اثر 8 هفته تمرینات ثبات دهنده مرکزی منتخب همراه با مصرف ویتامین D بر کیفیت زندگی و سلامت روان زنان مبتلا به کمردرد مزمن غیر اختصاصی

نوع مقاله : مقاله پژوهشی

نویسندگان

گروه تربیت بدنی، واحد قائمشهر، دانشگاه آزاد اسلامی، قائمشهر، ایران

چکیده

مقدمه و هدف: بر اساس شواهد فعالیت‌های ورزشی و ویتامینD، علاوه بر نقش خود در توسعه سلامت جسمانی، تاثیر مهمی بر اختلالات شناختی، رفتاری و خلقی دارند. در مطالعه حاضر اثربخشی تمرینات ثبات دهنده مرکزی و مصرف ویتامین D بر کیفیت زندگی و سلامت روان زنان مبتلا به کمردرد مزمن بررسی شد.
مواد و روش ها: در این مطالعه کارآزمایی بالینی بر روی زنان دارای کمردرد مزمن انجام شد، در ابتدا 48 بیمار به روش نمونه‌گیری در دسترس انتخاب، سپس بطور تصادفی به 4 گروه کنترل، تمرین، ویتامین D و ترکیبی (تمرین + ویتامین D) تقسیم شدند. تمرینات ثبات دهنده مرکزی طی 8 هفته توسط گروه‌های تمرین و ترکیبی انجام شد و گروه‌های ویتامینD  و ترکیبی (50000 واحد) مصرف نمودند. از پرسشنامه‌های کیفیت زندگی (SF-36) و سلامت عمومی (GHQ) برای       جمع آوری داده‌ها استفاده شد. آنالیز داده‌ها با استفاده از آزمون‌های t زوجی و تحلیل واریانس یک طرفه در سطح معناداری کمتر از 05/0 انجام شد.
نتایج: سطوح ویتامین D در تمامی آزمودنی‌ها پایین‌تر از حد نرمال بود. کیفیت زندگی و سلامت عمومی زنان مبتلا به کمردرد پس از تمرینات ورزشی، مصرف ویتامین D و مداخله ترکیبی بهبود یافت. بعلاوه مداخله ترکیبی با افزایش بیشتری در کیفیت زندگی در مقایسه با دو مداخله درمانی دیگر و توسعه سلامت روان در مقایسه مصرف ویتامین D همراه بود.
نتیجه‌گیری: به نظر می‌رسد روش‌های درمانی استفاده از تمرینات ثبات دهنده مرکزی، مصرف ویتامین D و یا مداخله ترکیبی می‌تواند به افراد مبتلا به کمردرد با سطح پایین ویتامین D در بهبود کیفیت زندگی و سلامت عمومی کمک نماید.

کلیدواژه‌ها


عنوان مقاله [English]

The effect of 8 weeks of selected central stabilization exercises with vitamin D consumption on the quality of life and mental health of women with non-specific chronic back pain

نویسندگان [English]

  • masoumeh habibian
  • Seyyed Jafar Moosavi
  • ali davari
Department of Physical Education and Sports Sciences, Qaemshahar Branch, Islamic Azad University, Qaemshahar, Iran
چکیده [English]

Background and Objective: According to evidence, sports activities and vitamin D, in addition to their role in developing physical health, have a considerable impact on cognitive, behavioral and mood disorders. In the present study, the effectiveness of core stabilization exercises and vitamin D consumption on quality of life (QL) and mental health (MH) of women with chronic low back pain was investigated.
Materials and Methods: This clinical trial study was performed on women with chronic low back pain. First, 48 patients were selected by available sampling method, then randomly divided into 4 groups: control, exercise, vitamin D and combined (exercise+vitamin D). Core stabilization exercises were performed by training and combined groups for 8 weeks, and vitamin D and combined groups took vitamin D (50,000 IU) weekly. SF-36 QL and general health (GHQ) questionnaires were used to collect data. Data analysis was performed using paired t-test and  one-way analysis of variance at a significance level of P< 0.05.
Results: Vitamin D levels were lower than normal in all subjects. The QL and MH of women with low back pain improved after exercise, vitamin D intake, and combined intervention. The combined intervention was associated with a greater increase in QL compared to the other two therapeutic interventions and the development of MH compared to vitamin D intake.
Conclusion: It seems that therapies using core stabilization exercises, vitamin D intake or combination intervention can help people with low back pain and low levels of vitamin D in improving QL and MH.

