fa اثربخشی مداخله توانبخشی رایانه یار- یکپارچگی حسی، مصرف دارو و ترکیب دو روش در بهبود بازداری پاسخ کودکان با اختلال نارسایی توجه/ فزون کنشی توانبخشی Rehabilitation مقاله پژوهشی اصیل Original Research Article <strong>زمینه و هدف:</strong> اختلال نارسایی توجه/ فزون کنشی یکی از شایع ترین مشکلات کودکان است. لذا این مطالعه با هدف تعیین اثر بخشی مداخله توانبخشی رایانه یار- یکپارچگی حسی، دارودرمانی و ترکیب دو روش در بهبود بازداری پاسخ در این کودکان انجام شد.<br> <strong>روش بررسی:</strong> در مطالعه نیمه آزمایشی و آینده نگر حاضر از بین ۳۵ دبستان عادی پسرانه که با روش تصادفی طبقه ای انتخاب شده بودند، ۴۵ &nbsp;کودک ۷ تا ۱۲ سال با اختلال نارسایی توجه/فزون کنشی از نوع ترکیبی که به روش نمونه گیری در دسترس انتخاب و با استفاده از مقیاس کانرز و تشخیص روانپزشک شناسایی و از لحاض بهره هوشی همسان شده بودند، به طور تصادفی به ۳ گروه آزمایشی( توانبخشی رایانه یار- یکپارچگی حسی، دارودرمانی و ترکیب دو روش) تقسیم و بعد از مداخله و بعد از پیگیری یک ماهه با هم مقایسه شدند. ابزار پژوهش آزمون عملکرد یکپارچه دیداری شنیداری &nbsp;بوده است. برنامه تمرینی منتخب شامل تمرینات توانبخشی رایانه یار- یکپارچگی حسی طبق پروتکل تعیین شده به مدت ۳ ماه، هفته ای سه جلسه، هر جلسه ۸۰ دقیقه بود. برای تجزیه و تحلیل داده ها از آزمون تحلیل کواریانس با اندازه گیری مکرر و از نرم افزار <span dir="LTR">spss</span> برای تحلیل آماری در سطح معنی داری &nbsp;۰۵/۰ = <span dir="LTR">&alpha;</span> استفاده شد<br> <strong>یافته ها</strong>: تحلیل یافته ها نشان داد که بین سه روش مداخله ای در بعد بینایی ۸۸۳/۰<span dir="LTR">p=</span> و شنوایی ۲۶۵/۰<span dir="LTR">p=</span> در مرحله پس آزمون تفاوت معناداری وجود نداشت. در مرحله پیگیری نیز دو روش ترکیبی و توانبخشی رایانه یار-یکپارچگی حسی در دو بعد بینایی (۰۰۱/۰ <span dir="LTR">p=</span>) و شنوایی (۰۰۳/۰ <span dir="LTR">p=</span>) بهبود معناداری در بازداری پاسخ نسبت به روش دارودرمانی نشان دادند. در واقع گروه دارو درمانی بر خلاف دو گروه دیگر تقریبا به اندازه مرحله پیش آزمون افت عملکرد داشت.<br> <strong>نتیجه گیری:</strong> با توجه به نتایج مطالعه حاضر می توان ادعا کرد که برنامه مداخله تمرینی می تواند در بهبود بازداری پاسخ به صورت پایدار و مداوم نسبت به روش دارو درمانی موثر واقع شود.<br> &nbsp; <strong>Abstract:</strong><br> <strong>Background & Objective</strong>: Attention Deficit/Hyperactivity Disorder (ADHD) is a common disorder in childhood and it is of particular importance to find effective treatment which can diminish the intensity and depth as symptoms. Although the main cause of this disorder is unknown, many believe that this disorder is a neurological psychiatric disorder which depend on frontal lobe. On one hand, shortcomings in the functioning frontal lobe may be related to some signs of shortcomings of self-regulatory such as Response Inhibition that is common in this disorder. Different treatments are used to treat attention deficit/hyperactivity disorder such as medication, Cognitive, behavioral, combines and supplements. Drug treatment is the predominant treatment.&nbsp; Health concerns associated with the drug such as important side effects have shown that it is necessary cures for the disorder to be designed which targets directly nerve-psychological disorders of these children and bring about sustainable improvements for them. Among of many different treatment methods, considering the Sensory Integrity Model presented by Ayres in 1974 for first time regarding children with learning disorders, sensory integrity can affect the functions of various parts of the brain including cerebellum, basal gangalia and grid arrangement and cause the improvement of cognitive and main symptoms of ADHD. Also the few studies are done in the field of cognitive computer games to alleviate symptoms of attention deficit / hyperactivity disorder which can increase the skills of response inhibition in children due to training orientation skills, response inhibition and multi-step commands Assuming that practice intervention with an emphasize on Rehabilitation Computer Based Tasks-Nerve Sensory Integration can be equivalent to the effects of medication on symptoms of children with attention deficit / hyperactivity disorder without disturbing side effects, This study is aimed to compare three treatments with an emphasis on Rehabilitation Computer Based Tasks-Nerve Sensory Integration, Pharmacotherapy and the combination of two paths to Improving&nbsp; Response Inhibition of children with attention deficit / hyperactivity disorder.