脊柱侧弯特定运动疗法结合支具对青少年特发性脊柱侧弯的疗效分析

Effect of physiotherapeutic scoliosis specific exercises combined with brace on adolescent idiopathic scoliosis

目的探讨脊柱侧弯特定运动疗法结合支具对青少年特发性脊柱侧弯的治疗效果。方法选取2016年1月至2020年9月在首都医科大学附属北京儿童医院就诊并行非手术治疗的青少年特发性脊柱侧弯患者54例,随机分为观察组(26例)和对照组(28例)。观察组采用脊柱侧弯特定运动疗法结合支具治疗,随访时间(26.8±7.1)个月;对照组单纯进行支具治疗,随访时间(28.3±8.6)个月。比较两组治疗前和末次随访时的Cobb角、躯干偏移距离(TS)、顶椎偏离距离(AVT)、顶椎旋转度(AVR)及其矫正率,并评价两组患者的治疗效果。结果观察组和对照组治疗前的Cobb角分别为31.1°±4.3°和32.2°±4.7°,差异无显著性(P>0.05);末次随访时分别为21.0°±6.1°和25.9°±6.0°,均明显低于治疗前,且观察组明显低于对照组,差异有显著性(P<0.05)。末次随访时观察组的Cobb角矫正率为32.2%,明显高于对照组的19.0%,差异有显著性(P<0.05)。治疗前两组TS、AVR比较差异无显著性(P>0.05);末次随访时观察组TS、AVR均明显低于治疗前,差异有显著性(P<0.05),而对照组TS、AVR与治疗前比较差异无显著性(P>0.05)。治疗前观察组AVT明显低于对照组,差异有显著性(P<0.05);末次随访时两组AVT均明显低于治疗前,且观察组明显低于对照组,差异有显著性(P<0.05)。末次随访时两组TS、AVT、AVR的矫正率比较差异均无显著性(P>0.05)。末次随访时观察组治疗有效率为77%,与对照组(61%)比较差异无显著性(P>0.05)。结论脊柱侧弯特定运动结合支具与单纯支具治疗对青少年特发性脊柱侧弯均有较好的矫正效果,且脊柱侧弯特定运动结合支具对Cobb角的矫正效果更佳。

Objective To analyse the effect of physiotherapeutic scoliosis specific exercises(PSSE)combined with brace during the treatment of adolescent idiopathic scoliosis(AIS).Method From January,2016 to September,2020,54 AIS patients treated in our hospital were enrolled.They were randomly divided into observation group(PSSE and brace)and control group(brace).There were 26 cases in observation groups,and 28 cases in control group(6 male and 22 female).The follow-up time of observation group was(26.8±7.1)months,and that of control group was(28.3±8.6)months.The Cobb angle,apex vertebral rotation(AVR),apex vertebral translocation(AVT)and trunk shift(TS)were measured before and at the last follow-up.Result The Cobb angles of the observation group and the control group before treatment were 31.1°±4.3°and 32.2°±4.7°respectively,with no significant difference(P>0.05);At the last follow-up,they were 21.0°±6.1°and 25.9°±6.0°respectively,which were significantly lower than that before treatment,and the observation group was significantly lower than that of the control group(P<0.05).At the last follow-up,the Cobb angle correction rate in the observation group was 32.2%,significantly higher than 19.0%in the control group(P<0.05).There was no significant difference in TS and AVR between the two groups before treatment(P>0.05);At the last follow-up,TS and AVR in the observation group were significantly lower than those before treatment(P<0.05),while TS and AVR in the control group had no significant difference compared with those before treatment(P>0.05).Before treatment,AVT in the observation group was significantly lower than that in the control group(P<0.05);At the last follow-up,AVT in both groups was significantly lower than that before treatment,and that in the observation group was significantly lower than that in the control group(P<0.05).There was no significant difference in the correction rates of TS,AVT and AVR between the two groups at the last follow-up(P>0.05).At the last follow-up,the effective rate of the observation group was 77%,and there was no significant difference compared with the control group(61%,P>0.05).Conclusion PSSE combined with brace and brace alone both have an effect on the correction of AIS,and the correction rate of PSSE combined with brace group is higher.