تأثیر تمرینات شناختی و تای چی بر کارکردهای شناختی و کیفیت زندگی بیماران مبتلا به سکته مغزی

نوع مقاله : مقاله پژوهشی

نویسندگان

1 گروه آموزش تربیت بدنی، دانشگاه فرهنگیان، صندوق پستی 889-14665 تهران، ایران

2 روانشناسی عمومی، گروه علوم انسانی، دانشکده علوم انسانی، دانشگاه آزاد اسلامی، واحد شهرکرد، شهرکرد، ایران.

3 استادیار، گروه تربیت بدنی گرایش رفتار حرکتی، واحد مرند، دانشگاه آزاد اسلامی، مرند، ایران.

4 گروه تربیت بدنی، واحد ماکو، دانشگاه آزاد اسلامی، ماکو، ایران.

5 گروه تربیت بدنی، واحد تبریز، دانشگاه آزاد اسلامی، تبریز، ایران.

چکیده

هدف: هدف این پژوهش بررسی و مقایسه تأثیر تمرینات شناختی و تای چی بر عملکرد شناختی و کیفیت زندگی بیماران مبتلا به سکته مغزی بود.
روش‌ها: این مطالعه از یک روش شبه تجربی استفاده کرد که شامل طراحی پیش‌آزمون و پس‌آزمون با گروه کنترل می‌باشد. نمونه آماری شامل 45 بیمار مرد مبتلا به سکته بود که به‌طور تصادفی به سه گروه تمرین شناختی، تمرین تای چی و گروه کنترل تقسیم شدند. عملکرد شناختی و کیفیت زندگی به ترتیب با استفاده از آزمون ارزیابی شناختی مونترال و مقیاس کیفیت زندگی بیماران سکته مغزی اندازه‌گیری گردید. یک برنامه توانبخشی شناختی مبتنی بر رایانه و یک فرم تعدیل شده از تمرینات تای چی به‌طور هفتگی به مدت 2 ماه اجرا شد. برای تحلیل داده‌ها از آزمون تحلیل واریانس با اندازه‌گیری‌های مکرر استفاده شد.
یافته‌ها: نتایج نشان داد که نمرات عملکرد شناختی در گروه‌های تمرین شناختی و تای چی نسبت به گروه کنترل در پس‌آزمون بهبود یافته است (134/5=F، 010/0=P)؛ در حالی که تفاوت معناداری بین دو گروه تمرین شناختی و تای چی مشاهده نشد. همچنین، نتایج به‌دست‌آمده نشان‌دهنده بهبود نمرات کیفیت زندگی در گروه‌های تمرین شناختی و تای چی نسبت به گروه کنترل در پس‌آزمون بود (013/4=F، 025/0=P)؛ در حالی که تفاوت معناداری بین دو گروه تمرین شناختی و تای چی مشاهده نشد.
نتیجه گیری: تمرینات شناختی و تای‌چی ممکن است تأثیرات مثبتی بر روی توانایی‌های شناختی وکیفیت زندگی بیماران مبتلا به سکته مغزی داشته باشند و می­توانند به­عنوان یک فعالیت مؤثر برای بهبود عملکرد شناختی و کیفیت زندگی در بیماران مبتلا به سکته شناخته شوند.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

Effect of Cognitive Training and Tai Chi on Cognitive Functions and Quality of Life in Patients with Stroke

نویسندگان [English]

  • Farzaneh Davari 1
  • Hossein Barati Sedeh 2
  • Abdollah Hemayattablab 3
  • Azam Heydarzadeh 4
  • Mir Hamid Salehian 5
1 Assistant Professor, Department of Physical Education, Farhangian University, P.O. Box 14665-889, Tehran, Iran.
2 Ms in, General Psychology, Department of Humanities, Faculty of Humanities, Islamic Azad University, Shahrekord Branch, Shahrekord, Iran.
3 Department of Physical Education, Marand branch, Islamic Azad University, Marand, Iran.
4 Department of Physical Education, Maku Branch, Islamic Azad University, Maku, Iran.
5 Department of Physical Education, Tabriz Branch, Islamic Azad University, Tabriz, Iran
چکیده [English]

