بر تمرینات کنترل حرکتی در محیط آب و خشکی بر تقارن توزیع فشار کف­پایی در زنان مبتلا به </span></span></span><span dir="LTR" style="font-size:9.5pt"><span style="line-height:119%">NSCLBP</span></span><span lang="FA" style="font-size:11.5pt"><span style="line-height:119%"><span style="font-family:"B Nazanin""> بود.<b> </b></span></span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:119%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman",serif"><b><span lang="FA" style="font-size:11.5pt"><span style="line-height:119%"><span style="font-family:"B Nazanin"">مواد و روش­ها:</span></span></span></b> <span lang="AR-SA" style="font-size:11.5pt"><span style="line-height:119%"><span style="font-family:"B Nazanin"">این مطالعه کارآزمایی بالینی، در سال 1403 در دانشگاه بوعلی سینا همدان انجام شد.</span></span></span><span lang="FA" style="font-size:11.5pt"><span style="line-height:119%"><span style="font-family:"B Nazanin""> تعداد 60 زن مبتلا به </span></span></span><span dir="LTR" style="font-size:9.5pt"><span style="line-height:119%">NSCLBP</span></span><span lang="FA" style="font-size:11.5pt"><span style="line-height:119%"><span style="font-family:"B Nazanin""> به­صورت در دسترس انتخاب و به­طور تصادفی به گروه تجربی و کنترل تخصیص یافتند (30</span></span></span><span dir="LTR" style="font-size:9.5pt"><span style="line-height:119%">n=</span></span><span lang="FA" style="font-size:11.5pt"><span style="line-height:119%"><span style="font-family:"B Nazanin"">). گروه تجربی به مدت 4 هفته تمرینات کنترل حرکتی در محیط آب و خشکی همراه با آموزش علوم اعصاب دریافت کردند و گروه کنترل مداخله­ای دریافت نکردند. شدت درد، ترس از حرکت، و توزیع فشار کف­پایی در دو مرحله پیش آزمون و پس آزمون ارزیابی شدند. جهت تجزیه و تحلیل داده­ها از آنالیز کوواریانس چندمتغیره استفاده شد.</span></span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:119%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman",serif"><b><span lang="FA" style="font-size:11.5pt"><span style="line-height:119%"><span style="font-family:"B Nazanin"">یافته­ها:</span></span></span></b><span lang="FA" style="font-size:11.5pt"><span style="line-height:119%"><span style="font-family:"B Nazanin""> مقایسه نتایج بین گروهی نشان داد که تفاوت معناداری در کاهش درد (001/0></span></span></span><span dir="LTR" style="font-size:9.5pt"><span style="line-height:119%">P</span></span><span lang="FA" style="font-size:11.5pt"><span style="line-height:119%"><span style="font-family:"B Nazanin"">) ، ترس از حرکت (001/0></span></span></span><span dir="LTR" style="font-size:9.5pt"><span style="line-height:119%">P</span></span><span lang="FA" style="font-size:11.5pt"><span style="line-height:119%"><span style="font-family:"B Nazanin"">) بهبود تقارن توزیع فشار کف­پایی</span></span></span><span lang="AR-SA" style="font-size:11.5pt"><span style="line-height:119%"><span style="font-family:"B Nazanin""> در گروه تجربی در مقایسه با گروه کنترل</span></span></span><span lang="FA" style="font-size:11.5pt"><span style="line-height:119%"><span style="font-family:"B Nazanin""> مشاهده شد</span></span></span> <span lang="FA" style="font-size:11.5pt"><span style="line-height:119%"><span style="font-family:"B Nazanin"">(001/0></span></span></span><span dir="LTR" style="font-size:9.5pt"><span style="line-height:119%">P</span></span><span lang="FA" style="font-size:11.5pt"><span style="line-height:119%"><span style="font-family:"B Nazanin"">).</span></span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:119%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman",serif"><b><span lang="FA" style="font-size:11.5pt"><span style="line-height:119%"><span style="font-family:"B Nazanin"">نتیجه­گیری:</span></span></span></b><span lang="FA" style="font-size:11.5pt"><span style="line-height:119%"><span style="font-family:"B Nazanin""> ترکیب آموزش علوم اعصاب با تمرینات کنترل حرکتی در بازه زمانی 4 هفته­ای به­طور معناداری با اندازه اثر متوسط شدت درد و ترس از حرکت را کاهش داد و تقارن توزیع فشار کف­پایی را بهبود بخشید. بنابراین، پیشنهاد می­شود فیزیوتراپیست­ها برای توان­بخشی بیماران مبتلا به </span></span></span><span dir="LTR" style="font-size:9.5pt"><span style="line-height:119%">NSCLBP</span></span><span lang="FA" style="font-size:11.5pt"><span style="line-height:119%"><span style="font-family:"B Nazanin""> تمرینات مذکور را در نظر بگیرند.</span></span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:119%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman",serif"><b><span lang="FA" style="font-size:11.5pt"><span style="line-height:119%"><span style="font-family:"B Nazanin"">واژه­های کلیدی:</span></span></span></b><span lang="FA" style="font-size:11.5pt"><span style="line-height:119%"><span style="font-family:"B Nazanin""> کمردرد مزمن غیراختصاصی، توزیع فشار کف­پایی، کنترل حرکتی، آموزش علوم اعصاب درد، آب­درمانی</span></span></span></span></span></span></span></span><br>
