Razi Journal of Medical Sciences
مجله علوم پزشکی رازی
RJMS
Medical Sciences
http://rjms.iums.ac.ir
39
journal39
2228-7043
2228-7051
en
jalali
1399
7
1
gregorian
2020
10
1
27
8
online
1
fulltext
fa
تاثیر یوگای خنده و فعالیتهای حسی - حرکتی بر اضطراب و مهارتهای حرکتی درشت در کودکان طیف اوتیسم با عملکرد بالا
The effect of laughter yoga and sensory-motor activities on anxiety and gross motor skills in children with high-functioning autism spectrum
توانبخشی روانی
Psychiatric Rehabilitation
پژوهشي
Research
<strong><span style="color:#0070c0;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;">زمینه و هدف:</span></span></span></strong> <span style="color:black;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;">اختلال طیف اوتیسم از گروه اختلالات رشدی عصبی است. با توجه به نتایج پژوهش</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:Times New Roman,serif;"><span style="font-size:10.0pt;"></span></span></span></span><span style="color:black;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;">ها، کودکان دارای اختلال اوتیسم در رشد مهارت</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:Times New Roman,serif;"><span style="font-size:10.0pt;"></span></span></span></span><span style="color:black;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;">های حرکتی بنیادی، مهارت</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:Times New Roman,serif;"><span style="font-size:10.0pt;"></span></span></span></span><span style="color:black;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;">های حرکتی ظریف و درشت، هماهنگی حرکتی، مشکلات تعادلی، انجام مهارت</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:Times New Roman,serif;"><span style="font-size:10.0pt;"></span></span></span></span><span style="color:black;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;">های روزمره، مهارت</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:Times New Roman,serif;"><span style="font-size:10.0pt;"></span></span></span></span><span style="color:black;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;">های اجتماعی و ارتباطی، در سطح پایین</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:Times New Roman,serif;"><span style="font-size:10.0pt;"></span></span></span></span><span style="color:black;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;">تری نسبت به کودکان عادی قرار دارند و همچنین اضطراب یکی از شایع</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:Times New Roman,serif;"><span style="font-size:10.0pt;">­</span></span></span></span><span style="color:black;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;">ترین اختلالات در میان این کودکان می</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:Times New Roman,serif;"><span style="font-size:10.0pt;">­</span></span></span></span><span style="color:black;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;">باشد. در این پژوهش تاثیر یوگای خنده و </span></span></span><span style="color:black;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;">فعالیت</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:Times New Roman,serif;"><span style="font-size:10.0pt;"></span></span></span></span><span style="color:black;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;">های حسی _ حرکتی را</span></span></span><span style="color:black;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;"> بر اضطراب و مهارت</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:Times New Roman,serif;"><span style="font-size:10.0pt;"></span></span></span></span><span style="color:black;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;">های حرکتی</span></span></span> <span style="color:black;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;">درشت</span></span></span><span style="color:black;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;"> در کودکان اوتیسم را سنجیده</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:Times New Roman,serif;"><span style="font-size:10.0pt;"></span></span></span></span><span style="color:black;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;">ایم.</span></span></span><br>
<strong><span style="color:#0070c0;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;">روش کار:</span></span></span></strong> <span style="color:black;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;">پژوهش از لحاظ روش نیمه تجربی و از لحاظ هدف کاربردی با طرح پیش آزمون - پس آزمون می</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:Times New Roman,serif;"><span style="font-size:10.0pt;"></span></span></span></span><span style="color:black;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;">باشد</span></span></span><span style="color:black;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;">. جامعه آماری این پژوهش،</span></span></span><span style="color:black;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;"> کلیه کودکان پسر 7 تا 10 ساله دارای اختلال طیف اوتیسم با عملکرد بالا در شهر مشهد می</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:Times New Roman,serif;"><span style="font-size:10.0pt;"></span></span></span></span><span style="color:black;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;">باشند. </span></span></span><span style="color:black;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;">تعداد 45 کودک دارای اختلال اوتیسم در سه گروه 15 نفره: گروه اول: تمرینات یوگای خنده، گروه دوم: تمرینات حسی - حرکتی، گروه سوم: ترکیبی (یوگای خنده و تمرینات حسی - حرکتی)، به صورت تصادفی تقسیم و مورد آزمایش قرار گرفته</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:Times