اثر تمرینات مقاومتی و هوازی بر هورمون‌های محور HPA در بیماران مبتلا به مولتیپل اسکلروزیس

نوع مقاله : مقاله پژوهشی Released under (CC BY-NC 4.0) license I Open Access I


1 فیزیولوژی ورزشی، دانشکده تربیت بدنی، دانشگاه گیلان، رشت، ایران

2 فیزیولوژی ورزش، دانشکده تربیت بدنی وعلوم ورزشی، دانشگاه گیلان، رشت، ایران

3 استاد تمام گروه نورولوژی/ بیمارستان پورسینا/دانشکده پزشکی/ دانشگاه علوم پزشکی گیلان / رشت / ایران



هدف: بیماری مولتیپل اسکلروزیس یک بیماری خود‌ایمن بوده که در آن سیستم ایمنی به خود حمله کرده و باعث آسیب و ایجاد التهاب می‌شود. کورتیزول که یکی از مهم‌ترین هورمون‌های محور HPA است ارتباط مستقیم با میزان التهاب در بدن بیماران ام‌اس دارد و تحقیقات نشان داده که اختلال در این محور ممکن است باعث تغییر علائم بیماری ام‌اس شود، بنابراین هدف پژوهش حاضر بررسی تأثیر دو برنامه تمرین هوازی و مقاومتی بر هورمون‌های محور HPA  در زنان مبتلا به بیماری ام‌اس بود. روش شناسی: این پژوهش نیمه‌تجربی با حضور ۳۰ زن مبتلا به بیماری ام‌اس (نوع عودکننده - بهبود یابنده با مقیاس ناتوانی ۰ تا ۵/۵) در بازة سنی ۲۰ تا ۴۰ سال انجام شد. شرکت‌کنندگان به طور تصادفی در سه گروه ۱۰ نفری هوازی، مقاومتی و کنترل تقسیم شدند. بیماران به مدت ۸ هفته با تواتر ۳ روز در هفته تمرینات را انجام دادند که هر جلسه شامل گرم‌کردن، تمرینات مقاومتی، تمرینات هوازی و سردکردن بود. تمامی حرکات طوری طراحی شده بودند که در محیط خانه انجام پذیرد. در هر جلسه نیز مربیان توسط تماس تصویری از کیفیت اجرای تمرینات اطمینان حاصل کردند. نمونه‌های خونی قبل و پس از پروتکل از شریان بازویی شرکت‌کنندگان جمع‌آوری شدند.  داده‌ها با تحلیل واریانس اندازه‌گیری مکرر عاملی ۲×۳ و آزمون بونفرونی تحلیل شدند. یافته‌ها: پروتکل تمرینی مورد بررسی توانایی ایجاد تغییرات قابل‌توجهی در هورمون‌های محور هیپوتالاموس - هیپوفیز - آدرنال در زنان مبتلا به ام اس را نشان نداد. در حقیقت، سطح کورتیزول (۹۴۶/۰=P) افزایش داشته؛ اما همانند سایر هورمون‌ها مانند دوپامین (۵۶۱/0=P)، تستوسترون (۷۱۴/0=P) و آدرنوکورتیکوتروپین (۹۳۳/0=P) به‌عنوان پاسخ به مداخلات تمرینی نداشته است. نتیجه‌گیری: بر اساس نتایج تحقیق حاضر، 8 هفته تمرینات هوازی و مقاومتی (مبتنی بر تمرین در خانه) توانایی ایجاد تغییرات قابل‌توجهی در سطوح هورمونی محور HPA در بیماران ام­اس افسرده و توانایی حرکتی نسبتاً محدود را نداشت.



عنوان مقاله [English]

The effect of resistance and aerobic exercises on the hormones of the HPA axis in patients with multiple sclerosis

نویسندگان [English]

  • maryam shahbazi 1
  • payam saidie 2
  • Alia Saberi 3
1 Exercise Physiology Department, University of Guilan, Rasht, Iran
2 Department of exercise physiology, University of Guilan, Rasht, IRAN
3 Professor, Department of Neurology, Poursina Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
چکیده [English]

Aim:      Multiple sclerosis is an autoimmune disease in which the immune system attacks itself and causes damage and inflammation. Cortisol, which is one of the most important hormones of the HPA axis, is directly related to the level of inflammation in the body of MS patients, and research has shown that disruption of this axis may cause changes in the symptoms of MS, so the purpose of this study is to investigate the effect of two aerobic and resistance training programs on hormones. HPA axis in women with MS. Methods: This semi-experimental research was conducted with the participation of 30 women diagnosed with relapsing-remitting MS (with a disability scale ranging from 0 to 5.5) within the age range of 25 to 50. The participants were randomly divided into three groups: aerobic exercise (10 participants), resistance exercise (10 participants), and control group (10 participants). The patients engaged in exercise sessions three times a week for 8 weeks, including warm-up, resistance training, aerobic exercises, and cooldown. All movements were designed to be performed in a home environment. Trainers ensured exercise quality through video calls. Blood samples were collected from the participants' brachial before and after the protocol. Data analysis employed tow-way ANOVA with repeated measures and Bonferroni’s post hoc test. Statistical analysis was conducted using SPSS version 26 software, with a significance level of 0/05. Results:  The studied exercise protocol did not show the ability to make significant changes in the hormones of the hypothalamus-pituitary-adrenal axis in women with MS. In fact the level of cortisol (P=0.946) has been increased but likewise the other hormones such as dopamine (P=0.561), testosterone (P=0.714) and adrenocorticotropin (P=0.933) there were no significant change as a response to training interference. Conclusion:  Based on the results of the current study, 8 weeks of aerobic and resistance exercises (home-based training) did not show the ability to significantly alter the hormonal levels of the HPA axis in patients with depression and relatively limited mobility.

کلیدواژه‌ها [English]

  • Multiple sclerosis
  • aerobic exercise
  • resistance exercise
  • HPA axis hormones
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