کلیدواژه‌ها [English]

  • Chronic low back pain
  • Selected core stabilization exercises
  • Mental health (MH)
  • Quality of life (QL)
  • Vitamin D
  1. Alighias M, Tavafian S, Niknami S. Chronic low back pain, nurses, mental health, educational intervention. The Journal of Toloo-e-behdasht 2016; 14 (6):384-95.
  2. Agnus Tom A, Rajkumar E, John R, Joshua George A. Determinants of quality of life in individuals with chronic low back pain: a systematic review. Health Psychology and Behavioral Medicine 2022;10(1):124-44.
  3. Cieza A, Causey K, Kamenov K, Hanson SW, Chatterji S, Vos T. Global estimates of the need for rehabilitation based on the Global Burden of Disease study 2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 2020; 396:2006-17.
  4. Hu Y, Yang Z, Li Y, Xu Y, Tian M, Jiang N, et al. Prevalence and Associated Factors of Depressive Symptoms Among Patients With Chronic Low Back Pain: A Cross-Sectional Study. Frontiers in Psychiatry 2022;12:820782.
  5. Ghafouri M, Teymourzadeh A, Nakhostin-Ansari A, Sepanlou SG, Dalvand S, Moradpour F, et al. Prevalence and predictors of low back pain among the Iranian population: Results from the Persian cohort study. Annals of Medicine and Surgery 2022;74:103243.
  6. Tsuji T, Matsudaira K, Sato H, Vietri J. The impact of depression among chronic low back pain patients in Japan. BMC musculoskeletal disorders 2016;17(1):447.
  7. Kamper SJ, Apeldoorn AT, Chiarotto A, Smeets RJ, Ostelo RW, Guzman J, et al. Multidisciplinary biopsychosocial rehabilitation for chronic low back pain. Cochrane database of systematic reviews 2014;(9):CD000963.
  8. Tepper S, Dabush Y, Shahar DR, Endevelt R, Geva D, Ish-Shalom S. Vitamin D Status and Quality of Life in Healthy Male High-Tech Employees. Nutrients 2016;8(6):366.
  9. Husky MM, Ferdous Farin F, Compagnone P, Fermanian C, Kovess-Masfety V. Chronic back pain and its association with quality of life in a large French population survey. Health and Quality of Life Outcomes 2018;16(1):195.
  10. Fernandez M, Colodro-Conde L, Hartvigsen J, Ferreira ML, Refshauge KM, Pinheiro MB, et al. Chronic low back pain and the risk of depression or anxiety symptoms. insights from a longitudinal twin study. The Spine Journal 2017; 17:905-12.
  11. Zadro J, Shirley D, Ferreira M, Carvalho-Silva AP, Lamb SE, Cooper C, et al. Mapping the association between vitamin D and low back pain: a systematic review and meta-analysis of observational studies. Pain Physician 2017;20:611–40.
  12. Ghai B, Bansal D, Kanukula R, Gudala K, Sachdeva N, Dhatt SS, et al.Vitamin D Supplementation in Patients with Chronic Low Back Pain: An Open Label, Single Arm Clinical Trial. Pain Physician 2017;20(1):E99-105.
  13. Callegari ET, Reavley N, Gorelik A, Garland SM, Wark JD; Safe-D study team. Serum 25-hydroxyvitamin D and mental health in young Australian women: Results from the Safe-D study. Journal of Affective Disorders 2017;224:48-55.
  14. Wilkins C, Sheline Y, Roe C, Birge S, Morris J. Vitamin D deficiency is associated with low mood and worse cognitive performance in older adults. The American Journal of Geriatric Psychiatry 2006;14:1032-40.
  15. Chu F, Ohinmaa A, Klarenbach S, Wong ZW, Veugelers P. Serum 25-Hydroxyvitamin D Concentrations and Indicators of Mental Health: An Analysis of the Canadian Health Measures Survey. Nutrients 2017;9(10):1116.
  16. Penckofer S, Byrn M, Adams W, Emanuele MA, Mumby P, Kouba J, Wallis DE. Vitamin D Supplementation Improves Mood in Women with Type 2 Diabetes. Journal of Diabetes Research 2017;82326831-11.
  17. Chang WD, Lin HY, Lai PT. Core strength training for patients with chronic low back pain. Journal of Physical Therapy Science 2015;27(3):619-22.
  18. Cho I, Jeon C, Lee S, Lee D, Hwangbo G. Effects of lumbar stabilization exercise on functional disability and lumbar lordosis angle in patients with chronic low back pain. Journal of Physical Therapy Science 2015;27(6):1983-5.
  19. Gordon R, Bloxham S. A systematic review of the effects of exercise and physical activity on non-specific chronic low back pain. Healthcare 2016;4(2). pii: E22.
  20. Akbarnya F, Habibian M, Moosavi. Evaluation of the Effectiveness of Core Stabilization Exercise and Vitamin D Intake on Pain and Functional Disability Levels in Women with Chronic Non-specific Low Back Pain. Journal of Health and Care 2020; 22 (3):199-212.
