施罗斯疗法联合核心肌群训练治疗青少年特发性脊柱侧弯的临床研究

Clinical study of Schroth therapy combined with core muscle training in the treatment of adolescent idiopathic scoliosis

目的探讨施罗斯疗法联合核心肌群训练对青少年脊柱侧弯患者脊柱畸形和步行改善的效果。方法选取2020年1月至2023年1月郑州市第二人民医院康复医学科和黄河中心医院收治的100例青少年特发性脊柱侧弯患者作为研究对象,应用随机数字表分为研究组和对照组,每组各50例。对照组采用施罗斯疗法,研究组在对照组基础上采用核心肌群训练,以上治疗均持续6个月。比较两组Cobb角、躯干旋转角(ATR)、顶椎偏移距离(AVT)。采用Footscan足底压力测试系统测量自然行走状态下的步态及足底压力测量参数。采用NeuroCom平衡测训系统测量非稳定状态下睁/闭目双足支撑身体重心位移变化速度。采用脊柱侧凸研究学会22项问卷表(SRS-22)评估生活质量。结果与治疗前比较,两组治疗6个月后Cobb角、ATR、AVT减小,且研究组小于对照组(P<0.05)。与治疗前比较,两组治疗6个月后步速和总支撑相占步行周期比例增加,但差异无统计学意义(P>0.05)。与治疗前比较,两组治疗6个月后足底压力中心漂移指数(CPEI)降低,且研究组低于对照组(P<0.05)。与治疗前比较,两组治疗6个月后睁目和闭目双足非稳定支撑速度均降低,且研究组低于对照组(P<0.05)。与治疗前比较,两组治疗6个月后SRS-22各维度评分及总分增加,且研究组高于对照组(P<0.05)。结论施罗斯疗法联合核心肌群训练对青少年脊柱侧弯患者的治疗效果显著,能够显著降低Cobb角、ATR和AVT,改善脊柱畸形和足底压力分布,提高身体平衡能力和生活质量。

Objective To explore the effect of Schroth therapy combined with core muscle training on improving spinal deformities and walking in adolescent patients with scoliosis.Methods One-hundred cases of adolescent patients with scoliosis admitted to the Department of Rehabilitation Medicine of Zhengzhou Second Hospital and Yellow River Central Hospital From January 2020 to January 2023 were selected as the research objects.They were randomly assigned into observation group(n=50)and control group(n=50).Patients in the control group were treated with Schroth therapy,while those in the observation group were treated with Schroth therapy combined with core muscle training.All treatments lasted for 6 months.The Cobb angle,angle of trunk rotation(ATR),and apical vertebral translation(AVT)between two groups were compared.Using the Footscan plantar pressure testing system,gait and plantar pressure during natural walking were measured.Using the NeuroCom balance training system,changing speed of the center of gravity displacement of the bipedal support body in the unsteady state of open/closed eyes was measured.The Scoliosis Research Society-22 questionnaire(SRS-22)was used to evaluate the quality of life.Results Compared with those before treatment,Cobb angle,ATR,and AVT significantly decreased in both groups after 6 months of treatment,which were significantly smaller in the observation group than the control group(P<0.05).Compared with those before treatment,the proportion of walking speed and total support to walking cycle increased in both groups after 6 months of treatment,but the difference was not statistically significant(P>0.05).Compared with those before treatment,the center of pressure excursion index(CPEI)of the two groups significantly decreased after 6 months of treatment,which was significantly lower in the observation group than the control group(P<0.05).Compared with before those treatment,the unsteady support speed at the state of eyes open or closed significantly decreased in both groups after 6 months of treatment,which was significantly lower in the observation group than the control group(P<0.05).Compared with those before treatment,the SRS-22 scores and total scores after 6 months of treatment significantly increased in both groups,which were significantly higher in the observation group than the control group(P<0.05).Conclusion Schroth therapy combined with core muscle training can significantly reduce the Cobb Angle,ATR and AVT,and improve spinal deformity,plantar-pressure distribution,body balance and quality of life in adolescent patients with scoliosis,with a clinical application value.