Razi Journal of Medical Sciences

fa تاثیر تمرینات پیلاتس، یوگا و تراباند بر حداکثر اکسیژن مصرفی دانش آموزان دختر با ناهنجاری کایفوز وضعیتی شهر نطنز The effect weeks Pilates, Yoga and TheraBand Training on the Maximal Oxygen Consumption of Girl students with Postural Kyphosis in Natanz City طب ورزش Sports Medicine پژوهشي Research چکیده فارسی:  زمینه و هدف: یکی از عوامل مهم تعیین کننده سبک زندگی سالم کودکان در سن مدرسه از طریق پیشگیری از ناهنجاری ها، حرکت روزانه است. هدف این پژوهش، بررسی تاثیر هشت هفته تمرینات پیلاتس، یوگا و تراباند بر حداکثر اکسیژن مصرفی دانش آموزان دختر با ناهنجاری کایفوز وضعیتی شهر نظنز اصفهان می باشد. روش کار: تحقیق حاضر از نوع نیمه تجربی می باشد. بدین منظور 45 دانش آموز دختر 14 تا 18 سال با زاویه کایفوز بیشتر از 42 درجه و در سه گروه تمرینی پیلاتس (15 نفر)، یوگا (15 نفر) و تراباند (15 نفر) انتخاب شدند. در این مطالعه از کایفومتر جهت ارزیابی کایفوز پشتی استفاده شد. همچنین شـاخصهای عملکرد ریوی همچون ظرفیت حیاتی (Forced Vital Capacity)، ظرفیت بازدمی فعال در ثانیه اول (Forced Expiratory Volume in First Second) و نسبت ظرفیت بازدمی فعال در ثانیه اول به ظرفیت حیاتی (FVC/FEV1) بـا استفاده از اسپیرومتری ارزیابی شد. پس از ارزیابی متغیرهای آزمودنی ها برنامه های تمرینی را به مدت هشت هفته و سه جلسه در هر هفته انجام دادند. پس از پایان هشت هفته مجددا ارزیابی ها در سه گروه انجام شد.از آزمون آنالیز آنووا در نرم افزار Spss نسخه 24 جهت تحلیل آماری در سطح معناداری 05/0 α ≤ استفاده شد. یافته ها: نتایج نشان داد هر سه برنامه تمرینی اثر معنی داری بر کاهش زاویه کایفوز پشتی داشت (001/0=P). همچنین در زمینه شـاخصهای عملکرد ریوی نشان داد استفاده از تمرینات پیلاتس و یوگا اثر معنی داری بر بهبود در شاخص های ظرفیت حیاتی (FVC) (001/0=P)، ظرفیت بازدمی فعال در ثانیه اول (FEV1) (001/0=P) داشت. نتیجه گیری: نتایج تحقیق حاضر نشان دهنده اثر مثبت تمرینات با تراباند، پیلاتس و یوگا بر کاهش کایفوز پشتی دختران دانش آموزان بود. همچنین در زمینه شاخص های عملکرد تنفسی نتایج نشان داد که استفاده از تمرینات پیلاتس و یوگا در مقایسه با تمرینات با تراباند اثر بیشتری دارد.   Background & Aims: Normal lung function varies among individuals due to factors such as age, gender, physical activity level, body mass index, and lifestyle habits (1). Abnormalities refer to undesirable changes that disrupt the skeletal structure and normal alignment of the body (2). Today's sedentary lifestyle, characterized by children sitting in school for 6 to 7 hours and then spending several additional hours in front of a television or computer, poses significant health risks. One crucial factor in promoting a healthy lifestyle for school-age children and preventing abnormalities is daily physical activity (4). Research has demonstrated that exercising three times a week can significantly reduce the angle of kyphosis and help prevent its occurrence (12). A key principle is the centrality of exercise, which involves the proper activation of muscles in the lumbopelvic region and axial extension. These muscles are consistently engaged during Pilates exercises, contributing to improved spinal alignment, facilitating balanced movements, and enhancing central motor control (13, 14). Conversely, yoga exercises can also be effective in reducing dorsal kyphosis and subsequently improving breathing by correcting trunk alignment and the patterns of breathing and muscles that affect both breathing and kyphosis (15). When kyphosis and a forward head position are present, diaphragmatic breathing is limited. In contrast, the accessory inspiratory muscles become overactivated, leading to their overuse (16). Aerobic exercise can effectively improve breathing by engaging the respiratory muscles in a beneficial manner (17). Therefore, the present study seeks to determine whether Pilates, yoga, and Theraband exercises affect the maximum oxygen consumption of female students with postural kyphosis. Methods: This study is prospective in terms of time, semi-experimental in terms of methodology, and applied in terms of subject matter. A total of 45 eligible female students, aged 14 to 18 years, participated purposefully. The sample size was determined using G*POWER software, considering