  21. Suh JH, Kim H, Jung GP, Ko JY, Ryu JS. The effect of lumbar stabilization and walking exercises on chronic low back pain: A randomized controlled trial. Medicine (Lippincott Williams & Wilkins Journal) 2019;98(26):e16173.
  22. Rainville J, Hartigan C, Martinez E, Limke J, Jouve C, Finno M. Exercise as a treatment for chronic low back pain. Journal of Spine 2004;4(1):106-15.
  23. Hearing CM, Chang WC, Szuhany KL, Deckersbach T, Nierenberg AA, Sylvia LG. Physical Exercise for Treatment of Mood Disorders: A Critical Review. Current Behavioral Neuroscience Reports 2016;3(4):350-59.
  24. Yang CY, Tsai YA, Wu PK, Ho  SY,  Chou CY, Shih-FongHuang SF. Pilates-based core exercise improves health-related quality of life in people living with chronic low back pain: A pilot study. Journal of Bodywork and Movement Therapies 2021; 27: 294-99.
  25. Huiberts LM, Smolders KCHJ. Effects of vitamin D on mood and sleep in the healthy population: Interpretations from the serotonergic pathway. Sleep Medicine Reviews 2021;55:101379.
  26. Zar A, Alavi S, Hosseini SA, Jafari M. Effect of sport activities on the quality of life, mental health, and depression of the individuals with disabilities. International Journal of Research in Nursing 2018; 4 (3):31-9.
  27. Motsinger S, Lazovich D, MacLehose RF, Torkelson CJ, Robien K. Vitamin D intake and mental health-related quality of life in older women: the Iowa Women's Health Study. Maturitas 2012;71(3):267-73.
  28. Bahrami A, Mazloum SR, Maghsoudi S, Soleimani D, Khayyatzadeh SS, Arekhi S, et al.. High Dose Vitamin D Supplementation Is Associated With a Reduction in Depression Score Among Adolescent Girls: A Nine-Week Follow-Up Study. Journal of Dietary Supplements 2018; 15(2):173-82.
  29. Patrick RP, Ames BN. Vitamin D and the omega-3 fatty acids control serotonin synthesis and action, part 2: relevance for ADHD, bipolar disorder, schizophrenia, and impulse behavior. The FASEB Journal 2015 ;29(6):2207-22.
  30. Eyles D, Almeras  L, Benech P, Patatian  A, Mackay-Sim  A, Mcgrath J, et al. Developmental vitamin D deficiency alters the expression of genes encoding mitochondrial, cytoskeletal and synaptic proteins in the adult rat brain. The Journal of Steroid Biochemistry and Molecular Biology 2007; 103: 538-45.
  31. Helde-Frankling M, Björkhem-Bergman L. Vitamin D in Pain Management. International Journal of Molecular Sciences 2017;18(10):2170.
  32. Ali M, Uddin Z, Hossain A. Combined Effect of Vitamin D Supplementation and Physiotherapy on Reducing Pain Among Adult Patients With Musculoskeletal Disorders: A Quasi-Experimental Clinical Trial. Frontiers in Nutrition 2021;8:717473.
  33. Hossein Abadi MR, Ghasemi GhA, Goharjo ME, Feizi M. Effects of Conventional Core Stability and Core Stability Suspension Exercises on Multifidus Muscle Endurance, Pain and Quality of Life in People with Nonspecific Chronic Low Back Pain. Jundishapur Journal of Microbiology 2019; 18(6):571-84.
  34. Heidari RS, Sahebozamani M, Karimi Afshar F. Comparison of the Effects of 8 Weeks of Core Stability Exercise on Ball and Sling Exercise on The Quality of Life and Pain in The Female With Non-Specific Chronic Low Back Pain (NSLBP). Journal of Advances in Medical and Biomedical Research 2018; 26 (117):44-56.
  35. Akodu AK, Tella BA, Olujobi OD. Effect of Stabilization Exercise on Pain and Quality of Life of Patients with Non-specific Chronic Low Back Pain. African Journal of Physiotherapy and Rehabilitation Sciences 2015;7 (1 & 2): 7 -11.
  36. Balci NÇ, Aytar A, Atici E, Ta şkin G, Gül şen M, Demirsoz M. The effect of aquatic and land exercises on pain, health related quality of life, kinesiophobia and disability in chronic low back pain: A randomized clinical trial. Journal of Novel Physiotherapy and Physical Rehabilitation 2021; 7(2): 062-67.
  37. Akodu AK, Akindutire OM. The effect of stabilization exercise on pain-related disability, sleep disturbance, and psychological status of patients with non-specific chronic low back pain. The Korean Journal of Pain 2018;31(3):199-205.
  38. Deslandes AC. Exercise and Mental Health: What did We Learn in the Last 20 Years?. Frontiers in Psychiatry 2014;5:66.
  39. von Berens A, Fielding RA, Gustafsson T, Kirn D, Laussen J, Nydahl M, et al. Effect of exercise and nutritional supplementation on health-related quality of life and mood in older adults: the VIVE2 randomized controlled trial. BMC Geriatrics 2018;18(1):286.