Negrini Stefano, Zaina Fabio, Romano Michele, Negrini Alessandra, Parzini Silvana
Italian Scientific Spine Institute, Via Roberto Bellarmino 13/1, Milan, Italy.
J Rehabil Med. 2008 Jun;40(6):451-5. doi: 10.2340/16501977-0195.
To compare the effect of Scientific Exercises Approach to Scoliosis (SEAS) exercises with "usual care" rehabilitation programmes in terms of the avoidance of brace prescription and prevention of curve progression in adolescent idiopathic scoliosis.
Prospective controlled cohort observational study.
Seventy-four consecutive outpatients with adolescent idiopathic scoliosis, mean 15 degrees (standard deviation 6) Cobb angle, 12.4 (standard deviation 2.2) years old, at risk of bracing who had not been treated previously.
Thirty-five patients were included in the SEAS exercises group and 39 in the usual physiotherapy group. The primary outcome included the number of braced patients, Cobb angle and the angle of trunk rotation.
There were 6.1% braced patients in the SEAS exercises group vs 25.0% in the usual physiotherapy group. Failures of treatment in the worst-case analysis were 11.5% and 30.8%, respectively. In both cases the differences were statistically significant. Cobb angle improved in the SEAS exercises group, but worsened in the usual physiotherapy group. In the SEAS exercises group, 23.5% of patients improved and 11.8% worsened, while in the usual physiotherapy group 11.1% improved and 13.9% worsened.
These data confirm the effectiveness of exercises in patients with scoliosis who are at high risk of progression. Compared with non-adapted exercises, a specific and personalized treatment (SEAS) appears to be more effective.
比较科学脊柱侧弯运动疗法（SEAS）与“常规护理”康复计划在避免青少年特发性脊柱侧弯患者使用支具以及预防侧弯进展方面的效果。
前瞻性对照队列观察研究。
74例连续的青少年特发性脊柱侧弯门诊患者，平均Cobb角为15度（标准差6），年龄12.4岁（标准差2.2），有使用支具的风险且此前未接受过治疗。
35例患者纳入SEAS运动疗法组，39例纳入常规物理治疗组。主要结局包括使用支具的患者数量、Cobb角和躯干旋转角度。
SEAS运动疗法组使用支具的患者为6.1%，而常规物理治疗组为25.0%。在最坏情况分析中，治疗失败率分别为11.5%和30.8%。两种情况的差异均具有统计学意义。SEAS运动疗法组的Cobb角有所改善，而常规物理治疗组则恶化。在SEAS运动疗法组中，23.5%的患者病情改善，11.8%的患者病情恶化，而在常规物理治疗组中，11.1%的患者病情改善，13.9%的患者病情恶化。
这些数据证实了运动疗法对有高度进展风险的脊柱侧弯患者的有效性。与非适应性运动相比，一种特定的个性化治疗（SEAS）似乎更有效。
