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在支具撤离期进行特定锻炼可避免青少年特发性脊柱侧凸(AIS)患者的矫正丢失:获2008年SOSORT最佳临床论文奖。

Specific exercises performed in the period of brace weaning can avoid loss of correction in Adolescent Idiopathic Scoliosis (AIS) patients: Winner of SOSORT's 2008 Award for Best Clinical Paper.

作者信息

Zaina Fabio, Negrini Stefano, Atanasio Salvatore, Fusco Claudia, Romano Michele, Negrini Alessandra

机构信息

ISICO Milano, Milan, Italy.

出版信息

Scoliosis. 2009 Apr 7;4:8. doi: 10.1186/1748-7161-4-8.

Abstract

BACKGROUND

Exercises are frequently performed in order to improve the efficacy of bracing and avoid its collateral effects. Very frequently there is a loss of correction during brace weaning in AIS treatment.

AIM

To verify the efficacy of exercises in reducing correction loss during brace weaning.

STUDY DESIGN

Retrospective controlled study.

POPULATION

Sixty-eight consecutive patients (eight males), age 15 +/- 1 and Cobb angle 22 +/- 8 degrees at start of brace weaning.

METHODS

The start of brace weaning was defined as the first visit in which the wearing of brace for less than 18/24 hours was prescribed (according to our protocol, at Risser 3). Patients were divided into two groups according to whether or not exercises were performed: (1) EX (exercises), included 39 patients and was further divided into two sub-groups: SEAS (who performed exercises according to our institute's protocol, 14 patients) and OTH (other exercises, 25 patients) and (2) CON (controls, 29 patients) that was divided into two other sub-groups: DIS (discontinuous exercises, 19 patients) and NO (no exercises, 10 patients). Complete brace weaning was defined as the first visit in which the brace was no longer prescribed (ringapophysis closure or Risser 5, according to our protocol). ANOVA and Chi Square tests were performed.

RESULTS

There was no difference between groups at baseline. However, at the end of treatment, 2.7 years after the start of the weaning process, Cobb angle increased significantly in both the DIS and NO groups (3.9 degrees and 3.1 degrees Cobb, respectively). The SEAS and OTH groups did not change. Comparing single groups, OTH (with respect to DIS) had a significant difference (P < 0.05).

CONCLUSION

Exercises can help reduce the correction loss in brace weaning for AIS.

摘要

背景

经常进行锻炼以提高支具治疗的效果并避免其副作用。在特发性脊柱侧凸(AIS)治疗中,支具停用期间经常出现矫正丢失。

目的

验证锻炼在减少支具停用期间矫正丢失方面的效果。

研究设计

回顾性对照研究。

研究对象

68例连续患者(8例男性),支具停用开始时年龄15±1岁,Cobb角22±8度。

方法

支具停用开始定义为首次就诊时规定支具佩戴时间少于18/24小时(根据我们的方案,Risser 3级时)。根据是否进行锻炼将患者分为两组:(1)锻炼组(EX),包括39例患者,进一步分为两个亚组:SEAS(按照我们机构的方案进行锻炼,14例患者)和OTH(其他锻炼方式,25例患者);(2)对照组(CON),29例患者,分为另外两个亚组:DIS(间断锻炼,19例患者)和NO(不锻炼,10例患者)。完全停用支具定义为首次就诊时不再开具支具(根据我们的方案,椎弓根间骨桥闭合或Risser 5级)。进行方差分析和卡方检验。

结果

基线时两组之间无差异。然而,在治疗结束时,即停用过程开始2.7年后,DIS组和NO组的Cobb角均显著增加(分别增加3.9度和3.1度Cobb角)。SEAS组和OTH组未发生变化。比较单个组时,OTH组(相对于DIS组)有显著差异(P<0.05)。

结论

锻炼有助于减少AIS患者支具停用期间的矫正丢失。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ceb1/2672077/d8c176729e3c/1748-7161-4-8-2.jpg

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