Objective: The purpose of this research was to investigate and compare the effects of cognitive training and Tai Chi on the cognitive performance and quality of life of patients with stroke.
Methods: This study employed a semi-experimental design that included pre-test and post-test assessments with a control group. The sample consisted of 45 male patients with stroke who were randomly assigned to three groups: cognitive training, Tai Chi, and a control group. Cognitive performance and quality of life were measured using the Montreal Cognitive Assessment and the Stroke Specific Quality of Life Scale, respectively. A computer-based cognitive rehabilitation program and a modified form of Tai Chi exercises were implemented weekly over a period of two months. Data analysis was conducted using repeated measures ANOVA.
Results: The results indicated that cognitive performance scores improved in the cognitive exercise and Tai Chi groups compared to the control group in the post-test (F=5.134, P=0.010); however, no significant difference was found between the cognitive exercise and Tai Chi groups. Additionally, the findings demonstrated an improvement in quality-of-life scores in the cognitive exercise and Tai Chi groups compared to the control group in the post-test (F=4.013, P=0.025), with no significant difference observed between the two exercise groups.
Conclusion: Cognitive training and Tai Chi may have positive effects on the cognitive abilities and quality of life of patients with stroke, and they can be recognized as effective strategies for enhancing cognitive performance and overall well-being in individuals with stroke.

کلیدواژه‌ها [English]

  • Stroke
  • Cognitive Training
  • Tai Chi
  • Cognitive Function
  • Quality of Life

مراجع

  1. Murphy, S. J., Werring, D. J. Stroke: causes and clinical features. Medicine, 2020, 48(9), 561–566.
  2. Hilkens, N. A., Casolla, B., Leung, T. W., & de Leeuw, F. E. Stroke. Lancet, 2024, 403(10446), 2820–2836. https://doi.org/10.1016/S0140-6736(24)00263-4
  3. Tadi, P., & Lui, F. Acute Stroke. In StatPearls. StatPearls Publishing. 2023.
  4. Campbell BV, Khatri, P. Stroke. Lancet, 2020, 396(10244), 129–142.

