اثربخشی تمرینات یوگا، دارو درمانی و درمان ترکیبی بر کاهش علائم نقص توجه انتخابی و تکانشگری کودکان دارای اختلال نقص توجه/ بیش فعالی

نوع مقاله : مقاله پژوهشی

نویسندگان

1 دکتری تخصصی، بخش توانبخشی ماساژ و سلامت جسمانی دانشگاه دولتی ورزش، مسکو، روسیه.

2 دکتری تخصصی، سچینوا اولین دانشگاه پزشکی دولتی مسکو بخش داروسازی، مسکو، روسیه.

3 دکتری تخصصی، دانشکده روانشناسی، دانشگاه دوستی ملل مسکو، روسیه.

چکیده

هدف: هدف از پژوهش حاضر مقایسه اثربخشی تمرینات یوگا، دارودرمانی و درمان ترکیبی بر کاهش علائم نقص توجه انتخابی و تکانشگری کودکان دارای اختلال  نقص توجه/بیش فعالی بود.
 روش­ها: روش پژوهش نیمه تجربی با طرح پیش‌آزمون – پس‌آزمون بود. بدین منظور تعداد 60 کودک دارای اختلال نقص توجه/بیش فعالی به صورت هدفمند و با استفاده از مصاحبه توسط روان پزشک و مقیــاس رتبه بنــدی کانــرز - فــرم والدیــن (CPRS) شناسایی و به صورت تصادفی به چهار گروه کنترل، تمرینات یوگا، دارو درمانی و درمان ترکیبی تقسیم شدند. در مرحله پیش آزمون پرسشــنامه اختلال کمبود توجه-بیش فعالی سوانسون و نولان پلهام (1980) و تکانشگری کودکان پاتون و همکاران (1995) توسط والدین تکمیل شد. در مرحله مداخله، گروه تمرینات یوگا به مدت هشت هفته به تمرینات یوگا پرداختند، گروه دارودرمانی در این مدت داروی ریتالین دریافت کردند؛ و گروه ترکیبی هم تمرینات یوگا انجام دادند و هم ریتالین دریافت کردند. گروه کنترل در این مدت هیج مداخله درمانی دریافت نکرد. در نهایت، پرسشنامه های تحقسق مجدداً توزیع و جمع آوری شد.  برای تحلیل داده ها از آزمون‌های کولموگروف-اسمیرنوف و تحلیل کوواریانس در سطح معنی داری P<0.05 استفاده شد.
 نتایج:  نتایج آزمون تحلیل کواریانس نشان داد اگرچه تمرینات یوگا و دارو درمانی منجر به کاهش علائم نقص توجه انتخابی و تکانشگری در کودکان دارای نقص توجه/بیش فعالی شد (P<0.05)؛ اما اثربخشی درمان ترکیبی بیشتر بود (P<0.05).
نتیجه ­گیری: براساس نتایج این مطالعه می‌توان تمرینات یوگا را به عنوان مکمل دارو درمانی در بهبود علائم نقص توجه/بیش فعالی توصیه نمود.
 

کلیدواژه‌ها

عنوان مقاله [English]

Effectiveness of Yoga Exercises, Drug Therapy, and Combined Therapy in Reducing Symptoms of Selective Attention Deficit and Impulsivity among Children with Attention Deficit/Hyperactivity Disorder

نویسندگان [English]

  • Hasan Shafaei 1
  • Hossein Ahmadi Sarsahra 2
  • Niloofar Rezaei 3
1 . PhD, Department of Physical Rehabilitation, Massage and Health-Improving Physical Culture Named after I. M. Sarkizov-Serazini RSUFKSMiT, 105122 Moscow, Russia.
2 Ph.D, Sechenov First MSMU of the Ministry of Health of the Russian Federation (Sechenov University), A. P. Nelyubin Institute of Pharmacy, Moscow, Russia.
3 Ph.D, Peoples' Friendship University of Russia, Ulitsa Miklukho-Maklaya, 6, 117198 Moscow, Russia.
چکیده [English]

Purpose: The aim of this research is to compare the effectiveness of yoga exercises, drug therapy, and combined therapy in reducing symptoms of selective attention deficit and impulsivity in children with attention deficit/hyperactivity disorder (ADHD).
Methods: The research method was semi-experimental with a pre-test-post-test design. Sixty children with attention deficit/hyperactivity disorder were identified through interviews with a psychiatrist and the Conners Parent Rating Scale, and randomly assigned to four groups: control, yoga exercises, drug therapy, and combined therapy. During the pre-test, questionnaires on attention deficit-hyperactivity disorder and impulsivity were completed by parents. During the intervention phase, the yoga exercises group engaged in yoga exercises for eight weeks, the drug therapy group received Ritalin, and the combined therapy group did both yoga exercises and received Ritalin. The control group did not receive any intervention. Finally, questionnaires were redistributed and collected for analysis using analysis of covariance (ANCOVA) test (P<0.05).
Results: The results showed that while yoga exercises and drug therapy led to a reduction in symptoms of selective attention deficit and impulsivity in children with attention deficit/hyperactivity disorder, the effectiveness of combined therapy was greater (P<0.05).
Conclusions: Based on our results, yoga exercises can be recommended as a complementary therapy to drug therapy in improving symptoms of attention deficit/hyperactivity.

