fa اثر تمرینات ترکیبی بر فاکتور نکروز توموری آلفا و اینترلوکین 10 در بیماران مبتلا به مولتیپل اسکلروزیس: یک مرور نظام‌مند و فراتحلیل فیزیولوژی ورزش Sport Physiology مروری Review Article <span style="font-size:11pt"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span calibri="" style="font-family:"><b><span lang="AR-SA" style="font-size:10.0pt"><span style="font-family:Yagut"><span style="color:black">زمینه و هدف:</span></span></span></b> <span lang="FA" style="font-size:10.0pt"><span style="font-family:Yagut"><span style="color:black">مولتیپل اسکلروزیس یکی از شایع‌ترین بیماری‌های دستگاه اعصاب مرکزی است و در اثر تخریب غلاف میلین ایجاد می‌شود. فعالیت ورزشی به عنوان یک راهکار عملی نقش مهمی در افزایش فاکتور نکروز توموری آلفا و اینترلوکین 10 در بیماران مبتلا به مولتیپل اسکلروزیس دارد، هر چند در مورد مناسب‌ترین برنامه ورزشی تفاهم عمومی وجود ندارد. لذا هدف مطالعه حاضر تعیین و بررسی اثر تمرینات ترکیبی بر فاکتور نکروز توموری آلفا و اینترلوکین 10 در بیماران مبتلا به مولتیپل اسکلروزیس ‌بود.</span></span></span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span calibri="" style="font-family:"><span lang="FA" style="font-size:10.0pt"><span style="font-family:Yagut"><span style="color:black"></span></span></span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span calibri="" style="font-family:"><b><span lang="AR-SA" style="font-size:10.0pt"><span style="font-family:Yagut"><span style="color:black">روش بررسی:</span></span></span></b><span lang="AR-SA" style="font-size:10.0pt"><span style="font-family:Yagut"><span style="color:black"> این یک مطالعه به شکل مرور سیستماتیک همراه با فراتحلیل می‌باشد، </span></span></span><span lang="FA" style="font-size:10.0pt"><span style="font-family:Yagut"><span style="color:black">جستجوی سیستماتیک مقالات انگلیسی و فارسی منتشر شده از پایگاه‌های اطلاعاتی</span></span></span><span dir="LTR" style="font-size:8.0pt"><span arial="" style="font-family:"><span style="color:black">PubMed </span></span></span><span lang="FA" style="font-size:10.0pt"><span style="font-family:Yagut"><span style="color:black">، </span></span></span><span dir="LTR" style="font-size:8.0pt"><span arial="" style="font-family:"><span style="color:black">Web of Science</span></span></span><span lang="FA" style="font-size:10.0pt"><span style="font-family:Yagut"><span style="color:black">، </span></span></span><span dir="LTR" style="font-size:8.0pt"><span arial="" style="font-family:"><span style="color:black">Scopus</span></span></span><span lang="FA" style="font-size:10.0pt"><span style="font-family:Yagut"><span style="color:black">، </span></span></span><span dir="LTR" style="font-size:8.0pt"><span arial="" style="font-family:"><span style="color:black">Sid</span></span></span><span lang="FA" style="font-size:10.0pt"><span style="font-family:Yagut"><span style="color:black"> و </span></span></span><span dir="LTR" style="font-size:8.0pt"><span arial="" style="font-family:"><span style="color:black">Magiran</span></span></span><span lang="FA" style="font-size:10.0pt"><span style="font-family:Yagut"><span style="color:black"> تا ژانویه سال 2025 انجام شد. تفاوت میانگین وزنی و فاصله اطمینان 95 درصد(</span></span></span><span dir="LTR" style="font-size:8.0pt"><span arial="" style="font-family:"><span style="color:black">CI</span></span></span><span lang="FA" style="font-size:10.0pt"><span style="font-family:Yagut"><span style="color:black">) با استفاده از مدل اثر تصادفی محاسبه گردید. ناهمگونی با استفاده از آزمون(</span></span></span><span dir="LTR" style="font-size:8.0pt"><span arial="" style="font-family:"><span style="color:black">I2</span></span></span><span lang="FA" style="font-size:10.0pt"><span style="font-family:Yagut"><span style="color:black">) و سوگیری انتشار با تحلیل بصری فونل پلات و آزمون </span></span></span><span dir="LTR" style="font-size:8.0pt"><span arial="" style="font-family:"><span style="color:black">Egger</span></span></span><span lang="FA" style="font-size:10.0pt"><span style="font-family:Yagut"><span style="color:black"> بررسی شدند.</span></span></span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span calibri="" style="font-family:"><b><span lang="AR-SA" style="font-size:10.0pt"><span style="font-family:Yagut"><span style="color:black"></span></span></span></b></span></span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span calibri="" style="font-family:"><b><span lang="AR-SA" style="font-size:10.0pt"><span style="font-family:Yagut"><span style="color:black">یافته&shy;ها:</span></span></span></b><span lang="AR-SA" style="font-size:10.0pt"><span style="font-family:Yagut"><span style="color:black"> نتایج نشان داد </span></span></span><span lang="FA" style="font-size:10.0pt"><span style="font-family:Yagut"><span style="color:black">8 مطالعه‌ای که شامل 256 آزمونی مبتلا به مولتیپل اسکلروزیس وارد فراتحلیل شدند.