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<div class="msocomtxt" id="_com_1" language="JavaScript" on=""><illegal tag=""><span style="font-size:10pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span calibri="" style="font-family:"><span dir="LTR" style="font-size:12.0pt"></span></span></span></span></span></illegal></div>
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<span style="font-size:10pt"><span style="line-height:140%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><a name="_Hlk114425361"><b><span style="font-size:9.0pt"><span style="line-height:140%">Background and Objectives: </span></span></b></a><span style="font-size:9.0pt"><span style="line-height:140%">Motor control disorder in patients with chronic non-specific low back pain (NSCLBP) can change the plantar pressure distribution, increase the spine loading, and lead to the development of NSCLBP. The present study aimed to determine the effect of adding pain neuroscience education to motor control exercises in water and dry environments on plantar pressure distribution symmetry in women with NSCLBP.</span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:140%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:9.0pt"><span style="line-height:140%">Materials and Methods: </span></span></b><span style="font-size:9.0pt"><span style="line-height:140%">This clinical trial was conducted in 2024 at Bu Ali Sina University, Hamadan. Sixty women with NSCLBP were conveniently selected and randomly assigned into experimental and control groups (n=30). The experimental group received motor control exercises in water and land environments along with neuroscience education for 4 weeks, and the control group did not receive any intervention. Pain intensity, </span></span><span lang="EN" style="font-size:9.0pt"><span style="line-height:140%">kinesiophobia</span></span><span style="font-size:9.0pt"><span style="line-height:140%">, and plantar pressure distribution were assessed in the pre-test and post-test stages. Multivariate analysis of covariance (MANCOVA) was used to analyze the data.</span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:140%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:9.0pt"><span style="line-height:140%">Results:</span></span></b> <span lang="EN" style="font-size:9.0pt"><span style="line-height:140%">Comparison of the results between the groups showed that there was a significant difference in pain reduction (p<0.001), kinesiophobia (p<0.001), and improvement in plantar pressure distribution symmetry in the experimental group compared to the control group (p<0.001).</span></span><span dir="RTL" lang="FA" style="font-size:9.0pt"><span style="line-height:140%"><span style="font-family:"B Nazanin""></span></span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:140%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:9.0pt"><span style="line-height:140%">Conclusion:</span></span></b><span style="font-size:9.0pt"><span style="line-height:140%"> Combination of neuroscience education and motor control exercises over a 4-week period significantly reduced pain intensity and kinesiophobia with a medium effect size and improved the plantar pressure distribution symmetry. Therefore, it is suggested that physiotherapists consider the mentioned exercises for the rehabilitation of patients with NSCLBP <b>Keywords:</b> Chronic non-specific low back pain, Plantar pressure distribution, Motor control, Pain neuroscience training, Hydrotherapy</span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:140%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><span style="font-size:9.0pt"><span style="line-height:140%"></span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:140%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:9.0pt"><span style="line-height:140%">Funding:</span></span></b><span style="font-size:9.0pt"><span style="line-height:140%"> This study did not have any funds.</span></span><span dir="RTL" lang="FA" style="font-size:9.0pt"><span style="line-height:140%"><span style="font-family:"B Nazanin""></span></span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:140%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:9.0pt"><span style="line-height:140%">Conflict of interest:</span></span></b><span style="font-size:9.0pt"><span style="line-height:140%"> None declared.