青少年特发性脊柱侧凸与伏案时长的相关性研究及其足底压力分析

Correlation between adolescent idiopathic scoliosis and the length of learning at table and analysis of plantar pressure

目的:探讨青少年特发性脊柱侧凸(AIS)的发展与伏案时长的相关性及足底压力测试在AIS患者康复诊疗中的应用可行性。方法:选取17例AIS患者为观察组,另选取17名同年龄健康人为对照组。问卷调查观察组伏案时间等信息数据,分析观察组内不同伏案时长与侧凸角度的相关性;使用三维步态分析系统测量受试者的静态足底压力、峰值压力(PP)和触地面积(CA)。结果:伏案总时长>5h较1~3h和3~5h的脊柱侧凸角度均明显增大(均P<0.05);连续伏案2~3h较1~2h的脊柱侧凸角度明显增大(P<0.05),且连续伏案>3h较1~2h和2~3h的脊柱侧凸角度均显著显增大(均P<0.05)。观察组在步行周期中足弓、第1跖骨头、第2~5趾骨处较对照组PP值均更大(P<0.01,0.05),且在足弓和足跖的CA均较对照组更大(P<0.01,0.05),而足跟和足趾的CA均小于对照组(均P<0.01)。观察组“C”型凸侧足底M2区及前足压力均显著大于凹侧(均P<0.05)。结论:伏案时长会对AIS患者脊柱侧凸角度造成一定影响,脊柱侧凸角度大小会造成足底压力分布的特定性改变,进而引发骨盆以及双下肢各关节力学结构的改变。AIS患者在长期伏案时需重视安排规律的脊柱放松活动,并进行足底压力测试,以便对异常改变采取相应的防治措施。

Objective:To explore the relationship between the developments of adolescent idiopathic scoliosis(AIS)and the time spent at a desk,and the feasibility of plantar pressure test in rehabilitation diagnosis and treatment of AIS patients.Methods:Seventeen AIS patients were selected as the observation group,and 17 healthy people were selected as the control group.The desk time and other information data were surveyed by a questionnaire in the observation group,and the correlation between the length of the desk time and the angle of scoliosis was analyzed.Static plantar pressure,peak pressure(PP),and contact area(CA)were measured using a three-dimensional gait analysis system.Results:After the length of sitting exceeded 5 h,the angle of scoliosis increased significantly compared with 1-3 h and 3-5 h(all P<0.05),the angle of scoliosis increased significantly(P<0.05)compared with that of 1-2 h after prolonged sitting for 2-3 h(P<0.05),and the angle of scoliosis at prolonged sitting of more than 3 h increased significantly compared with that at 1-2 h and 2-3 h(all P<0.05).In the observation group,PP values at the arch,the 1st metatarsal bone and the 2nd-5th phalangeal bone were larger than those in the control group(P<0.01,0.05),and CA in both arch and plantar was larger than that in the control group(P<0.01,0.05),and that in both heels and toes was lower than that in the control group(all P<0.01).In patients with type"C"scoliosis,the static plantar pressure in the convex M2 area was significantly higher than that in the concave side(P<0.05).Conclusion:The length of bending over the table does have certain influence on the scoliosis angle of AIS patients,and the size of scoliosis angle will cause specific changes in the plantar pressure distribution,and then cause changes in the mechanical structure of the pelvis and joints of both lower limbs.AIS patients should pay attention to arrange regular spinal relaxation activities during long-term desk sitting,and conduct plantar pressure test,so as to take corresponding prevention and treatment measures for abnormal changes.