特定运动疗法对青少年特发性脊柱侧凸矫正效果的Meta分析

Meta analysis of the efficacy of physiotherapeutic scoliosis specific exercises in the treatment of adolescent idiopathic scoliosis

目的探讨特定运动疗法(physiotherapeutic scoliosis specific exercises,PSSE)对青少年特发性脊柱侧凸(adolescent idiopathic scoliosis,AIS)患者的干预效果。方法在知网、维普、万方、PubMed、Web of Science、Springerlink、IEEE数据库平台上检索关于PSSE干预AIS的随机对照研究。使用RevMan 5.4对PSSE改善AIS患者Cobb’s角、躯干旋转角(angle of trunk rotation,ATR)、胸椎后凸角(thoracic kyphosis,TK)和脊柱侧凸研究学会22(Scoliosis Research Society-22,SRS-22)问卷评分开展Meta分析。结果纳入9篇随机对照试验(randomized controlled trial,RCT)文献,AIS患者422例。Meta分析结果显示,PSSE改善AIS患者Cobb’s角(MD=3.29,95%CI:2.24~4.33,P<0.00001),ATR(MD=1.65,95%CI:1.00~2.30,P<0.00001),TK(MD=3.60,95%CI:0.63~6.57,P=0.02)均有良好效果。SRS-22问卷中的治疗满意度评分差异有统计学意义(P=0.001),然而疼痛、自我形象、功能活动以及心理健康评分差异无统计学意义(P≥0.05)。结论PSSE干预对AIS患者脊柱Cobb’s角、ATR和TK有改善作用。

Objective To explore the intervention effect of specific exercise therapy on AIS patients.Methods Randomized controlled studies on specific exercise therapy intervention in adolescent idiopathic scoliosis were retrieved on the database platforms of Knowledge Infrastructure,Vip,Wanfang,PubMed,Web of Science,Springerlink,and IEEE.The meta-analysis was conducted using RevMan 5.4 on specific exercise therapy to improve Cobb's angle,angle of trunk rotation(ATR),thoracic kyphosis(TK),and SRS-22 questionnaire survey data in AIS patients.Results Nine RCT literatures were included,and 422 AIS patients were included.According to the meta-analysis results,specific exercise therapy can improve Cobb's angle(MD=3.29,95%CI:2.24-4.33,P<0.00001),ATR(MD=1.65,95%CI=1.00-2.30,P<0.00001)and TK(MD=3.60,95%CI=0.63-6.57,P=0.02)of AIS patients.The scores of treatment satisfaction in SRS-22 questionnaire scores were statistically different,but there was no statistically significant difference in pain,self-image,functional activities,and mental health(P≥0.05).Conclusions Specific exercise therapy intervention can improve the Cobb's angle,Angle of Trunk Rotation and Thoracic Kyphosis angle of AIS patients.