</span></span><span dir="RTL" lang="FA" style="font-size:9.0pt"><span style="line-height:140%"><span style="font-family:"B Nazanin""></span></span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:140%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:9.0pt"><span style="line-height:140%">Ethical considerations:</span></span></b><span style="font-size:9.0pt"><span style="line-height:140%"> The Ethics committee of Bu-Ali Sina University approved the study (IR.BASU.REC.1402.095). </span></span><span dir="RTL" lang="FA" style="font-size:9.0pt"><span style="line-height:140%"><span style="font-family:"B Nazanin""></span></span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:140%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:9.0pt"><span style="line-height:140%">Authors’ contributions:</span></span></b></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:140%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:9.0pt"><span style="line-height:140%">- Conceptualization: </span></span></b><span style="font-size:9.0pt"><span style="line-height:140%">Ali Yalfani, Fatemeh Sori</span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:140%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:9.0pt"><span style="line-height:140%">- Methodology: </span></span></b><span style="font-size:9.0pt"><span style="line-height:140%">Ali Yalfani, Fatemeh Sori</span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:140%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:9.0pt"><span style="line-height:140%">- Data collection:</span></span></b><span style="font-size:9.0pt"><span style="line-height:140%"> Fatemeh Sori, Mohammadreza Ahmadi, Azadeh Asgarpoor</span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:140%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:9.0pt"><span style="line-height:140%">- Formal analysis:</span></span></b><span style="font-size:9.0pt"><span style="line-height:140%"> Fatemeh Sori, Mohammadreza Ahmadi, Azadeh Asgarpoor<b> </b></span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:140%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:9.0pt"><span style="line-height:140%">- Supervision:</span></span></b><span style="font-size:9.0pt"><span style="line-height:140%"> Ali Yalfani</span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:140%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:9.0pt"><span style="line-height:140%">- Project administration:</span></span></b><span style="font-size:9.0pt"><span style="line-height:140%"> Ali Yalfani</span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:140%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:9.0pt"><span style="line-height:140%">- Writing – original draft:</span></span></b><span style="font-size:9.0pt"><span style="line-height:140%"> Ali Yalfani</span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:140%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:9.0pt"><span style="line-height:140%">- Writing – review & editing:</span></span></b><span style="font-size:9.0pt"><span style="line-height:140%"> Fatemeh Sori, Mohammadreza Ahmadi, Azadeh Asgarpoor </span></span><span style="font-size:9.0pt"><span style="line-height:140%"></span></span></span></span></span></span></span><br>
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<div><span style="font-size:10pt"><span style="line-height:150%"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:8.0pt"><span style="line-height:150%">Citation:</span></span></b><span style="font-size:8.0pt"><span style="line-height:150%"> Sori F, Yalfani A, Ahmadi MR, Asgarpoor A. The Effect of Adding Pain Neuroscience Education to Motor Control Exercises in Water and Dry Environments on Plantar Pressure Distribution Symmetry in Women with Non-Specific Chronic Low Back Pain: A Clinical Trial. </span></span> <i><span style="font-size:8.0pt"><span style="line-height:150%">J Rafsanjan</span></span></i><span style="font-size:8.0pt"><span style="line-height:150%"> <i>Univ Med Sci</i> 2025; 23 (12): 1076-92. [Farsi]</span></span><span style="font-size:8.0pt"><span style="line-height:150%"></span></span></span></span></span></div>
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کمردرد مزمن غیراختصاصی, توزیع فشار کفپایی, کنترل حرکتی, آموزش علوم اعصاب درد, آبدرمانی
Chronic non-specific low back pain, Plantar pressure distribution, Motor control, Pain neuroscience training, Hydrotherapy
1076
1092
http://journal.rums.ac.ir/browse.php?a_code=A-10-3026-5&slc_lang=fa&sid=1
Ali
Yalfani
فاطمه
سوری
m.ahmadi01@phe.basu.ac.ir
6900319475328460060016
0009-0005-2061-4143
No
دانشکده علوم ورزشی، دانشگاه بوعلی سینا، همدان
Fatemeh
Sori
علی
یلفانی
powerlifter.ahmadi@gmail.com
6900319475328460060017
6900319475328460060017
Yes
دانشکده علوم ورزشی، دانشگاه بوعلی سینا، همدان
Mohammadreza
Ahmadi
محمدرضا
احمدی
mohammadreza.ahmadi189@gmail.com
6900319475328460060018
6900319475328460060018
No
دانشکده علوم ورزشی، دانشگاه بوعلی سینا، همدان
Azadeh
Asgarpoor
آزاده
عسگرپور
6900319475328460060019
6900319475328460060019
No
دانشکده علوم ورزشی، دانشگاه بوعلی سینا، همدان