New Roman,serif;"><span style="font-size:10.0pt;"></span></span></span></span><span style="color:black;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;">اند. تمرینات در 24 جلسه 45 دقیقه ای برگزار شده است. در ابتدا و انتهای 24 جلسه از والدین خواسته شد تا مقیاس اضطراب کودکان اسپنس _ نسخه والدین را پر کرده و آزمون </span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:Times New Roman,serif;"><span style="font-size:10.0pt;">MABC2</span></span></span></span><span style="color:black;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;"> (مهارت </span></span></span><span style="color:black;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;">هدف گیری و گرفتن</span></span></span><span style="color:black;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;">) از کودکان</span></span></span><span style="color:black;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;"> برای تعیین تأثیر تمرینات حسی _ حرکتی بر روی مهارت­های درشت به صورت پیش آزمون و پس آزمون گرفته شد.</span></span></span><span style="color:black;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;"></span></span></span><br>
<strong><span style="color:#0070c0;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;">یافته ­ها:</span></span></span></strong> <span style="color:black;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;">بین تأثیر تمرینات </span></span></span><span style="color:black;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;">یوگای خنده، فعالیت حسی _ حرکتی، گروه ترکیبی بر روی اضطراب در کودکان اوتیسم با عملکرد</span></span></span> <span style="color:black;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;">بالا تفاوت معناداری وجود ندارد (05/0<</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:Times New Roman,serif;"><span style="font-size:10.0pt;">p</span></span></span></span><span style="color:black;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;">). بین تأثیر تمرینات </span></span></span><span style="color:black;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;">یوگای خنده، فعالیت حسی - حرکتی، گروه ترکیبی بر روی مهارت­های حرکتی (درشت) در کودکان اوتیسم با عملکرد</span></span></span> <span style="color:black;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;">بالا تفاوت معناداری وجود دارد (05/0></span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:Times New Roman,serif;"><span style="font-size:10.0pt;">p</span></span></span></span><span style="color:black;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;">).</span></span></span><br>
<strong><span style="color:#0070c0;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;">نتیجهگیری:</span></span></span></strong> <span style="color:black;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;">تمرینات یکپارچگی حسی - حرکتی و یوگای خنده با توجه به اینکه در محیط آرام، دوستانه، همراه با بازی و تخلیه هیجانات صورت گرفته است، توانسته تأثیر مثبتی بر روی کم شدن اضطراب و بهبود عملکرد مهارت های درشت در کودکان اوتیسم با عملکرد بالا داشته باشد، بنابراین بهتر است این تمرینات در برنامه هفتگی این کودکان قرار گیرد.</span></span></span><span style="color:black;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;"></span></span></span><span dir="LTR"></span>
<strong>Background:</strong> One of the serious diseases in the group of developmental diseases is autism spectrum disorders that appear in early childhood (usually before the age of 3). Autism spectrum disorder is a group of neurodevelopmental disorders. According to research results, children with autism have lower levels of basic motor skills, fine and gross motor skills, motor coordination, balance issues, performing daily skills, social and communicational skills, as well as anxiety. It is one of the most common disorders among these children. The results of research on laughter yoga indicate the positive effect of this exercise program on various diseases, but considering that the effect of laughter yoga on children with autism disorder have not been studied yet, same as the effect of sensory motors activities that is not been measured by the MABC_2 test. In this study, we measured the effect of laughter yoga on anxiety and the effect of sensorimotor activity on gross skills in children with high-functioning autism spectrum.<br>
<strong>Methods:</strong> The statistical population of this study is all 7 to 10 years old boys with high-functioning autism spectrum disorder (referring to autism centers) in Mashhad. For statistical sampling, non-random sampling method available from 9 autism centers, 45 children with autism aged 7 to 10 years with high performance (with expert opinion and Garz test) were selected and divided into three groups of 15: first group Laughter Yoga, Group 2: Sensory-Motor Exercises, Group 3: Combination (Laughter Yoga and Sensory-Motor Exercises) were randomly divided and tested. The research is semi-experimental in terms of method and applied in terms of purpose with pre-test-post-test design.<br>
The exercises are held in 24 sessions of 45 minutes. At the beginning and end of the 24 training sessions, parents of children with autism were asked to complete the Spence Children's Anxiety Scale - the parents' prescription and the MABC2 test to determine the effect of sensory-motor exercises on gross skills. Pre-test and post-test were taken.<br>
