fa بررسی تاثیر تحریکات حس سطحی و عمقی بر فعالیت های روزمره زندگی و عملکرد حرکتی اندام فوقانی بیماران سکته مغزی کاردرمانی Psychiatric Occupational therapy پژوهشي Research <strong><span style="font-family:b mitra;"><span style="font-size:10.0pt;">زمینه و هدف</span></span></strong>: <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">نقایص</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">حسی</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">از</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">جمله</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">عوارض</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">شایع</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">سکته</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">‌های</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">مغزی</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">هستند</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">و</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">مطالعات</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">مختلف</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">میزان</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">شیوع</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">این</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">نقایص</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">را</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">در</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">بیماران</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">سکته</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">مغزی</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">بین</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">11 تا</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">85%</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">گزارش</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">نموده‌اند.</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">این</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">نقایص</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">در</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">اندام</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">فوقانی</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">همی</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">پلژیک</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">از</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">فقدان</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">حس‌های</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">اولیه</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">تا</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">ادراکات</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">پیچیده‌تر</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">متفاوت</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">هستند و سبب کاهش</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">استفاده</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">از</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">اندام</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">مبتلا،</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">ضعف</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">در</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">دستکاری</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">حرکتی ظریف</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">اشیا،</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">ضعف</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">در</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">مهارت‌های</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">گرفتن</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">می‌گردند</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">و</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">در</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">نهایت</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">منجر</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">به</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">کاهش</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">سطح</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">فعالیت در</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">سمت</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">مبتلا</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">و</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">نهایتاً کاهش</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">کیفیت</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">زندگی</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">فرد</span></span></span> <span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">می‌شوند. هدف از مطالعه حاضر بررسی تأثیر تحریکات حس سطحی و عمقی بر فعالیت‌های روزمره زندگی و عملکرد حرکتی اندام فوقانی بیماران سکته مغزی می‌باشد.</span></span></span><br> <strong><span style="color:black;"><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;">: این پژوهش از نوع مداخله‌ای کارآزمایی بالینی یک سویه کور بود که بر روی 60 بیمار سکته مغزی مزمن انجام شد. پیش از شروع مداخله عملکرد اندام فوقانی بیماران (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;">Fugle-Meyer</span></span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">) و فعالیت‌های روزمره زندگی (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;">Barthel</span></span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">) مورد ارزیابی قرار گرفتند و سپس درمان آغاز گردید. بیماران در این فاز به مدت 6 هفته تحت درمان تحریکات حس سطحی و عمقی قرار گرفتند. درمان بر پایه رویکرد رود انجام شد.</span></span></span><br> <strong><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">یافته‌ها</span></span></span></strong><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">: نتایج تحقیق حاضر نشان داد که بیماران گروه مداخله بهبودی معنی‌داری را در عملکرد حرکتی </span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">(</span></span></span><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;">0001/0</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><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;"> و فعالیت‌های روزمره زندگی اندام فوقانی نشان دادند (0001/0</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><span style="color:black;"><span style="font-family:b mitra;"><span style="font-size:10.0pt;"></span></span></span><br> <strong><span style="color:black;"><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;">: بر اساس نتایج به دست آمده به نظر می‌رسد تحریکات حس سطحی و عمقی بر عملکرد حرکتی و فعالیت‌های روزمره زندگی اندام فوقانی بیماران سکته مغزی مزمن موثر می‌باشد.</span></span></span><br> &nbsp; <strong>Background</strong>: Sensory defects are one of the common complications of stroke. Various studies have reported the prevalence of these deficits in stroke patients between 11 and 85%. These defects in the upper limb of the hemiplegic vary from the lack of primary senses to more complex perceptions, and they reduce the use of the affected limb. Weakness in fine motor manipulation of objects, weakness in the skills of grasping, decrease in the level of activity on the affected side and ultimately a decrease in the quality of life of the individual are seen. The purpose of this study was to evaluate the effect of extroceptive and proprioceptive sensory stimulation on daily living activity and motor function of upper limb in stroke patients.<br> <strong>Methods</strong>: This interventional study was a blind clinical trial that was performed on 60 patients with chronic stroke. Upper limb function (Fugle-Meyer test) and daily living activity (Barthel test) were evaluated. Patients received extroceptive and proprioceptive sensory stimulation for 6 weeks. Treatment was based on the Rood approach.<br> <strong>Results</strong>: The results of this study showed that the intervention group had significant improvement in motor function (p<0.0001) and daily living activity of upper limb (p<0.0001).<br> <strong>Conclusion</strong>: Based on the results, it can be implied that extroceptive and proprioceptive sensory stimulation are effective methods in improvement of motor function and daily living activity of the stroke patient&rsquo;s upper limb.<br> &nbsp; سکته مغزی, تحریکات حس سطحی و عمقی, عملکرد حرکتی, فعالیت های روزمره زندگی Stroke, Exteroceptive and proprioceptive sensory stimulation, Motor function, Daily living activity 55 61 http://rjms.iums.ac.ir/browse.php?a_code=A-10-3844-1&slc_lang=fa&sid=1 Maryamn Derakhshanfar مریم درخشانفر rainbowderakhshan@gmail.com 3900319475328460044281 3900319475328460044281 No Tehran University of Medical Sciences, Tehran, Iran. دانشگاه علوم پزشکی تهران، تهران، ایران Parvin Raji پروین راجی praji@tums.ac.ir 3900319475328460044282 0000000310786177 Yes Tehran University of Medical Sciences, Tehran, Iran. دانشگاه علوم پزشکی تهران، تهران، ایران Hossein Bagheri حسین باقری hbagheri@tums.ac.ir 3900319475328460044283 3900319475328460044283 No Tehran University of Medical Sciences, Tehran, Iran. دانشگاه علوم پزشکی تهران، تهران، ایران Mahmood Jalili محمود جلیلی mjalili@farabi.tums.ac.ir 3900319475328460044284 3900319475328460044284 No Tehran University of Medical Sciences, Tehran, Iran. دانشگاه علوم پزشکی تهران، تهران، ایران Hossein Tarhsaz حسین طرح ساز designmakerr66@yahoo.com 3900319475328460044285 3900319475328460044285 No School of Razi, Kermanshah, Iran دانشگاه رازی کرمانشاه، کرمانشاه، ایران.