</span></span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="font-family:Yagut"><span style="color:black"> تمرینات ترکیبی سبب تغییرغیرمعنی‌دار </span></span></span><span dir="LTR" style="font-size:8.0pt"><span arial="" style="font-family:"><span style="color:black">TNF-a</span></span></span> <span dir="LTR" style="font-size:8.0pt"><span arial="" style="font-family:"><span style="color:black">]</span></span></span><span lang="FA" style="font-size:10.0pt"><span style="font-family:Yagut"><span style="color:black">118</span></span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="font-family:Yagut"><span style="color:black">/0</span></span></span><span lang="AR-SA" style="font-family:Yagut"><span style="color:black">=</span></span><span dir="LTR" style="font-size:8.0pt"><span arial="" style="font-family:"><span style="color:black">p</span></span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="font-family:Yagut"><span style="color:black">، (499/1ـ الی 168/0) </span></span></span><span lang="FA" style="font-size:10.0pt"><span style="font-family:Yagut"><span style="color:black">665</span></span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="font-family:Yagut"><span style="color:black">/0ـ</span></span></span><span lang="AR-SA" style="font-family:Yagut"><span style="color:black">=</span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="font-family:Yagut"><span style="color:black">‌</span></span></span><span dir="LTR" style="font-size:8.0pt"><span arial="" style="font-family:"><span style="color:black">[WMD</span></span></span><span style="font-size:10.0pt"><span style="font-family:Yagut"><span style="color:black"> و </span></span></span><span dir="LTR" style="font-size:8.0pt"><span arial="" style="font-family:"><span style="color:black">IL-10</span></span></span> <span dir="LTR" style="font-size:8.0pt"><span arial="" style="font-family:"><span style="color:black">]</span></span></span><span lang="FA" style="font-size:10.0pt"><span style="font-family:Yagut"><span style="color:black">649</span></span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="font-family:Yagut"><span style="color:black">/0</span></span></span><span lang="AR-SA" style="font-family:Yagut"><span style="color:black">=</span></span><span dir="LTR" style="font-size:8.0pt"><span arial="" style="font-family:"><span style="color:black">p</span></span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="font-family:Yagut"><span style="color:black"> ،(</span></span></span><span lang="FA" style="font-size:10.0pt"><span style="font-family:Yagut"><span style="color:black">508</span></span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="font-family:Yagut"><span style="color:black">/1ـ الی 421/2) 456/0</span></span></span><span lang="AR-SA" style="font-family:Yagut"><span style="color:black">=</span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="font-family:Yagut"><span style="color:black">‌</span></span></span><span dir="LTR" style="font-size:8.0pt"><span arial="" style="font-family:"><span style="color:black">[WMD</span></span></span><span style="font-size:10.0pt"><span style="font-family:Yagut"><span style="color:black"> نسبت به گروه شاهد </span></span></span><span lang="FA" style="font-size:10.0pt"><span style="font-family:Yagut"><span style="color:black">در بیماران مبتلا به مولتیپل اسکلروزیس</span></span></span> <span lang="AR-SA" style="font-size:10.0pt"><span style="font-family:Yagut"><span style="color:black">گردید.</span></span></span><span lang="FA" style="font-size:10.0pt"><span style="font-family:Yagut"><span style="color:black"></span></span></span></span></span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span calibri="" style="font-family:"><b><span lang="AR-SA" style="font-size:10.0pt"><span style="font-family:Yagut"><span style="color:black">نتیجه&shy;گیری:</span></span></span></b><span lang="AR-SA" style="font-size:10.0pt"><span style="font-family:Yagut"><span style="color:black"> نتایج فراتحلیل حاضر نشان داد که تمرینات ترکیبی موجب کاهش فاکتور نکروز توموری آلفا و افزایش اینترلوکین 10 در بیماران مبتلا به مولتیپل اسکلروزیس می‌شود و بنابراین می‌تواند به عنوان یک مداخله غیردارویی و کاربردی برای بیماران مبتلا به مولتیپل اسکلروزیس پیشنهاد شود.