Weiss Hans-Rudolf, Dieckmann Jörg, Gerner Hans Jürgen
Asklepios Katharina Schroth-Klinik, Korczakstrasse 2, D-55566 Bad Sobernheim, Germany.
Pediatr Rehabil. 2003 Jan-Mar;6(1):39-45. doi: 10.1080/1363849031000109237.
The purpose of this study was to answer the question of whether a course of in-patient rehabilitation of 4-6 weeks results in a significant postural improvement in patients with a structural kyphosis. Since all clinical measuring parameters are liable to high margins of error and measuring the surface with the formetric system has shown high reliability in previous studies, this system has been used to evaluate the results of rehabilitation in patients with Scheuermann's disease.
A pre-/post-interventional study was undertaken including only patients (n = 136) with Scheuermann's kyphosis and a thoracic curve pattern. 62 female patients with an average age of 19 years and 74 male patients of average age 20 years were diagnosed with the Formetric system before an in-patient rehabilitation programme of 4-6 weeks. For this study, the maximal kyphotic angle was evaluated.
The average kyphotic angle as measured by the surface topography system before inpatient rehabilitation was 60.7 degrees (SD 11.2) and after 54.9 degrees (SD 12.1) for the whole sample of 136 patients. The improvements where highly significant in the t-test. In the cases of the female patients, the maximal kyphotic angle decreased from 62 degrees to nearly 54 degrees; in the cases of the male patients it had decreased from 60 degrees to nearly 55 degrees by the end of the programme.
After the in-patient treatment, the kyphotic angle decreased very significantly. The range of change was far greater than the margin of error and, thus, the following conclusion may be reached: In-patient rehabilitation with an intensive programme of treatment may result in a correction of structural kyphoses in which there are clear signs of Scheuermann's disease. Consequently in-patient rehabilitation is recommended for adolescents in cases of Scheuermann's kyphoses.
本研究旨在回答4至6周的住院康复疗程是否能使结构性脊柱后凸患者的姿势得到显著改善这一问题。由于所有临床测量参数都存在较高的误差范围，且在先前研究中使用体型测量系统测量体表已显示出高可靠性，因此该系统被用于评估休门氏病患者的康复效果。
进行了一项干预前后研究，仅纳入患有休门氏脊柱后凸且为胸椎曲度类型的患者（n = 136）。在进行为期4至6周的住院康复计划之前，使用体型测量系统对62名平均年龄为19岁的女性患者和74名平均年龄为20岁的男性患者进行了诊断。本研究评估了最大后凸角度。
对于136名患者的整个样本，住院康复前通过体表地形系统测量的平均后凸角度为60.7度（标准差11.2），康复后为54.9度（标准差12.1）。在t检验中，改善非常显著。对于女性患者，最大后凸角度从62度降至近54度；对于男性患者，到疗程结束时，该角度从60度降至近55度。
住院治疗后，后凸角度显著降低。变化范围远大于误差范围，因此可以得出以下结论：强化治疗方案的住院康复可能会矫正存在明显休门氏病体征的结构性脊柱后凸。因此，对于患有休门氏脊柱后凸的青少年，建议进行住院康复治疗。
