نوع مقاله : مقاله پژوهشی

نویسندگان

• سعید ایل بیگی ¹
• محمد رضا حقی رودی ²
• اصغر نیک سرشت ³
• مهدی علیدوست ⁴

¹ دانشیار بیومکانیک ورزشی، دانشکده علوم ورزشی، دانشگاه بیرجند، بیرجند، ایران

² کارشناسی ارشد فیزیولوژی ورزشی، دانشکده علوم ورزشی، دانشگاه بیرجند، بیرجند، ایران

³ استادیار دانشگاه آزاد اسلامی واحد جهرم

⁴ کارشناسی ارشد بیومکانیک ورزشی، دانشکده علوم ورزشی، دانشگاه بیرجند، بیرجند، ایران

چکیده

از ام‌اس به‌عنوان یکی از شایع­ترین بیماری­های مزمن و خود­ایمنی در سیستم عصبی مرکزی یاد می­شود. از مهم­ترین مشکلات این بیماران، نقص­های تعادلی و مشکلات مربوط به ضعف­های عضلانی و خستگی است؛ ازاین‌رو هدف اصلی پژوهش حاضر، بررسی تأثیر دوازده هفته تمرین پیلاتس بر تعادل، قدرت عضلانی و خستگی در بیماران مبتلا به ام‌اس بود. در پژوهش نیمه تجربی حاضر، 22 زن و مرد مراجعه‌کننده به انجمن ام‌اس استان فارس به‌صورت تصادفی و هدفمند به دو گروه مساوی یازده نفره تجربی و کنترل تقسیم شدند. اندازه­گیری تعادل در این تحقیق به‌وسیله آزمون برگ، اندازه­گیری خستگی با دستگاه الکترومیوگرافی و اندازه­گیری قدرت عضلانی به‌وسیله دینامومتر دستی قبل و بعد از انجام تمرینات پیلاتس صورت گرفت. تحلیل داده­ها با آزمون­های تی مستقل و وابسته انجام شد. نتایج پژوهش نشان داد که تمرینات پیلاتس به‌طور معناداری به کاهش خستگی عضلانی، بهبود شاخص­های تعادلی و بهبود قدرت عضلانی مبتلایان به ام‌اس منجر شده است. پیشنهاد نهایی محقق به این صورت بیان می­شود که این روش تمرینی می­تواند برای بهبود تعادل، قدرت عضلانی و کاهش خستگی در این بیماران مناسب باشد.

کلیدواژه‌ها

• مولتیپل اسکلروزیس
• پیلاتس
• تعادل
• خستگی عضلانی
• قدرت عضلانی

موضوعات

• بیومکانیک ورزشی

عنوان مقاله [English]

The Effect of a Pilates Exercise Training on Muscle Fatigue, Balance Indices and Muscle Strength in Patients with Multiple Sclerosis

نویسندگان [English]

• Saeed Ilbeigi ¹
• mohamad reza haghiroodi ²
• Asghar Nikseresht ³
• Mehdi Alidoost ⁴

¹ Associate professor of Sport Biomechanics, Faculty of Sport Sciences, University of Birjand, Birjand, Iran

² Master of Exercise Physiology, Faculty of Sports Sciences, University of Birjand, Birjand, Iran

³ Assistant Professor of Islamic Azad University, Jahrom Branch

⁴ Master of Sports Biomechanics, Faculty of Sports Sciences, University of Birjand, Birjand, Iran

چکیده [English]