https://doi.org/10.1016/S0140-6736(20)31179-X

  1. Kuriakose, D., & Xiao, Z. Pathophysiology and Treatment of Stroke: Present Status and Future Perspectives. International Journal of Molecular Sciences, 2020, 21(20), 7609.
  2. Khaku, A. S., & Tadi, P. Cerebrovascular Disease. In StatPearls. StatPearls Publishing. 2023.
  3. Campbell, BV, De Silva, DA, Macleod MR, Coutts SB, Schwamm LH., Davis SM, Donnan, GA. Ischaemic stroke. Nature reviews. Disease Primers, 2019, 5(1), 70. https://doi.org/10.1038/s41572-019-0118-8
  4. Saini, V., Guada, L., & Yavagal, D. R. Global Epidemiology of Stroke and Access to Acute Ischemic Stroke Interventions. Neurology, 2021, 97(20), 6–16.
  5. Hui, C., Tadi, P., Khan Suheb, M. Z., & Patti, L. Ischemic Stroke. In StatPearls. StatPearls Publishing. 2024.
  6. Boehme AK, Esenwa C, Elkind MS. Stroke Risk Factors, Genetics, and Prevention. Circulation Research, 2017, 120(3), 472–495. https://doi.org/10.1161/circresaha.116.308398
  7. Gallucci, L., Sperber, C., Guggisberg, A. G., Kaller, C. P., Heldner, M. R., Monsch, A. U., Hakim, A., Silimon, N., Fischer, U., Arnold, M., & Umarova, R. M. Post-stroke cognitive impairment remains highly prevalent and disabling despite state-of-the-art stroke treatment. International Journal of Stroke, 2024, 19(8), 888–897.
  8. Haring H. P. Cognitive impairment after stroke. Current Opinion in Neurology, 2002, 15(1), 79–84.
  9. Cramer SC, Richards LG, Bernhardt J, Duncan P. Cognitive Deficits After Stroke. Stroke, 2023, 54(1), 5–9.
  10. D'Souza, C. E., Greenway, M. R. F., Graff-Radford, J., & Meschia, J. F. Cognitive Impairment in Patients with Stroke. Seminars in Neurology, 2021, 41(1), 75–84.
  11. El Husseini, N., Katzan, I. L., Rost, N. S., Blake, M. L., Byun, E., Pendlebury, S. T., Aparicio, H. J., Marquine, M. J., Gottesman, R. F., Smith, E. E. Cognitive Impairment After Ischemic and Hemorrhagic Stroke: A Scientific Statement from the American Heart Association/American Stroke Association. Stroke, 2023, 54(6), e272–e291.
  12. Renjen, P. N., Gauba, C., & Chaudhari, D. Cognitive Impairment After Stroke. Cureus, 2015, 7(9), e335.
  13. Lo, J. W., Crawford, J. D., Desmond, D. W., Bae, H. J., Lim, J. S., Godefroy, O., Roussel, M., Kang, Y., Jahng, S., Köhler, S., Staals, J., Verhey, F., Chen, C., Xu, X., Chong, E. J., Kandiah, N., Yatawara, C., Bordet, R., Dondaine, T., Mendyk, A. M. Stroke and Cognition (STROKOG) Collaboration Long-Term Cognitive Decline After Stroke: An Individual Participant Data Meta-Analysis. Stroke, 2022, 53(4), 1318–1327.
  14. Bártlová S, Šedová L, Havierniková L, Hudáčková A, Dolák, F., Sadílek, P. Quality of Life of Post-stroke Patients. Zdravstveno Varstvo, 2022, 61(2), 101–108. https://doi.org/10.2478/sjph-2022-0014
  15. Chen Q, Cao C, Gong L, Zhang Y. Health related quality of life in stroke patients and risk factors associated with patients for return to work. Medicine, 2019, 98(16), e15130. https://doi.org/10.1097/md.0000000000015130
  16. Wan, M., Zhang, Y., Wu, Y., Ma, X. Cognitive behavioural therapy for depression, quality of life, and cognitive function in the post-stroke period: systematic review and meta-analysis. Psychogeriatrics, 2024, 24(4), 983–992.
  17. Shao, X., Xi, Y., Pan, L., Li, X., Lin, Q., Tian, K., Wang, R., Gao, Y., Gao, H., Tan, Z., & Zhu, X. The effectiveness of Tai Chi for patients with mild cognitive impairment: a systematic review and meta-analysis. Frontiers in Neuroscience, 2024, 18, 1467595.
  18. Song, R., Park, M., Jang, T., Oh, J., & Sohn, M. K. Effects of a Tai Chi-Based Stroke Rehabilitation Program on Symptom Clusters, Physical and Cognitive Functions, and Quality of Life: A Randomized Feasibility Study. International Journal of Environmental Research & Public Health, 2021, 18(10), 5453.
  19. Su, J. J., Lin, R. S. Y., Batalik, L., Abu-Odah, H., Pepera, G., Xu, Q., & Yeung, W. F. Effects of mind-body exercise on physical and psychosocial well-being of stroke patients: A systematic review and network meta-analysis. Geriatric Nursing, 2024, 55, 346–353.
  20. Lyu, D., Lyu, X., Zhang, Y., Ren, Y., Yang, F., Zhou, L., Zou, Y., & Li, Z. (). Tai Chi for Stroke Rehabilitation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Frontiers in Physiology, 2018, 9, 983.
  21. Wu, S., Chen, J., Wang, S., Jiang, M., Wang, X., & Wen, Y. Effect of Tai Chi Exercise on Balance Function of Stroke Patients: A Meta-Analysis. Medical Science Monitor Basic Research, 2018, 24, 210–215.
  22. Yeh, T. T., Wu, C. Y., Hsieh, Y. W., Chang, K. C., Lee, L. C., Hung, J. W., Lin, K. C., Teng, C. H., & Liao, Y. H. Synergistic effects of aerobic exercise and cognitive training on cognition, physiological markers, daily function, and quality of life in stroke survivors with cognitive decline: study protocol for a randomized controlled trial. Trials, 2017, 18(1), 405.
  23. Zhang, H. W., Zheng, R., Xu, C., Lin, Z. X., Qin, Y., Cai, J., & Yuan, Q. Tai Chi for improving recovery after stroke. The Cochrane Database of Systematic Reviews, 2018(3), CD010207.
  24. Zhang, Y., Wang, S., Chen, P., Zhu, X., & Li, Z. Tai Chi for stroke rehabilitation: protocol for a systematic review.  BMJ Open, 2016,6(6), e010866.
  25. Zhong, X., Yan, X., Liang, H., Xia, R., Chen, B., & Zhao, H. J. Evaluation of eight-style Tai chi on cognitive function in patients with cognitive impairment of cerebral small vessel disease: study protocol for a randomised controlled trial. BMJ Open, 2021, 11(2), e042177. https://doi.org/10.1136/bmjopen-2020-042177
  26. Nasreddine, Z. S., Phillips, N. A., Bédirian, V., Charbonneau, S., Whitehead, V., Collin, I., Cummings, J. L., & Chertkow, H. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. Journal of the American Geriatrics Society, 2005, 53(4), 695–699. https://doi.org/10.1111/j.1532-5415.2005.53221.x
  27. Kariyawasam, P. N., Pathirana, K. D., & Hewage, D. C. (). Factors associated with health-related quality of life of patients with stroke in Sri Lankan context. Health & Quality of Life Outcomes, 2020, 18(1), 129.

