青少年特发性脊柱侧凸运动疗法:现状、争议与挑战

Exercise therapy for adolescent idiopathic scoliosis: current situation, controversy and challenges

近年来,青少年特发性脊柱侧凸非手术疗法越来越受关注,支具在控制脊柱侧凸进展上起着关键的作用。脊柱侧凸特定运动疗法被认为是具有潜在价值的疗法,目标包括预防侧凸进展、改善呼吸功能、预防侧凸引起的疼痛综合征、改善形体外观。特定运动疗法结合支具矫正的目标是控制进展、避免外科手术。然而,当前对脊柱侧凸特定运动疗法的认识存在一些分歧,其中的原因是:缺乏高质量的研究证据,特定运动与一般运动在概念上被混淆,另外就是运动的针对性以及患者的依从性。本文针对目前存在的问题进行剖析,并提出解决问题的思路,为临床、科研提供参考。

In recent years,the non-surgical treatment of adolescent idiopathic scoliosis has been more and more concerned,and the brace has played a key role in controlling the deterioration and progression of scoliosis. Physiotherapeutic Scoliosis Specific Exercises (PSSE)is considered to be of potential value.Its objectives include preventing the progression of scoliosis,improving the respiratory function,preventing the pain syndrome caused by scoliosis,and improving the aesthetic appearance.The goal of PSSE combined with brace correction is to control progress and avoid surgery.However,there are some differences in the current understandings of the PSSE due to the lack of highquality research evidence,the confusion between the concepts of specific movement and general movement,and the targeting of movement and the patient compliance.This paper analyzes the existing problems and puts forward the possible solutions to them,which can provide reference for clinical and scientific researches.