an effect size of 0.6, an alpha level of 0.05, and a beta level of 0.85. The participants were divided into three training groups: Pilates (15 participants), yoga (15 participants), and Theraband (15 participants). Participants voluntarily entered the study after meeting the inclusion criteria (presence of dorsal kyphosis greater than 42 degrees and absence of respiratory problems) and the exclusion criteria (excessive fatigue during exercises due to severe musculoskeletal weakness, absence from two consecutive sessions, or absence from three non-consecutive sessions). They also completed a consent form and a data collection form.To conduct this study, the researcher visited the schools in Natanz city where they worked and invited female students with kyphosis greater than 42 degrees to participate (18). After coordinating with the school principal and obtaining consent from the students' parents, the researcher evaluated kyphosis variables and lung volume indices. The subjects were then divided into three groups: Pilates, yoga, and Theraband exercises, and they participated in the exercise program for eight weeks. Upon completion of this period, the subjects were re-evaluated in the post-test phase.  Method of Assessing Dorsal Kyphosis: A kyphometer was utilized in this study to evaluate kyphosis. To determine the angle of dorsal kyphosis, the angle between the spinous processes of the T3-T4 and T11-T12 vertebrae was measured. For the assessment, the subject was instructed to stand barefoot with their weight evenly distributed between both legs and their arms positioned straight at their sides. In this posture, the block connected to the marker point was placed on the first numbered point, while the block connected to the protractor was positioned on the second marker point (19). Pulmonary Function Indices: In this study, pulmonary function indices were measured using spirometry to assess lung capacity and volume, in accordance with the standards set by the American Thoracic Society. A portable calibrated spirometer (COMPACT model, manufactured by Vitalograph, England) was employed in a medical center by a trained technician. The average predicted percentages of each lung function variable, based on age and gender, were calculated and estimated using a spirometer. To familiarize the participants with spirometry, they received necessary training. Before the test, the subjects were seated for 5 minutes, after which they were asked to stand in front of the spirometer in a normal and comfortable position while placing a special clip on their noses. At least three acceptable tests were conducted for each subject, and from these tests, the highest values of forced vital capacity (FVC) and forced expiratory volume in the first second (FEV1) were selected. The spirometry indices examined in this study included forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), and the ratio of forced expiratory volume in the first second to vital capacity (FVC/FEV1) (20). Pilates exercise program: It was performed over an 8-week period, with three sessions per week. The program included breathing exercises, warm-up (stretching and balance), basic and specialized Pilates exercises, and a cool-down that included stretching exercises (21). Yoga Exercise Program: Participants performed general Iyengar yoga 3 days per week (1 hour each day) (Table 2) and Iyengar yoga exercises with an emphasis on spine and shoulder exercises 2 days per week (30 minutes each day). All exercise sessions began with mountain pose (tadasana), followed by poses that focused primarily on lengthening the spine and improving flexibility, balance, muscle strength, and endurance. The yoga exercises were performed for 8 weeks, with a 10-minute warm-up before and a 10-minute cool-down after the exercises (22). Theraband exercises: This study was conducted for 8 weeks and 3 sessions per week, and the exercises are presented in the table below. A 10-minute warm-up was performed before the exercises and a 10-minute cool-down was performed after the exercises (23). Results: The results of the present study showed that all three exercise programs had a significant effect on reducing the angle of dorsal kyphosis (P=0.001). Also, studies conducted in the field of pulmonary function indices showed that the use of Pilates and yoga exercises had a significant effect on improving vital capacity (FVC) (P=0.001), forced expiratory capacity in the first second (FEV1) (P=0.001). In the field of intergroup comparison, the results also showed a significant difference between the Pilates-Theraband (P=0.001) and Yoga-Theraband (P=0.001) groups. Conclusion: The present study showed the effect of exercises with Theraband, Pilates and yoga on reducing the dorsal kyphosis of female students. Also, in the field of respiratory function indices, the results showed that the use of Pilates and yoga exercises has a greater effect compared to exercises with Theraband. It is recommended that the present study be conducted in people with upper crossed syndrome. Also, the lasting effect of Pilates, yoga and Theraband exercises on the dorsal kyphosis angle and respiratory function indices of girls with dorsal hyperkyphosis should be determined. Considering the greater effect of Pilates and yoga exercises compared to exercises with Theraband on respiratory indices, the use of yoga and Pilates exercises to improve the respiratory function of girls with dorsal hyperkyphosis is recommended to health-related educators. Munawwarah et al. (2023) noted the effect of additional breathing exercises along with postural exercises on reducing hyperkyphosis curves in the elderly. Based on the results, there is a significant difference between adding breathing exercises to postural exercises and postural exercises alone in reducing the hyperkyphosis curve (26). Pilates and yoga exercises, by providing mobility to the trunk area and also by creating tension in the flexor muscles of the spine and increasing the strength in the extensor muscles, can improve the muscle balance between the opposing and opposing muscle groups in this area and thereby significantly reduce the angle of the dorsal kyphosis (29). Regarding the effect of Pilates and yoga exercises on reducing the angle of the dorsal kyphosis, it can be stated that by using the muscles of the whole body, they strengthen the deep muscles of the trunk and thereby improve the condition of the dorsal kyphosis (30). In the context of the effect of yoga exercises, the effects of concentration in this type of exercise on respiratory muscles can also be mentioned. In this regard, McKay et al. (2016) in their study entitled The Effect of Continuous Yoga Breathing Practice on the Human Cardiorespiratory System showed that the use of these exercises significantly changes end-expiratory gases, which leads to complex fluctuations in cardiovascular and cerebrovascular variables and, if practiced continuously, may reduce chemical sensitivity (39).   کایفوز, پیلاتس, یوگا, ظرفیت حیاتی kyphosis (MeSH ID: D007738), Pilates (MeSH ID: D026241), yoga (MeSH ID: D015013), Vital Capacity (MeSH ID: D014797) 0 0 http://rjms.iums.ac.ir/browse.php?a_code=A-10-3597-4&slc_lang=fa&sid=1 Fatemeh Masumi Masumi فاطمه معصومی shaghayeghm054@gmail.com 3900319475328460090923 3900319475328460090923 No Department of Sport Injuries and Corrective Exercises, School of Physical Education and Sports Science, Allameh Tabataba'i University, ، دانشکده تربیت بدنی و علوم ورزشی علامه طباطبائی، تهران، ایران Farideh Babakhani فریده باباخانی Farideh_babakhani@yahoo.com 3900319475328460090924 3900319475328460090924 Yes Department of Sport Injuries and Corrective Exercises, School of Physical Education and Sports Science, Allameh Tabataba'i University, ، دانشکده تربیت بدنی و علوم ورزشی علامه طباطبائی، تهران، ایران Ramin Baluchi رامین بلوچی ram_b81@yahoo.com 3900319475328460090925 3900319475328460090925 No Department of Sport Injuries and Corrective Exercises, School of Physical Education and Sports Science, Allameh Tabataba'i University, ، دانشکده تربیت بدنی و علوم ورزشی علامه طباطبائی، تهران، ایران