کلیدواژه‌ها [English]

  • Drug Therapy
  • Attention Deficit/Hyperactivity Disorder
  • Impulsivity
  • Yoga
  • Selective Attention

مراجع

  1. Barkley RA. Major life activity and health outcomes associated with attention-deficit/hyperactivity disorder. Journal of clinical psychiatry, 2002; 63, 10-15.
  2. Loe IM, Feldman HM. Academic and educational outcomes of children with ADHD. Journal of pediatric psychology, 2007; 32(6), 643-654. 1093/jpepsy/jsl054
  3. Hashemi M. Cognitive deficits in attention deficit hyperactivity disorder. Studies in psychology and educational sciences (Center for the Development of Modern Education in Iran), 2018; 24(4), 13-21.‎ In Persian
  4. Fried R, Chan J, Feinberg L, Pope A, Woodworth KY, Faraone SV, Biederman J. Clinical correlates of working memory deficits in youth with and without ADHD: a controlled study. Journal of clinical and experimental neuropsychology, 2016; 38(5), 487-496. http://dx.doi.org/10.1080/13803395.2015.1127896
  5. Yadi F, Kiamanesh A, Bahrami H. Comparison of the effectiveness of narrative therapy and play therapy training on the level of compatibility, attention and concentration of female students suffering from ODD. Revista Turismo Estudos e Práticas-RTEP/UERN, 2020; (1), 1-13.
  6. Piepmeier AT, Shih CH, Whedon M, Williams LM, Davis ME, Henning DA, Etnier JL. The effect of acute exercise on cognitive performance in children with and without ADHD. Journal of Sport and Health Science, 2015; 4(1), 97-104.

http://dx.doi.org/10.1016/j.jshs.2014.11.004

  1. Cohen SC, Harvey DJ, Shields RH, Shields GS, Rashedi RN, Tancredi DJ, Schweitzer JB. The effects of yoga on attention, impulsivity and hyperactivity in pre-school age children with ADHD symptoms. Journal of Developmental and Behavioral Pediatrics: JDBP, 2018; 39(3), 200-12.

http://dx.doi.org/10.1097/dbp.0000000000000552

  1. Langberg JM, Becker SP. Does long-term medication use improve the academic outcomes of youth with attention-deficit/hyperactivity disorder?. Clinical Child and Family Psychology Review, 2012; 15, 215-33. 1007/s10567-012-0117-8
  2. Raggi VL, Chronis AM. Interventions to address the academic impairment of children and adolescents with ADHD. Clinical child and family psychology review, 2006; 9, 85-111. http://dx.doi.org/10.1007/s10567-006-0006-0
  3. Steeger CM, Gondoli DM, Gibson BS, Morrissey RA. Combined cognitive and parent training interventions for adolescents with ADHD and their mothers: A randomized controlled trial. Child Neuropsychology, 2016; 22(4), 394-419.

http://dx.doi.org/10.1080/09297049.2014.994485

  1. Chacko A, Kofler M, Jarrett M. Improving outcomes for youth with ADHD: A conceptual framework for combined neurocognitive and skill-based treatment approaches. Clinical child and family psychology review, 2014; 17, 368-384.1007/s10567-014-0171-5
  2. Yavari Barhaghtalab E, Asgary P, Naderi F, Heidarie A. Effect of cognitive rehabilitation on executive function (response retention and scheduling) in children with attention deficit hyperactivity disorder. The Scientific Journal of Rehabilitation Medicine, 2021; 10, 146-57.
  3. O'connell RG, Bellgrove MA, Dockree PM, Robertson IH. Cognitive remediation in ADHD: Effects of periodic non-contingent alerts on sustained attention to response. Neuropsychological rehabilitation, 2006; 16(6), 653-665. 1080/09602010500200250
  4. Butzer B, Day D, Potts A, Ryan C, Coulombe S, Davies B, Khalsa SS. Effects of a classroom-based yoga intervention on cortisol and behavior in second-and third-grade students: a pilot study. Journal of evidence-based complementary & alternative medicine, 2015; 20(1), 41-49. 1177/2156587214557695
  5. Hagen I, Nayar US. Yoga for children and young people’s mental health and well-being: research review and reflections on the mental health potentials of yoga. Frontiers in psychiatry, 2014; 5, 35-42.

