Pham V M, Houlliez A, Carpentier A, Herbaux B, Schill A, Thevenon A
Service de médecine physique et réadaptation, hôpital P.-Swynghedauw, rue du Pr-A.-Verhaeghe, 59037 Lille cedex, France.
Ann Readapt Med Phys. 2008 Jan;51(1):3-8, 9-15. doi: 10.1016/j.annrmp.2007.08.008. Epub 2007 Dec 3.
The main objective is to determine the influence of treatment by Chêneau brace on the quality of life (QoL) of adolescents with idiopathic scoliosis.
We used the QoL scale of Climent et al. "the Quality of Life Profile for Spine Deformities" (QLPSD, in which a higher score means a worse QoL) and visual analogue scales (VAS) for pain and for QoL ranging from 0 to 100mm. The study includes 108 subjects divided in three groups, a control group of 32 patients without brace, a full-time treated group (wearing a Chêneau brace 23/24 hours) of 41 patients, and a part-time treated group (wearing the brace during the night only) of 35 patients.
The QoL is significantly worse in the full-time treated group than in the group with night treatment and in the group without brace for the psychosocial functioning, the sleep disturbances, the back flexibility (P<0.001), the body image (P<0.01), as well as the overall score (P<0.001). On the other hand, there was no difference for the back pain. Among patients wearing the brace, the girls had an average QLPSD score higher than the boys for the psychosocial functioning, the body image, the overall score (P<0.05) and the back flexibility (P<0.01). Whereas there was no significant difference between the sexes for the sleep disturbances and the back pain. The QoL of patients who wear the brace was significantly correlated with degrees corrected wearing the brace and the patient's satisfaction on his or her health status. However, this correlation was very weak. On the other hand, there was no correlation between the quality of life and the age, the duration of brace treatment or the skeletal maturity (Risser sign). On VAS, the patients without brace have the highest score of QoL, followed the part-time treated patients while the full-time treated patients have the lowest score.
The wearing of the Chêneau brace involves a significant reduction in the QoL whatever instruments of evaluations of QoL, QLPSD or VAS. The QoL of the full-time treated patients was the lowest followed part-time treated patients while the QoL of the patients without brace was the highest. However, the brace does not influence the back pain in idiopathic scoliosis at teenage.
主要目的是确定使用施诺背架治疗对特发性脊柱侧弯青少年生活质量（QoL）的影响。
我们使用了克利门特等人的生活质量量表“脊柱畸形生活质量概况”（QLPSD，分数越高表明生活质量越差）以及疼痛和生活质量的视觉模拟量表（VAS），范围为0至100毫米。该研究包括108名受试者，分为三组，一个由32名未佩戴背架的患者组成的对照组，一个由41名患者组成的全时治疗组（每天佩戴施诺背架23/24小时），以及一个由35名患者组成的非全时治疗组（仅在夜间佩戴背架）。
在心理社会功能、睡眠障碍、背部柔韧性（P<0.001）、身体形象（P<0.01）以及总分（P<0.001）方面，全时治疗组的生活质量显著低于夜间治疗组和未佩戴背架组。另一方面，背痛方面没有差异。在佩戴背架的患者中，女孩在心理社会功能、身体形象、总分（P<0.05）和背部柔韧性（P<0.01）方面的平均QLPSD得分高于男孩。而在睡眠障碍和背痛方面，性别之间没有显著差异。佩戴背架患者的生活质量与佩戴背架时的矫正度数以及患者对自身健康状况的满意度显著相关。然而，这种相关性非常弱。另一方面，生活质量与年龄、背架治疗时间或骨骼成熟度（里塞尔征）之间没有相关性。在VAS上，未佩戴背架的患者生活质量得分最高，其次是非全时治疗的患者，而全时治疗的患者得分最低。
无论使用何种生活质量评估工具，QLPSD或VAS，佩戴施诺背架都会导致生活质量显著下降。全时治疗患者的生活质量最低，其次是非全时治疗患者，而未佩戴背架患者的生活质量最高。然而，背架对青少年特发性脊柱侧弯的背痛没有影响。
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