https://doi.org/10.1186/s12955-020-01389-3

  1. Emsaki, G., Molavi, H., Chitsaz, A., Movahed Abtahi, M. & Asgari, K. Psychometric Properties of the Montreal Cognitive Assessment (MoCA) in Parkinson's Disease Patients in Isfahan. Journal of Isfahan Medical School, 2011, 29(158), 1606-1615.
  2. Sakr, F., Dabbous, M., Akel, M., Salameh, P., & Hosseini, H. Construction and Validation of the 17-Item Stroke-Specific Quality of Life Scale (SS-QOL-17): A Comprehensive Short Scale to Assess the Functional, Psychosocial, and Therapeutic Factors of QOL among Stroke Survivors. International Journal of Environmental Research & Public Health, 2022, 19(23), 15668.
  3. Cerniauskaite M, Quintas R, Koutsogeorgou E, Meucci P, Sattin D, Leonardi M, Raggi A. Quality-of-life and disability in patients with stroke. American Journal of Physical Medicine & Rehabilitation, 2012, 91(13 Suppl 1), S39–S47. https://doi.org/10.1097/phm.0b013e31823d4df7
  4. De Luca R, Leonardi S, Spadaro L, Russo M, Aragona B, Torrisi M, Maggio MG, Bramanti A, Naro A, De Cola MC, Calabrò RS. Improving Cognitive Function in Patients with Stroke: Can Computerized Training Be the Future? Journal of Stroke & Cerebrovascular Diseases, 2018, 27(4), 1055–1060.
  5. Ding, M. Y., Xu, Y., Wang, Y. Z., Li, P. X., Mao, Y. T., Yu, J. T., Cui, M., & Dong, Q. Predictors of Cognitive Impairment After Stroke: A Prospective Stroke Cohort Study. Journal of Alzheimer’s Disease, 2019, 71(4), 1139–1151.
  6. Gao, R., Greiner, C., Ryuno, H., & Zhang, X. Effects of Tai Chi on physical performance, sleep, and quality of life in older adults with mild to moderate cognitive impairment. BMC Complementary Medicine & Therapies, 2024, 24(1), 423.
  7. Xuefang, L., Guihua, W., & Fengru, M. The effect of early cognitive training and rehabilitation for patients with cognitive dysfunction in stroke. International Journal of Methods in Psychiatric Research, 2021, 30(3), e1882.
  8. Han, K., Liu, G., Liu, N., Li, J., Li, J., Cui, L., Cheng, M., Long, J., Liao, X., Tang, Z., Liu, Y., Liu, J., Chen, J., Lu, H., & Zhang, H. Effects of Mobile Intelligent Cognitive Training for Patients with Post-Stroke Cognitive Impairment: A 12-Week, Multicenter, Randomized Controlled Study. Journal of Alzheimer’s Disease, 2024, 100(3), 999–1015.
  9. Ho, H. Y., Chen, M. D., Tsai, C. C., & Chen, H. M. Effects of computerized cognitive training on cognitive function, activity, and participation in individuals with stroke: A randomized controlled trial. NeuroRehabilitation, 2022, 51(1), 79–89.