http://dx.doi.org/10.3389/fpsyt.2014.00035

  1. Berwid OG, Halperin JM. Emerging support for a role of exercise in attention-deficit/hyperactivity disorder intervention planning. Current psychiatry reports, 2012; 14, 543-551. 1007/s11920-012-0297-4
  2. Skriver K, Roig M, Lundbye-Jensen J, Pingel J, Helge JW, Kiens B, Nielsen JB. Acute exercise improves motor memory: exploring potential biomarkers. Neurobiology of learning and memory, 2014; 116, 46-58.

http://dx.doi.org/10.1016/j.nlm.2014.08.004

  1. Kim H, Heo HI, Kim DH, Ko IG, Lee SS, Kim SE, Kim CJ. Treadmill exercise and methylphenidate ameliorate symptoms of attention deficit/hyperactivity disorder through enhancing dopamine synthesis and brain-derived neurotrophic factor expression in spontaneous hypertensive rats. Neuroscience letters, 2011; 504(1), 35-39. http://dx.doi.org/10.1016/j.neulet.2011.08.052
  2. Kjaer TW, Bertelsen C, Piccini P, Brooks D, Alving J, Lou HC. Increased dopamine tone during meditation-induced change of consciousness. Cognitive Brain Research, 2002; 13(2), 255-259. http://dx.doi.org/10.1016/s0926-6410(01)00106-9
  3. Yaghoobi H, Jazayeri A, Khoshabi K, Dolatshahi B, Niknam Z. Determining the effectiveness of neurofeedback on the cognitive performance of children with attention deficit/hyperactivity disorder. Daneshvar Behavat Scientific-Research Monthly, Shahed University, 2007; 15 (21), 71-84. In Persian
  4. Stephens I. Medical yoga therapy. Children, 2017; 4(2), 12.
  5. Naveen GH, Thirthalli J, Rao MG, Varambally S, Christopher R, Gangadhar BN. Positive therapeutic and neurotropic effects of yoga in depression: A comparative study. Indian journal of psychiatry, 55(Suppl 3), S400. 2013.

http://dx.doi.org/10.4103/0019-5545.116313

  1. Streeter CC, Gerbarg PL, Saper RB, Ciraulo DA, Brown RP. Effects of yoga on the autonomic nervous system, gamma-aminobutyric-acid, and allostasis in epilepsy, depression, and post-traumatic stress disorder. Medical hypotheses, 2012; 78(5), 571-579. http://dx.doi.org/10.1016/j.mehy.2012.01.021
  2. Payne P, Crane-Godreau MA. Meditative movement for depression and anxiety. Frontiers in psychiatry, 2013; 4, 71-80. http://dx.doi.org/10.3389/fpsyt.2013.00071
  3. Telles S, Sharma SK, Balkrishna A. Blood pressure and heart rate variability during yoga-based alternate nostril breathing practice and breath awareness. Medical science monitor basic research, 2014; 20, 184.

http://dx.doi.org/10.12659/msmbr.892063

  1. Torner L, Toschi N, Nava G, Clapp C, Neumann ID. Increased hypothalamic expression of prolactin in lactation: involvement in behavioural and neuroendocrine stress responses. European Journal of Neuroscience, 2002; 15(8), 1381-1389. 1046/j.1460-9568.2002.01965.x
  2. Chan E, Rappaport LA, Kemper KJ. Complementary and alternative therapies in childhood attention and hyperactivity problems. Journal of Developmental & Behavioral Pediatrics, 2003; 24, 4-8. 1097/00004703-200302000-00003
  3. Hurt E, Arnold LE, Lofthouse N. Quantitative EEG neurofeedback for the treatment of pediatric attention-deficit/hyperactivity disorder, autism spectrum disorders, learning disorders, and epilepsy. Child and Adolescent Psychiatric Clinics, 2014; 23(3), 465-486. http://dx.doi.org/10.1016/j.chc.2014.02.001
  4. Jensen PS, Kenny DT. The effects of yoga on the attention and behavior of boys with attention-deficit/hyperactivity disorder (ADHD). Journal of attention disorders, 2004; 7(4), 205-216. http://dx.doi.org/10.1177/108705470400700403
  5. Wang SM, Han C, Lee SJ, Jun TY, Patkar AA, Masand PS, Pae CU. Modafinil for the treatment of attention-deficit/hyperactivity disorder: a meta-analysis. Journal of psychiatric research, 2017; 84, 292-300. http://dx.doi.org/10.1016/j.jpsychires.2016.09.034
  6. Meppelink R, de Bruin EI, Bögels SM. Meditation or Medication? Mindfulness training versus medication in the treatment of childhood ADHD: a randomized controlled trial. BMC psychiatry, 2016; 1-16. http://dx.doi.org/10.1186/s12888-016-0978-3
  7. Thomas EM, Freeman TP, Poplutz P, Howden K, Hindocha C, Bloomfield M, Kamboj SK. Stimulating meditation: a pre-registered randomised controlled experiment combining a single dose of the cognitive enhancer, modafinil, with brief mindfulness training. Journal of Psychopharmacology, 2021; 35(6), 621-630. http://dx.doi.org/10.1177/0269881121991835
  8. Mehren A, Özyurt J, Lam AP, Brandes M, Müller HH, Thiel CM, Philipsen A. Acute effects of aerobic exercise on executive function and attention in adult patients with ADHD. Frontiers in psychiatry, 2019; 10, 132-39.

