Razi Journal of Medical Sciences

other اثر تمرینات مهارتی، قدرتی و ترکیبی بر ثبات دست برتر در کودکان کم‌توان ذهنی آموزش‌پذیر (7–14 سال) The Effect of Skill, Strength, and Combined Training on Hand Steadiness of the Dominant Hand in Educable Children with Intellectual Disabilities (Aged 7–14 Years) داروسازی Pharmacy پژوهشي Research <div style="text-align: justify;">زمینه و هدف: رشد مهارت‌های حرکتی ظریف، به‌ویژه ثبات دست، نقش مهمی در عملکرد تحصیلی و انجام فعالیت‌های روزمره کودکان دارد. این مهارت در کودکان کم‌توان ذهنی آموزش‌پذیر به دلیل محدودیت‌های شناختی و حرکتی با چالش‌هایی همراه است و نیازمند مداخلات مؤثر می‌باشد. هدف پژوهش حاضر، بررسی تأثیر یک دوره تمرینات مهارتی، قدرتی و ترکیبی بر ثبات دست کودکان کم‌توان ذهنی آموزش‌پذیر بود. روش کار: جامعه آماری این پژوهش را کلیه دانش‌آموزان دختر کم‌توان ذهنی آموزش‌پذیر شهر اصفهان تشکیل دادند که از میان آن‌ها 34 نفر در دامنه سنی 7 تا 14 سال به‌صورت در دسترس انتخاب شدند. شرکت‌کنندگان بر اساس نمرات پیش‌آزمون به‌صورت همگن در چهار گروه مهارتی (9 نفر)، قدرتی (8 نفر)، ترکیبی (9 نفر) و کنترل (8 نفر) قرار گرفتند. طرح پژوهش از نوع پیش‌آزمون–پس‌آزمون با گروه کنترل بود. داده‌ها با استفاده از آزمون MLS (مجموعه ابزار وینا) جمع‌آوری شد و برای تحلیل آماری از تحلیل واریانس عاملی مرکب در طرح 4 (گروه) × 2 (مرحله آزمون) استفاده شد. یافته‌ها: نتایج نشان داد که تمرینات مهارتی، قدرتی و ترکیبی تأثیر معناداری بر بهبود ثبات دست از نظر تعداد خطا داشتند (003/0=p  و 536/6= (30 و 3) F). همچنین تمرینات قدرتی و ترکیبی تأثیر معناداری بر کاهش زمان خطا داشتند (03/0= p و 579/12= (30 و 3) F) در حالی‌که تمرینات مهارتی در این متغیر تأثیر معناداری نشان نداد. مقایسه بین گروه ها نشان داد بین گروه‌های مهارتی ، قدرتی و ترکیبی تفاوت معنی داری وجود نداشت اما بین گروه‌های مهارتی و ترکیبی با گروه کنترل در متغیر تعداد خطا تفاوت معناداری مشاهده شد (004/0=p و 676/6=(28 و 5) F). در متغیر زمان خطا نیز تفاوت معناداری بین گروه‌ها مشاهده نشد. نتیجه‌گیری: در مجموع، نتایج این پژوهش نشان داد که تمرینات مهارتی، قدرتی و ترکیبی می‌توانند موجب بهبود ثبات دست در کودکان کم‌توان ذهنی آموزش‌پذیر شوند.</div> <div style="text-align: justify;"> Background & Aims: The development of fine motor skills is one of the fundamental factors in shaping children’s daily functional abilities and academic performance. Among the various components of these skills, hand steadiness plays a particularly important role, as it underlies many essential activities such as writing, drawing, manipulating educational tools, completing school tasks, and even performing simple personal routines. The ability to maintain controlled and stable hand movements enables children to carry out purposeful actions with appropriate accuracy, coordination, and speed, thereby enhancing their engagement and effectiveness in learning processes. In educable children with intellectual disabilities, the development of fine motor skills faces additional challenges due to cognitive limitations, delays in information processing, weaknesses in motor planning, and musculoskeletal difficulties. These children often exhibit slowness, motor instability, and reduced performance quality in activities requiring high motor precision. Therefore, improving fine motor skills- particularly hand steadiness- in this population requires structured and targeted training programs. Previous studies suggest that skill-based and strength-based exercises can improve motor control, the coordination of small hand muscles, and the strength of finger and wrist muscles. Skill-based exercises typically focus on activities that enhance accuracy, speed, and coordination, such as tracing patterns, bead manipulation, hand-based games, and purposeful therapeutic tasks. Strength-based exercises, on the other hand, emphasize increasing the power of the hand and forearm muscles, which can provide greater stability during movement. A combination of these approaches- integrated skill and strength training- may yield enhanced effectiveness, as it simultaneously builds muscular strength and refines fine motor abilities within purposeful activities. Despite the importance of motor interventions in improving the performance of children with intellectual disabilities, only a limited number of studies have comparatively examined the effects of skill-based, strength-based, and combined exercises on hand steadiness in educable children with intellectual disabilities. Consequently, there remains a research gap concerning the identification of the most effective type of exercise, highlighting the need for more rigorous investigations to determine which training method yields the greatest improvement in the motor abilities of this population. The purpose of the present study is grounded within this context. This research aims to investigate and compare the effects of a training program involving skill-based, strength-based, and combined exercises on hand steadiness in educable children with intellectual disabilities. The study seeks to provide reliable scientific evidence to support educators, therapists, and rehabilitation specialists in choosing the most appropriate training protocol for enhancing hand steadiness in these children. It is expected that the findings will not only contribute to improving motor performance but also promote academic participation and increase personal independence among