脊柱侧凸特定性训练对轻度青少年特发性脊柱侧凸的治疗价值Value of Scoliosis Specific Exercise for Mild Adolescent Idiopathic Scoliosis
袁望舒;沈建雄;陈丽霞;王海;余可谊;丛卉;
YUAN Wang-shu;SHEN Jian-xiong;CHEN Li-xia;WANG Hai;YU Ke-yi;CONG Hui;Department of Physical Medicine & Rehabilitation,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College;Department of Orthopedics,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College;
摘要(Abstract):
目的观察脊柱侧凸特定性训练(scoliosis specific exercise,SSE)对轻度青少年特发性脊柱侧凸(adolescent idiopathic scoliosis,AIS)的矫正效果。方法回顾性收集2016年1月至3月,在北京协和医院确诊并开始在物理医学康复科门诊接受SSE矫形治疗的轻度AIS患者临床资料。比较患者治疗前后Cobb角和轴向躯干旋转(axial trunk rotation,ATR)角,采用脊柱侧凸研究学会患者问卷-22 (Scoliosis Research Society Patient Questionnaire-22,SRS-22)分析患者对治疗效果的主观评价。结果共31例符合纳入和排除标准的患者入选本研究。患者治疗后Cobb角和ATR角均较治疗前减小(Cobb角:16. 29°±5. 05°比19. 23°±2. 85°,t=2. 955,P=0. 006; ATR角:5. 97°±2. 22°比7. 16°±1. 66°,t=4. 799,P=0. 000)。SRS-22量表评分中,治疗后满意度评分较治疗前显著增加[5. 0 (4. 0,5. 0)分比3. 0(3. 0,3. 0)分,Z=0. 000,P<0. 05]。结论 SSE能延缓甚至改善轻度AIS患者的脊柱畸形。
Objective The aim of this study was to observe the effects of the scoliosis specific exercise( SSE) on mild adolescent idiopathic scoliosis( AIS). Methods Clinical data of patients with mild AIS aged from 10 to 18 years who were treated by SSE in Peking Union Medical College Hospital between January and March,2016 were retrospectively collected. The Cobb angle,the angle of axial trunk rotation( ATR),and the scales of Scoliosis Research Society Patient Questionnaire-22( SRS-22) were evaluated before and after the treatment. Results Totally 31 patients meeting the inclusive and exclusive criteria were enrolled in this study. After the treatment,the Cobb angle and ATR angle decreased than before( Cobb angle: 16. 29° ±5. 05° vs. 19. 23° ±2. 85°,t = 2. 955,P = 0. 006; ATR angle: 5. 97° ± 2. 22° vs. 7. 16° ± 1. 66°,t = 4. 799,P = 0. 000). The satisfaction scale after the treatment was higher than that of before [5. 0( 4. 0,5. 0) vs. 3. 0( 3. 0,3. 0),Z =0. 000,P<0. 05]. Conclusion SSE might delay or even improve the spinal deformity in patients with mild AIS.
关键词(KeyWords):
特发性脊柱侧凸;青少年;脊柱侧凸特定性训练;保守治疗
idiopathic scoliosis;adolescent;scoliosis specific exercise;conservative treatment
基金项目(Foundation): 2018年北京市卫生与健康科技成果和适宜技术推广项目“脊柱侧凸特定性体操的临床推广”(2018-TG-34)
作者(Author):
袁望舒;沈建雄;陈丽霞;王海;余可谊;丛卉;
YUAN Wang-shu;SHEN Jian-xiong;CHEN Li-xia;WANG Hai;YU Ke-yi;CONG Hui;Department of Physical Medicine & Rehabilitation,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College;Department of Orthopedics,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College;
Email:
DOI:
参考文献(References):
- [1] Konieczny MR,Senyurt H,Krauspe R. Epidemiology of adolescent idiopathic scoliosis[J]. J Child Orthop,2013,7:3-9.
- [2] Rogala EJ,Drummond DS,Gurr J. Scoliosis:incidence and natural history. Aprospective epidemiological study[J]. J Bone Joint Surg Am,1978,60:173-176.
- [3] Kahanovitz N,Snow B,Pinter I. The comparative results of psychologic testing in scoliosis patients treated with electrical stimulation or bracing[J]. Spine,1984,9:442-444.
- [4] Payne WK 3rd,Ogilvie JW,Resnick MD,et al. Does scoliosis have a psychological impact and does gender make a difference?[J]. Spine,1997,22:1380-1384.
- [5] Upasani W,Caltoum C,Petcharaporn M,et al. Adolescent idiopathic scoliosis patients report increased pain at five years compared with two years after surgical treatment[J].Spine,2008,33:1107-1112.
- [6] Danielsson AJ,Nachemson AL. Back pain and function 22years after brace treatment for adolescent idiopathic scoliosis:a case-control study-partⅠ[J]. Spine,2003,28:2078-2086.