http://dx.doi.org/10.3389/fpsyt.2019.00132

  1. Montalva-Valenzuela F, Andrades-Ramírez O, Castillo-Paredes A. Effects of physical activity, exercise and sport on executive function in young people with attention deficit hyperactivity disorder: a systematic review. European journal of investigation in health, psychology and education, 2022; 12(1): 20-25. http://dx.doi.org/10.3390/ejihpe12010006
  2. Welsch L, Alliott O, Kelly P, Fawkner S, Booth J, Niven A. The effect of physical activity interventions on executive functions in children with ADHD: A systematic review and meta-analysis. Mental Health and Physical Activity, 2021; 20, 100379. http://dx.doi.org/10.1016/j.mhpa.2020.100379
  3. Harrison LJ, Manocha R, Rubia K. Sahaja yoga meditation as a family treatment programme for children with attention deficit-hyperactivity disorder. Clinical Child Psychology and Psychiatry, 2004; 9(4), 479-497.

http://dx.doi.org/10.1177/1359104504046155

  1. Sheela SJ, Manik KA, Sudhir PK. Role of yoga in attention, concentration, and memory of medical students. National Journal of Physiology, Pharmacy and pharmacology, 2018; 8(11), 1526-1526.

http://dx.doi.org/10.5455/njppp.2018.8.0723521082018

  1. Saxena K, Verrico CD, Saxena J, Kurian S, Alexander S, Kahlon RS, Gillan L. An evaluation of yoga and meditation to improve attention, hyperactivity, and stress in high-school students. The Journal of Alternative and Complementary Medicine, 2020; 26(8), 701-707. http://dx.doi.org/10.1089/acm.2020.0126
  2. Steiner NJ, Sidhu TK, Pop PG, Frenette EC, Perrin EC. Yoga in an urban school for children with emotional and behavioral disorders: A feasibility study. Journal of Child and Family Studies, 2013; 22, 815-826. http://dx.doi.org/10.1007/s10826-012-9636-7
  3. Madani S, Alizadeh H. Executive functions and effective strategies to improve them in students with attention deficit hyperactivity disorder. Exceptional Education Journal, 2018; 4(153), 55-63. http://dx.doi.org/10.7759/cureus.36143
  4. Gonzalez NA, Sakhamuri N, Athiyaman S, Randhi B, Gutlapalli SD, Pu J, Franchini A. A Systematic Review of Yoga and Meditation for Attention-Deficit/Hyperactivity Disorder in Children. Cureus, 2022; 15(3): 1-10. http://dx.doi.org/10.1037/t81067-000
  5. Conners CK, Sitarenios G, Parker JD, Epstein JN. The revised Conners' Parent Rating Scale (CPRS-R): factor structure, reliability, and criterion validity. Journal of abnormal child psychology, 1998; 26, 257-268.
  6. Torkman M, Kakabaraei K, Al-Sadat H. Effectiveness of drug therapy on executive functions, behavioral problems and clinical symptoms of attention deficit/hyperactivity disorder. Journal of the Faculty of Medicine of Mashhad University of Medical Sciences, 2021; 64(1); 1-12. In Persian
  7. Rashidipour Sh, Rahavi R, Namazizadeh M. The effect of yoga and neurofeedback on reducing attention disorder and hyperactive concentration in children aged 5-10. Sports Psychology Studies, 2017; 6(20), 37-48. In Persian
  8. Volkow ND, Ding YS, Fowler JS, Wang GJ, Logan J, Gatley JS, Wolf AP. Is methylphenidate like cocaine?: Studies on their pharmacokinetics and distribution in the human brain. Archives of general psychiatry, 1995; 52(6), 456-463.

http://dx.doi.org/10.1001/archpsyc.1995.03950180042006

Hashemi A, Khanmohamadi R, Sheikh M. The effect of yoga on cognitive function of Middle-aged women with mild cognitive impairment. Sports Psychology, 2021; 12(2): 1-16. In Persian. 10.48308/mbsp.5.2.1

روانشناسی ورزش
دوره 15، شماره 1
1402
صفحه 226-237

فایل ها

هم رسانی

ارجاع به این مقاله

آمار