educable children with intellectual disabilities. Methods: The statistical population of this study included all female educable students with intellectual disabilities in Isfahan, from which 34 participants aged 7 to 14 years were selected through convenience sampling. Based on pre-test scores, participants were homogenously assigned to four groups: skill training (n = 9), strength training (n = 8), combined training (n = 9), and control (n = 8). The study employed a pre-test–post-test design with a control group. Data were collected using the MLS (Vienna Test System) and analyzed using mixed-design analysis of variance in a 4 (group) × 2 (test phase) design. Results: The results indicated that skill, strength, and combined training had a significant effect on improving hand steadiness in terms of error number (p = 0.003, F(3, 30) = 6.536). In addition, strength and combined training significantly reduced error time (p = 0.03, F(3, 30) = 12.579), whereas skill training did not show a significant effect on this variable. Between-group comparisons revealed no significant differences among the skill, strength, and combined training groups; however, significant differences were observed between the skill and combined groups compared to the control group in error number (p = 0.004, F(5, 28) = 6.676). No significant differences were found among the groups in error time. Conclusion: The findings of the present study indicated that all three types of training interventions- skill-based, strength-based, and combined- produced significant improvements in hand steadiness among educable children with intellectual disabilities in terms of the number of errors. This suggests that participation in structured and purposeful training programs, regardless of the type of exercise, can help reduce slips, motor instability, and performance-related errors in tasks requiring precise hand control. The positive effects of all training programs on the error-count variable demonstrate that even simple skill-based exercises are capable of stimulating and strengthening the neuromotor processes involved in hand control. However, the findings related to error time present a different picture. The results showed that only strength-based and combined exercises were able to produce a significant reduction in error time, whereas skill-based exercises did not show such an effect. This difference may be attributed to the nature of strength and combined training, as strengthening the small muscles of the hand and forearm creates greater stability and endurance, which can improve the speed of movement execution while maintaining accuracy. In contrast, skill-based exercises primarily focus on enhancing coordination and precision and may require longer training periods to produce substantial changes in speed and execution time. The between-group comparisons also revealed important points. Although no significant differences were observed among the three training groups (skill-based, strength-based, and combined), both the skill-based and combined groups demonstrated better performance than the control group in the error-count variable. This finding suggests that even skill-based exercises alone can have protective and facilitative effects on hand steadiness, and that the absence of structured training in the control group likely contributed to the persistence of functional weaknesses. The lack of significant differences in error time among the groups may indicate that this variable is influenced by more complex factors and may require longer training durations, greater training intensity, or different combinations of interventions to show noticeable changes. Overall, the results of the present study demonstrate that structured training interventions can play an important role in enhancing the fine motor skills of educable children with intellectual disabilities. Skill-based exercises are effective in improving accuracy and reducing errors, while strength-based and combined exercises can additionally contribute to reducing execution time. Therefore, a combined training approach- one that simultaneously improves muscle strength and enhances coordination and precision- appears to be an appropriate strategy for educational and rehabilitation programs. Given the importance of hand steadiness in daily and academic activities, it is recommended that educators and therapists incorporate purposeful training programs into educational and therapeutic settings. Furthermore, future research with longer training periods, larger sample sizes, and the assessment of additional motor performance indicators is suggested to provide a more comprehensive understanding of the effectiveness of these interventions.</div> کم توان ذهنی, ثبات دست, آزمون MLS (ابزار وینا) Intellectual disability, Hand steadiness, Vienna Test System (MLS) 108 117 http://rjms.iums.ac.ir/browse.php?a_code=A-10-1-1782&slc_lang=other&sid=1 Maryam Amooei مریم آمویی Amoei1361@yahoo.com 3900319475328460090500 3900319475328460090500 Yes گروه آموزش تربیت بدنی، دانشگاه فرهنگیان، تهران، ایران Alireza Farsi علیرضا فارسی 3900319475328460090501 3900319475328460090501 No استاد گروه علوم رفتاری و شناختی در ورزش، دانشکده علوم ورزشی و تندرستی، دانشگاه شهید بهشتی، تهران، ایران.