特异性训练法对青少年特发性脊柱侧凸效果的Meta分析

Meta-analysis of scolosis-specific exercises for adolescent idiopathic scoliosis effectiveness

目的探讨特异性训练法(scolosis-specific exercises,SSE)在减少青少年特发性脊柱侧凸(adolescent idiopathic scoliosis,AIS)进展方面中的疗效及其安全性,为制定和推广AIS的非手术治疗方法及公共卫生决策提供支撑。方法以"scoliosis""spine""scoliosis-specific exercises""spinal deformities""idiopathic""adolescent""etiology""treatment""exercise";"脊柱侧凸""脊柱畸形""特发性""青少年""治疗"为检索词,在Pubmed,Embase,Sport Discus,Central,Web of Science,CNKI数据库中进行检索,检索时限从建库至2019年12月。应用Rev Man 5.3软件进行Meta分析。结果与对照组比较,SSE组能够更好地矫正患者的脊柱侧弯畸形,包括颈椎Cobb angle减小(n=245,MD=-6.88,95%CI=-7.70^-6.05,P<0.01)、腰椎Cobb angle减小(n=135,MD=-6.85,95%CI=-10.06^-3.63,P<0.01)、脊柱生理曲线的改善(n=217,MD=-4.13,95%CI=-7.92^-0.35,P<0.01);在改善生活质量方面,与对照组比较,SSE组能更好地提高患者的SRS-22功能(n=276,SMD=2.00,95%CI=1.69~2.30,P<0.01)和SRS-22自我形象(n=250,SMD=0.86,95%CI=0.58~1.14,P<0.01)、降低SRS-22疼痛值(n=206,SMD=0.81,95%CI=0.51~1.10,P<0.01)。结论脊柱侧凸特异性训练法能较好改善AIS患者的功能,获得更佳的矫形效果。将来还需要更多高质量研究进一步对SSE治疗AIS的疗效和安全性做出评价。

Objective To investigate the efficacy and safety of scolosis-specific exercises( SSE) in reducing adolescent idiopathic scoliosis( AIS) progression,and to provide a reference for developing and promoting AIS non-surgical treatment methods and public health decisions.Methods By using " scoliosis" " spine" " scoliosis-specific exercises" " spinal deformities" " idiopathic" " adolescent" " etiology" " treatment" " exercise" as Chinese and English search terms,literature search was conducted in PubMed,Embase,Sport,Discus,Central,Web of Science and CNKI databases from December,2019.The Rev Man 5.3 software was used for Meta-analysis.Results Compared with the control group,SSE shows positive effects on improving scoliosis,including reduction of Cobb Angle in cervical vertebra( n = 245,MD =-6.88,95%CI =-7.70--6.05,P<0.01),reduction of Cobb Angle in lumbar vertebra( n = 135,MD =-6.85,95% CI =-10.06--3.63,P< 0.01),improvement of physiological curve of spine( n =217,MD =-4.13,95%CI =-7.92--0.35,P<0.01);In terms of improving quality of life,compared with the control group,patients in the SSE group were better able to improve the function of SRS-22( n = 276,SMD = 2.00,95%CI = 1.69-2.30,P<0.01)and self-image of SRS-22( n = 250,SMD = 0.86,95%CI = 0.58-1.14,P<0.01) and reduce the pain value of SRS-22( n = 206,SMD = 0.81,95%CI = 0.51-1.10,P<0.01).Conclusion SSE treatment can better improve the function of AIS patients and obtain better orthopedic effects than other types of sports or standard nursing methods.In the future,more high-quality researches are needed to further evaluate the efficacy and safety of SSE treatment and other types of sports or standard care methods for AIS.