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1- University of Social Welfare and Rehabilitation Sciences, Tehran
2- Faculty of Rehabilitation, Isfahan University of Medical Sciences
3- University of Social Welfare and Rehabilitation Sciences,Tehran , sahossini@gmail.com
4- Faculty of Rehabilitation,Isfahan University of Medical Sciences
5- Faculty of Rehabilitation,Arak University of Medical Sciences
Abstract:   (178 Views)

Objective: Multiple sclerosis (MS) is a chronic inflammatory, demyelinating and neurodegenerative disorder of the central nervous system (CNS) and it is the most common cause of non-traumatic neurological disability in young adults. M.S among women, especially young women, is about 1.5 to three times more common in women than in men around the world. About 2.5 million people worldwide living with M.S. The destruction of myelin in certain areas exhibits certain signs and symptoms. Balance disorders are particularly problematic because they are associated with difficulty in moving from one position to another, sustaining an upright posture, and performing functional activities such as walking and turning, all of which predisposes people with MS to loss of equilibrium and falls. The high prevalence of MS puts Isfahan amongst the regions with the highest prevalence of MS in Asia and Oceania. the aim of this study was to use the holistic approaches of occupational therapy and investigate the physical and cognitive factors that affect the gait of patients who suffer from M.S. in the city of Isfahan (Attention, Cognition and Muscle strength of lower extremities).

Material&Method: The present study was a descriptive-correlational one and at-hand sampling method was used. The study population consisted of all patients with MS in Isfahan city in August 2017. A group of 70 patients (24 males and 46 females with mean age of 32.20 ± 7.55) met the inclusion-exclusion criteria and were enrolled in the study. To be eligible for the study, the patients had to meet the following inclusion criteria: participants had to have a neurologist-confirmed diagnosis of MS with MRI scan, the ability to read and write, and the ability to walk at least 100 meters independently. We excluded patients with cognitive impairments that might hinder understanding of the tasks to be accomplished, the presence of any comorbid neurologic condition other than M.S, and the patient's unwillingness to collaborate with the research process. After providing sufficient information about the research process and getting informed consent of patients, the questionnaire and tests provided to participants and completed. In this study we used some tools such as: Mini Mental Status Examination (MMSE), 10 Meter Walking Test (10 MWT), Timed Up and Go test(TUG), and Sit to Stand test and Stroop test. For data analysis, SPSS software version 16 and Pearson correlation coefficient and multiple regression analysis were used.

Results: In this study, 70 patients suffering from MS were participated. The results showed a significant negative correlation between the scores of walking speed test (10 m walking) and the scores of the functional strength of the lower extremities muscles (P <0.001) and attention (P = 0.01). It was also shown that there is a significant correlation between muscle strength of lower extremity and balance (P = 0.01). Regression analysis shown muscle strength of lower extremities has most contributions in predicting speed of walking in patients with M.S.

Conclusion: It can be concluded that according to the findings of this study, among the physical and cognitive factors affecting gait and balance such as muscle strength of lower extremity, cognition and attention, the muscle strength of lower extremity is the most important factor affecting the balance and speed of walking in patients with MS that still can walk. In the process of rehabilitation, especially in occupational therapy, special attention must be paid to a muscle strengthening program for the lower extremities of patients suffering from M.S.

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Type of Study: Original | Subject: Occupational Therapy
Received: 7/08/2018 | Accepted: 17/11/2018

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