原发性骨质疏松症患者胸椎后凸角度与躯体功能的相关性研究

Correlation of thoracic kyphosis angle with physical capacity in women with primary osteoporosis

目的:通过评定原发性骨质疏松症患者胸椎后凸角度、躯干屈伸肌群肌力、平衡功能和心肺功能,探讨骨质疏松症患者胸椎后凸角度与躯体功能的相关性。方法:原发性骨质疏松症女性53例,年龄54—84岁。评定胸椎后凸Cobb角、腰背肌肌力、腹直肌肌力、平衡功能(睁眼、闭眼单足站立时间和起立-行走计时测试时间)和心肺功能(胸廓扩张度和6min行走试验距离)并进行相关性分析。结果:本组患者胸椎Cobb角为17.2°—68.0°(平均[42.1±14.6]°)。Cobb角分别与腰背肌肌力(r=-0.452)、6min行走试验距离(r=-0.419)和睁眼单足站立时间(r=-0.299)呈负相关;Cobb角与腹直肌肌力、闭眼单足站立时间、胸廓扩张度和起立-行走计时测试时间无相关性。结论:原发性骨质疏松症患者胸椎后凸角度与腰背肌肌力、静态平衡功能和心肺功能负相关,与腹直肌肌力、胸廓扩张度和功能性活动能力无明显相关。因此,对于胸椎后凸角度越大的骨质疏松症患者越应加强上述受累躯体功能的评定与康复训练。

Objective：To investigate the relationship between thoracic kyphosis angle and physical capacity （trunk muscle strength,balance and cardiopulmonary function） through multidimensional clinical assessments in women with primary osteoporosis.Method：Fifty-three women aged from 54 to 84 years with primary osteoporosis were enrolled.Clinical assess ments including thoracic kyphosis Cobb angle,trunk muscle strength （back extensor strength [BES],rectus abdominis muscle strength）,balance （one leg standing [OLS] test with eyes open or closed,timed ‘up ＆ go’test） and cardiopulmonary function （thoracic expansion [TE],six-minute walk test [6MWT]） were performed.Result：The thoracic kyphosis Cobb angle showed significant negative correlations with BES （r=-0.452）,6MWT distance （r=-0.419） and OLS time with eyes open （r=-0.299）.However,no significant correlation was observed between Cobb angle and muscle strength of the rectus abdominis,OLS time with eyes closed,TE or timed ‘up ＆ go’ test time.Conclusion：Thoracic kyphosis is associated with physical limitations including weak BES,decreased static balance and cardiopulmonary dysfunction in women with primary osteoporosis.But kyphosis is not correlated with rectus abdominis muscle strength,TE or dynamic balance function.Therefore,the related physical limitations should be assessed and rehabilitation program is necessary in patients with greater kyphosis angle.