</span></span></span><span lang="FA" style="font-size:10.0pt"><span style="font-family:Yagut"><span style="color:black"></span></span></span></span></span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span calibri="" style="font-family:"><span lang="FA" style="font-size:10.0pt"><span style="font-family:Yagut"><span style="color:black"></span></span></span></span></span></span></span></span></span></span><br> &nbsp; <span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"><b><span lang="fa" style="font-size:10.0pt"><span arial="" style="font-family:"><span style="color:black">Background & aim:</span></span></span></b> <span lang="EN" style="font-size:10.0pt"><span arial="" style="font-family:"><span style="color:black">Multiple sclerosis is one of the most common diseases of the central nervous system and is caused by the destruction of the myelin sheath. Physical activity, as a practical intervention, plays an important role in increasing tumor necrosis factor-alpha and interleukin-10 in patients with multiple sclerosis; however, there is no general consensus on the most appropriate exercise program. Therefore, the aim of the present study was to determine and examine the effect of combined training on tumor necrosis factor-alpha and interleukin-10 in patients with multiple sclerosis.</span></span></span><b> </b></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"><b><span style="font-size:10.0pt"><span arial="" style="font-family:"><span style="color:black"></span></span></span></b></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"><b><span style="font-size:10.0pt"><span arial="" style="font-family:"><span style="color:black">Methods</span></span></span></b><span style="font-size:10.0pt"><span arial="" style="font-family:"><span style="color:black">: </span></span></span><span lang="EN" style="font-size:10.0pt"><span arial="" style="font-family:"><span style="color:black">The present study was conducted as a systematic review and meta-analysis</span></span></span><span style="font-size:10.0pt"><span arial="" style="font-family:"><span style="color:black">.</span></span></span><span lang="EN" style="font-size:10.0pt"><span arial="" style="font-family:"><span style="color:black"> Asystematic search of English and Persian articles published in the databases PubMed, Web of Science, Scopus, SID, and Magiran was performed up to January 2025. The weighted mean difference and 95% confidence interval (CI) were calculated using a random-effects model. Heterogeneity was assessed using the I&sup2; test, and publication bias was evaluated through visual inspection of funnel plots and Egger&rsquo;s test. </span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"><b><span style="font-size:10.0pt"><span arial="" style="font-family:"><span style="color:black"></span></span></span></b></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"><b><span style="font-size:10.0pt"><span arial="" style="font-family:"><span style="color:black">Results</span></span></span></b><b><span lang="EN" style="font-size:10.0pt"><span arial="" style="font-family:"><span style="color:black">:</span></span></span></b><span lang="EN" style="font-size:10.0pt"><span arial="" style="font-family:"><span style="color:black"> The results indicated that eight studies involving 256 participants with multiple sclerosis were included in the meta-analysis. Combined training resulted in a non-significant change in TNF-a [WMD= -0.665 (0.168 to -1.499) P=0.118] and IL-10 [WMD= 0.456 (2.421 to -1.508) P=0.649] Compared to the control group, it was found in patients with multiple sclerosis.</span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"><b><span style="font-size:10.0pt"><span arial="" style="font-family:"><span style="color:black"></span></span></span></b></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"><b><span style="font-size:10.0pt"><span arial="" style="font-family:"><span style="color:black">Conclusion</span></span></span></b><span style="font-size:10.0pt"><span arial="" style="font-family:"><span style="color:black">:</span></span></span><span lang="EN" style="font-size:10.0pt"><span arial="" style="font-family:"><span style="color:black"> The results of the present meta-analysis indicated that combined exercises reduce tumor necrosis factor alpha and increase interleukin 10 in patients with multiple sclerosis and therefore can be suggested as a non-pharmacological and practical intervention for patients with multiple sclerosis.</span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"><b><span style="font-size:10.0pt"><span arial="" style="font-family:"><span style="color:black"></span></span></span></b></span></span></span><br> &nbsp; تمرینات ترکیبی, فاکتور نکروز توموری آلفا, اینترلوکین 10‌, مولتیپل اسکلروزیس Combined exercises, tumor necrosis factor alpha, interleukin 10, multiple sclerosis. 678 694 http://armaghanj.yums.ac.ir/browse.php?a_code=A-10-2795-2&slc_lang=fa&sid=1 A Saremi‌ عباس صارمی a-saremi@araku.ac.ir 100319475328460033198 100319475328460033198 No Department of Exercise Physiology, Faculty of Sport Sciences, Arak University, Arak, Iran گروه فیزیولوژی ورزش، دانشکده علوم ورزشی، دانشگاه اراک، ایران O Zafarmand امید ظفرمند OMIDZAFARMAND2202@GMAIL.COM 100319475328460033199 100319475328460033199 Yes Department of Physical Education and Sports Sciences, School of Humanities, University of Yasouj, Yasouj, Iran. گروه تربیت بدنی و علوم ورزشی، دانشکده علوم انسانی، دانشگاه یاسوج، یاسوج، ایران.