تاثیر هشت هفته تمرینات ریباند بر تعادل، قدرت و استقامت عضلانی کودکان سندروم داون (مقاله علمی وزارت علوم)
درجه علمی: نشریه علمی (وزارت علوم)
آرشیو
چکیده
زمینه و هدف: کودکان دارای سندروم داون در عوامل آمادگی جسمانی، مانند تعادل، قدرت و استقامت عضلانی؛ توانایی کمتری نسبت به افراد سالم دارند. هدف از انجام این مطالعه، بررسی تاثیر هشت هفته تمرینات ریباند بر تعادل، قدرت و استقامت عضلانی کودکان سندروم داون بود. روش تحقیق: تعداد 30 کودک سندروم داون در دامنه سنی 12-7 سال و ضریب هوشی بین ۵۰ تا ۷۰، به روش نمونه گیری در دسترس انتخاب و به طور تصادفی به دو گروه 15 نفره شامل گروه تجربی و گروه کنترل تقسیم شدند. گروه تجربی تمرینات ریباند را به مدت هشت هفته و سه جلسه در هفته، هر جلسه به مدت 45 دقیقه به اجرا درآوردند. به منظور ارزیابی تعادل ایستا و پویا، از آزمون بروئینینکس- اوزرتسکی، ارزیابی قدرت فلکشن چهارسر از روش سنجش دستی عملکرد عضلانی، و ارزیابی استقامت عضلانی از آزمون اسکوات؛ قبل و بعد از انجام تمرینات استفاده شد. به منظور تحلیل داده ها، از آزمون های تحلیل واریانس دوراهه با اندازه گیری مکرر، در سطح معنی داری 05/0≥p استفاده شد. یافته ها: انجام هشت هفته تمرینات ریباند، موجب بهبود معنی داری در شاخص های تعادل ایستا (001/0>p) و پویا (001/0>p)، قدرت (001/0>p) و استقامت عضلانی (001/0>p) اندام تحتانی گردید. نتیجه گیری: با توجه به نتایج مطالعه حاضر، انجام تمرینات ریباند می تواند تعادل، قدرت و استقامت عضلانی را بهبود بخشیده و نهایتا موجب کاهش خطرات ناشی از سقوط در کودکان سندروم داون شود. لذا انجام این تمرینات به درمانگران توصیه می شود.The effect of 8-week of rebound exercises on balance, strength and muscle endurance of children with Down syndrome
Background and Aim: Children with Down syndrome (DS) demonstrate significant impairments in physical fitness components such as balance, muscle strength, and endurance compared to their healthy peers (4, 10). These deficits are largely attributed to factors such as hypotonia, joint laxity, and neurological impairments including delayed myelination and reduced neural density (3, 6). These limitations not only impact their ability to perform daily activities but also increase the risk of falls and related injuries (5). Although there is substantial evidence supporting the benefits of exercise interventions for individuals with intellectual disabilities, there is a paucity of research on the effects of rebound exercises-activities performed on mini-trampolines-on children with DS. Rebound exercises are posited to improve postural control, coordination, and muscle function due to their dynamic and engaging characteristics (12, 13). Therefore, the present study aimed to investigate the effects of an 8-week rebound exercise program on balance, muscle strength, and endurance in children with DS.Materials and Methods:This semi-experimental, applied study recruited 30 boys with DS, aged 7–12 years, with IQ scores between 50 and 70, from rehabilitation centers in Yazd, Iran. Participants were selected through convenience sampling and randomly assigned to either an experimental or control group (n=15 each). Inclusion criteria included the ability to walk independently, absence of cardiovascular or orthopedic disorders, no prior regular physical activity, and parental consent. Exclusion criteria were missing more than three sessions, withdrawal of consent, or discovery of hidden medical conditions. The study received ethical approval from the Ethics Committee of Yazd University (IR.YAZD.REC.1403.032).Pre- and post-intervention assessments included static and dynamic balance (Bruininks-Oseretsky test of motor proficiency, 2005) (15), knee flexor and extensor muscle strength (manual muscle testing per Daniels et al., 2007) (16), and lower limb muscular endurance (one-minute squat test). All tests were administered by trained assessors. The experimental group participated in an 8-week rebound exercise protocol, conducted three sessions per week, each session lasting 45 minutes. Each sessions included a warm-up, progressive trampoline-based exercises (e.g., jumping, hopping, high knees), and cool-down, followed guidelines from the American College of Sports Medicine and the Brockport Physical Fitness Test for individuals with disabilities (17). The control group maintained their usual daily activities without additional exercise. After the intervention, all measures were repeated.Data were analyzed using two-way repeated measures ANOVA to assess within- and between-group differences, with significance set at p≤0.05. G-Power software (version 3.1.9.7) was used to determine the minimum sample size (power=0.8, α=0.05, effect size=0.4), confirming that 24 participants were sufficient, though 30 were included for robustness (5).Findings: At baseline, there were no significant differences between the experimental and control groups in terms of age, or outcome measures. Following the 8-week intervention, the experimental group demonstrated statistically significant improvements in all primary outcomes compared to control group (Table 1). The results indicated a significant increase in static and dynamic balance, as well as lower limb strength and endurance in the exercise group. In other words, rebound exercises had a positive impact on these variables in children with DS. Static Balance: Participants in the experimental group showed a significant improvement in static balance scores compared to controls (p<0.001). Dynamic Balance: A two-way repeated measures ANOVA revealed that the intervention significantly improved dynamic balance, with greater improvements observed over time (F(1,28)=217.456, p<0.001) (Table 1).Hamstring Strength: A similar pattern was observed for hamstring muscle strength. The two-way repeated measures ANOVA showed a statistically significant increase from pre- to post-intervention in the experimental group (F(1,28)=27.325, p<0.001).Quadriceps Strength: For quadriceps strength, the analysis showed a statistically significant difference between pre- and post-test scores in the experimental group (F(1,28)=21.509, p<0.001). A significant between-group difference was also observed (F(1,28)=7.00, p=0.01). Conclusion: The findings demonstrate that an 8-week rebound exercise program significantly enhances static and dynamic balance, lower limb muscle strength (hamstrings and quadriceps), and muscular endurance in children with DS. These improvements may reduce the risk of falls and contribute to greater independence and quality of life. Given the accessibility, safety, and enjoyment associated with trampoline-based activities, therapists and educators are encouraged to incorporate rebound exercises into physical activity programs for children with DS. Future studies might also investigate the benefits of combining rebound training with other therapeutic modalities to maximize outcomes across cognitive and psychosocial domains.Ethical Considerations: This study was approved by the Ethics Committee of Yazd University (IR.YAZD.REC.1403.032). Informed consent was obtained from all parents or legal guardians.Compliance with Ethical Guideline: All procedures were conducted in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments.Funding: No external funding was received for this study.Conflicts of Interest: The authors declare no conflicts of interest.
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