https://doi.org/10.3233/NRE-220017

  1. Jiang, H., Li, H., Wang, Z., Xia, X., Su, Q., & Ma, J. Effect of Early Cognitive Training Combined with Aerobic Exercise on Quality of Life and Cognitive Function Recovery of Patients with Poststroke Cognitive Impairment. Journal of Healthcare Engineering, 2022, 9891192. https://doi.org/10.1155/2022/9891192
  2. Hu, C., Qin, X., Jiang, M., Tan, M., Liu, S., Lu, Y., Lin, C., & Ye, R. Effects of Tai Chi Exercise on Balance Function in Stroke Patients: An Overview of Systematic Review. Neural plasticity, 2022, 3895514. https://doi.org/10.1155/2022/3895514
  3. Kim, H., Kim, Y. L., & Lee, S. M. Effects of therapeutic Tai Chi on balance, gait, and quality of life in chronic stroke patients. International Journal of Rehabilitation Research, 2015, 38(2), 156–161. https://doi.org/10.1097/MRR.0000000000000103
  4. Li, Y., Zhang, Y., Cui, C., Liu, Y., Lei, M., Liu, T., Meng, L., & Jin, C. The effect of Tai Chi exercise on motor function and sleep quality in patients with stroke: A meta-analysis. International Journal of Nursing Sciences, 2017, 4(3), 314–321. https://doi.org/10.1016/j.ijnss.2017.07.002
  5. Milosevich, E. T., Moore, M. J., Pendlebury, S. T., & Demeyere, N. Domain-specific cognitive impairment 6 months after stroke: The value of early cognitive screening. International Journal of Stroke, 2024, 19(3), 331–341. https://doi.org/10.1177/17474930231224427
  6. Park, M., Song, R., Ju, K., Seo, J., Fan, X., Ryu, A., Li, Y., & Jang, T. Effects of Tai Chi and Qigong on the mobility of stroke survivors: A systematic review and meta-analysis of randomized trials. PloS One, 2022, 17(11), e0277541. https://doi.org/10.1371/journal.pone.0277541
  7. Park, M., Song, R., Ju, K., Shin, J. C., Seo, J., Fan, X., Gao, X., Ryu, A., & Li, Y. Effects of Tai Chi and Qigong on cognitive and physical functions in older adults: systematic review, meta-analysis, and meta-regression of randomized clinical trials. BMC Geriatrics, 2023, 23(1), 352.

https://doi.org/10.1186/s12877-023-04017-5

روانشناسی ورزش
دوره 17، شماره 2
بهمن 1404
صفحه 263-280

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سابقه مقاله

  • تاریخ دریافت: 24 آبان 1403
  • تاریخ بازنگری: 03 خرداد 1404
  • تاریخ پذیرش: 01 تیر 1404

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