- [7] Danielsson AJ,Nachemson AL. Back pain and function 23years after fusion for adolescent idiopathic scoliosis:a casecontrol study-partⅡ[J]. Spine,2003,28:E373-E383.
- [8] Sato T,Hirano T,Ito T,et al. Back pain in adolescents with idiopathic scoliosis:epidemiological study for 43 630pupils in Niigata City,Japan[J]. Eur Spine J,2011,20:274-279.
- [9] Negrini S,Donzelli S,Aulisa AG,et al. 2016 SOSORT guidelines:orthopaedic and rehabilitation treatment of idiopathic scoliosis during growth[J]. Scoliosis Spinal Disord,2018,13:3.
- [10] Kane WJ. Scoliosis prevalence:a call for a statement of terms[J]. Clin Orthop Relat Res,1977,(126):43-46.
- [11] Romano M,Negrini A,Parzini S,et al. SEAS(Scientific Exercises Approach to Scoliosis):a modern and effective evidence based approach to physiotherapic specific scoliosis exercises[J]. Scoliosis,2015,10:3.
- [12] Kuru T,Yeldan I,Dereli EE,et al. The efficacy of threedimensional Schroth exercises in adolescent idiopathic scoliosis:A randomized controlled clinical trial[J]. Clinl Rehabil,2016,30:181-190.
- [13] Zhuang Q, Qiu G, Li Q, et al. Modified PUMC classification for adolescent idiopathic scoliosis[J]. Spine J,2019,19:1518-1528.
- [14] Berdishevsky H,Lebel VA,Bettany-Saltikov J,et al. Physiotherapy scoliosis-specific exercises:a comprehensive review of seven major schools[J]. Scoliosis Spinal Disord,2016,4:11-20.
- [15] Monticone M,Nava C,Leggero V,et al. Measurement properties of translated versions of the Scoliosis Research Society-22 Patient Questionnaire, SRS-22:a systematic review[J]. Qual Life Res,2015,24:1981-1998.
- [16] Sanders JO,Browne RH,McConnell SJ,et al. Maturity assessment and curve progression in girls with idiopathic scoliosis[J]. J Bone Joint Surg Am,2007,89:64-73.
- [17] Rigo M. Patient evaluation in idiopathic scoliosis:radiographic assessment,trunk deformity and back asymmetry[J].Physiother Theory Pract,2011,27:7-25.
- [18] Hawes M. Impact of spine surgery on signs and symptoms of spinal deformity[J]. Pediatr Rehabil,2006,9:318-339.
- [19] Romano M,Minozzi S,Zaina F,et al. Exercises for adolescent idiopathic scoliosis:a Cochrane systematic review[J].Spine,2013,38:E883-E893.
- [20] Monticone M,Ambrosini E,Cazzaniga D,et al. Active self-correction and task-oriented exercises reduce spinal deformity and improve quality of life in subjects with mild adolescent idiopathic scoliosis. Results of a randomised controlled trial[J]. Eur Spine J,2014,23:1204-1214.
- [21] Negrini A,Negrini MG,Donzelli S,et al. Scoliosis-specific exercises can reduce the progression of severe curves in adult idiopathic scoliosis:a long-term cohort study[J]. Scoliosis,2015,11:10-20.
- [22] Paszewski M,Cie'slin'ski I,Nowobilski R,et al. Mental health of adults treated in adolescence with scoliosis-specific exercise program or observed for idiopathic scoliosis[J].Scientific World Journal,2014,2014:932827.
- [23] Negrini S,Aulisa AG, Aulisa L, et al. 2011 SOSORT guidelines:Orthopaedic and Rehabilitation treatment of idiopathic scoliosis during growth[J]. Scoliosis,2012,7:3.
- 特发性脊柱侧凸
- 青少年
- 脊柱侧凸特定性训练
- 保守治疗
idiopathic scoliosis - adolescent
- scoliosis specific exercise
- conservative treatment
- 袁望舒
- 沈建雄
- 陈丽霞
- 王海
- 余可谊
- 丛卉
YUAN Wang-shu- SHEN Jian-xiong
- CHEN Li-xia
- WANG Hai
- YU Ke-yi
- CONG Hui
- Department of Physical Medicine & Rehabilitation
- Peking Union Medical College Hospital
- Chinese Academy of Medical Sciences & Peking Union Medical College
- Department of Orthopedics
- Peking Union Medical College Hospital
- Chinese Academy of Medical Sciences & Peking Union Medical College
- 袁望舒
- 沈建雄
- 陈丽霞
- 王海
- 余可谊
- 丛卉
YUAN Wang-shu- SHEN Jian-xiong
- CHEN Li-xia
- WANG Hai
- YU Ke-yi
- CONG Hui
- Department of Physical Medicine & Rehabilitation
- Peking Union Medical College Hospital
- Chinese Academy of Medical Sciences & Peking Union Medical College
- Department of Orthopedics
- Peking Union Medical College Hospital
- Chinese Academy of Medical Sciences & Peking Union Medical College