Group 1: Laughter yoga exercises: Laughter yoga exercises were performed in 24 sessions by a researcher who was an international laugh yoga instructor, and each session lasted about 45 minutes. Each session includes exercises in 5 stages: the first part: warming up, the second part: breaking the ice, the third part: beginning techniques, the fourth part: laughter meditation, the fifth part: relaxation exercises. Stretching and jumping movements are performed at the beginning and between the performances of laughter yoga technique and yoga (pranayama) breathing. In all exercises, people were trained to make eye contact with other groups during the exercises and to have a fresh face.<br>
Group 2: Sensory-motor integration exercises: The general objectives of sensory-motor exercises in this study were to strengthen motor planning, balance, bilateral motor coordination, tactile sense and deep sense. The list of activities generally includes the following: rope playing, walking on footprints, painting with pencil and magic whiteboard, dropping small balls or balloons into hollow containers and moving them hand in hand, various exercises with beads Coloring, making collages and crafts with glue, separating mixed beans, hitting a stationary object with your hand, throwing a bag of beans or a ball at each other and trying to get it successfully.<br>
Group 3: as a combination of exercises, for 45 minutes, the people in the group performed both types of exercises (5 minutes of general warm-up, 20 minutes of laughter yoga exercises, then 20 minutes of sensory-motor exercises).<br>
<strong>Results: </strong>Based on the level of significance in the analysis of variance test with repeated measures, it can be concluded that within-group changes in the anxiety variable are significant (p=0.001); Therefore, it can be concluded that laughter yoga exercises, sensory-motor activity, combined group have a positive effect on anxiety in children with high performance autism (p=0.001). Also, intra-group changes in gross motor skills are significant (p=0.001); Therefore, it can be concluded that laughter yoga exercises, sensory-motor activity, combined group have a positive effect on motor skills (large) in children with high performance autism (p= 0.001). The results of analysis of variance with repeated measures and Beferroni post hoc test showed that there was no significant difference in anxiety between the three groups (p<0.05). Also, the results of this test showed that there was a significant difference in gross motor skills between the three groups (p˂0.05), in gross motor skills, only a significant difference was observed between the two groups of laughter yoga and the combined group (p=0.034). At the same time, the percentage of improvement in post-test anxiety compared to the pre-test in the laughing yoga group (25.5%), the sensorimotor activity group (12.6%) and the combination group (27.7%) indicate this. The combined group experienced a greater improvement in anxiety. Also, the percentage of improvement of motor skills in the post-test compared to the pre-test in the group of laughing yoga (13.1), sensory-motor activity group (38.5) and combination group (33.6) showed that the group of sensory activity - The motor and hybrid groups experienced further improvements in motor skills.<br>
<strong>Conclusion:</strong> The aim of this study was to investigate the effect of laughter yoga and sensory-motor activities on anxiety and gross motor skills in children with high performance autism. According to the results, the combined group on anxiety factor and sensory-motor activity had a higher effect on gross motor skills, which indicates that to improve gross skills, it is better to focus more on sensory-motor activities and Use laughter yoga to improve your anxiety factor. According to the results of our study on the positive effect of laughter yoga and sensory-motor activity on anxiety and gross motor skills in high-functioning autistic children, Health care providers and the educators can use the power of laughter to improve health, teaching and learning. This is important because teaching is not just about content but also about building relationships and strengthening human relationships. This can have a huge impact on the relationships of children with autism. Laughter improves the performance of children with autism by attracting and maintaining attention, reducing anxiety, increasing participation, and increasing motivation. Also, sensory-motor integration exercises should have a positive effect on children with high performance autism, considering that it has been able to play in a calm and friendly environment, along with playing and discharging emotions.
یوگای خنده, فعالیت حسی _ حرکتی, اضطراب, مهارت حرکتی درشت, کودک اوتیسم
Laughter Yoga, Sensory-motor activity, Anxiety, Gross Motor skills, Child with autism
192
208
http://rjms.iums.ac.ir/browse.php?a_code=A-10-5364-1&slc_lang=fa&sid=1
Saba
Ghafarian m.n
صبا
غفاریان مشهدی نژاد
3900319475328460054770
3900319475328460054770
No
Kish International Campus, University of Tehran, Kish, Iran
پردیس بین المللی کیش، دانشگاه تهران،کیش، ایران
Mahmoud
Sheykh
محمود
شیخ
prosheikh@yahoo.com
3900319475328460054771
3900319475328460054771
Yes
Faculty of Physical Education and Sports Sciences, University of Tehran, Tehran, Iran
دانشکده تربیت بدنی و علوم ورزشی، دانشگاه تهران، تهران، ایران
Elaheh
Arab ameri
الهه
عرب عامری
3900319475328460054772
3900319475328460054772
No
Department of Motor Behavior, Faculty of Physical Education and Sports Sciences, University of Tehran, Tehran, Iran
دانشکده تربیت بدنی و علوم ورزشی، دانشگاه تهران، تهران، ایران