Background and Purpose
Multiple sclerosis (MS) is a chronic autoimmune disorder characterized by the immune system mistakenly attacking the myelin sheath, the protective covering of nerve fibers in the central nervous system (CNS). This demyelination disrupts the efficient transmission of nerve signals, leading to a wide range of neurological symptoms that vary depending on the location and extent of the damage. Over time, the cumulative damage results in progressive motor and functional impairments, significantly impacting patients’ daily lives. Among the most debilitating symptoms of MS are balance disorders, muscle weakness, and fatigue, which collectively contribute to reduced mobility, increased risk of falls, and diminished independence. These symptoms not only affect physical health but also have profound psychological and social consequences, often leading to decreased quality of life and increased dependency on caregivers. Given the progressive and unpredictable nature of MS, managing its symptoms requires a multidisciplinary approach, including pharmacological treatments, physical therapy, and lifestyle modifications. Exercise has emerged as a promising non-pharmacological intervention to mitigate some of the physical challenges associated with MS. However, due to the variability in symptom severity and physical limitations among patients, finding an appropriate and effective exercise regimen is crucial. Pilates, a low-impact exercise method focusing on core strength, flexibility, balance, and controlled movements, has gained attention as a potential therapeutic tool for individuals with MS. Its adaptability to different fitness levels and emphasis on mindful movement make it particularly suitable for those with neurological conditions.
 Methods and Materials
This quasi-experimental study investigated the effects of a 12-week Pilates training program on balance, muscle fatigue, and muscle strength in individuals with MS. Twenty-two men and women were recruited from the Fars Province MS Association in Iran. Participants were purposively and randomly assigned to either an experimental group (n = 11), which underwent the Pilates intervention, or a control group (n = 11), which continued their usual daily activities without structured exercise. The experimental group participated in supervised Pilates sessions three times per week for 12 weeks, with each session lasting approximately 60 minutes. Exercises were tailored to accommodate participants’ physical capabilities, ensuring safety and gradual progression in intensity. Outcomes were assessed before and after the intervention. Balance was evaluated using the Berg Balance Scale (BBS), a widely used clinical tool assessing static and dynamic balance through functional tasks such as standing on one leg, reaching forward, and turning. Muscle fatigue was measured via electromyography (EMG), recording electrical activity during muscle contractions to assess endurance and fatigue patterns. Muscle strength was assessed using a manual dynamometer, focusing on key muscle groups involved in posture and mobility, including the quadriceps, hamstrings, and core muscles.
 Results
Following the 12-week Pilates intervention, the experimental group demonstrated significant improvements. Balance, as measured by the BBS, showed statistically significant enhancement (p < 0.05), indicating better postural stability and reduced fall risk. EMG assessments revealed a significant reduction in muscle fatigue (p < 0.05), suggesting improved muscular endurance and delayed fatigue onset during physical activities. Muscle strength, measured by dynamometry, increased notably (p < 0.05), particularly in the lower extremities and core muscles critical for maintaining upright posture and coordinated movement. These findings align with previous research highlighting the benefits of mind-body exercises like Pilates in enhancing neuromuscular function and physical performance in neurological disorders. The focus on core stabilization likely contributed to improved balance by maintaining the center of gravity and preventing falls. Controlled, rhythmic Pilates movements promote better muscle coordination and efficiency, which may explain reduced muscle fatigue. Additionally, the progressive resistance inherent in Pilates supports muscle strengthening without excessive strain on weakened or spastic muscles, making it a safe and effective option for MS patients.
 Conclusion
Pilates is a viable exercise intervention for managing MS-related symptoms, particularly due to its low-impact nature and adaptability to individual needs. Unlike high-intensity workouts that may exacerbate fatigue or trigger muscle spasms, Pilates offers a balanced approach that enhances physical function without overwhelming the nervous system. Furthermore, the mind-body connection fostered by Pilates can positively affect mental well-being, reducing stress and improving overall mood—benefits especially valuable for individuals coping with chronic conditions like MS. Despite promising results, limitations include the relatively small sample size and short intervention duration. Future research should explore long-term effects of Pilates in larger, more diverse MS populations, including individuals at various disease stages. Investigating potential neuroprotective effects, such as impacts on neuroplasticity and cognitive function, could expand Pilates’ therapeutic applications. Comparative studies with other exercise forms, such as yoga or conventional physical therapy, would help identify the most effective strategies for symptom management in MS.
Article Message
Pilates, as a low-impact and adaptable exercise method, can enhance balance, muscle strength, and fatigue resistance in individuals with MS, making it a recommended intervention for managing MS-related symptoms.

کلیدواژه‌ها [English]

• Multiple Sclerosis
• Pilates
• Balance
• Muscle Fatigue
• Muscle Strength