<br> <strong>Methods:</strong> This study is a kind of Quasi-experimental and prospective study including three groups: pretest-posttest-follow-up tests. Using stratified random method 35 schools were selected from schools in Dezful city and then using Conners Scale (Parent and teacher form) and diagnosis of Child and Adolescent Psychiatrist, 45 children 7 to 12 years old with attention deficit / hyperactivity disorder were available sampling selected and were identified in Prototype and after synchronization of intelligence and severity of the disorder, randomly divided into three experimental groups (Rehabilitation Computer Based Tasks-Nerve Sensory Integration group, pharmacotherapy group and combined group). Audiovisual integrated performance test IVA + PLUS was used in the pre-test and post-test and follow-up. The selected program includes rehabilitation computer based exercise combined with sensory integration training according to the protocol set for 3 months, 3 weeks a week, 80 minutes per session. Data collected using tests Levin, Mauchly, M-Box and repeated measure through SPSS-16 (p<0.05) were processed.<br> <strong>Findings:</strong> Analysis of the data showed that &nbsp;there is not significant difference between the three methods of intervention in the post-test. Study of changes during follow-up revealed that both combined and rehabilitation-sensory integration&nbsp; groups had a significant improvement in response inhibition variable than pharmacotherapy group. In fact, the pharmacotherapy group, unlike the other two groups had roughly the same decline in performance as the pretest.<br> <strong>Results:</strong> The results suggest that the program Rehabilitation Computer Based Tasks-Sensory Integration intervention in improving the response inhibition has more and more lasting effects than pharmacotherapy. according to the theory of plasticity of human brain, frequent cognitive training and&nbsp; motion skills practices by stimulating the senses causes structural and functional changes in neurons responsible for these actions in these children&rsquo;s brains. &nbsp;Also motion skills practices by stimulating the senses cause enhanced nerve branches and formation of new synapses following repeated use of neural pathways and increases ability to selectively response in people. Indeed, stimulating the senses in a long time causes increase in brain synapses and finally leads to high-level perception which in turn causes increase in attention and cognitive functions such as response inhibition<br> <br> &nbsp;<br> &nbsp;<br> &nbsp; اختلال نارسایی توجه/ فزون کنشی، توانبخشی رایانه یار-یکپارچگی حسی، دارو درمانی ، بازداری پاسخ attention deficit/hyperactivity disorder, Rehabilitation Computer Based Tasks-Sensory Integration pharmacotherapy, response inhibition 0 0 http://jdisabilstud.org/browse.php?a_code=A-10-1191-1&slc_lang=fa&sid=1 sara shamshiri سارا شمشیری s.shamshiri1985@yahoo.com 100319475328460014546 100319475328460014546 Yes mahmood sheikh محمود شیخ prosheikh@yahoo.com 100319475328460014547 100319475328460014547 No rasool hemayat talab رسول حمایت طلب rhemayat@ut.ac.ir 100319475328460014548 100319475328460014548 No forogh riahi فروغ ریاحی riahi13@gmail.com 100319475328460014549 100319475328460014549 No