Servei de Pneumología, URMAR, Hospital del Mar, IMIM, CEXS, Universitat Pompeu Fabra, CIBER de Enfermedades Respiratorias (CIBERES), ISC III, Barcelona, Spain.
Eur Respir J. 2010 Aug;36(2):393-400. doi: 10.1183/09031936.00025509. Epub 2009 Dec 23.
Adolescent idiopathic scoliosis (AIS) can lead to ventilatory restriction, respiratory muscle weakness and exercise limitation. However, both the causes and the extent of muscle dysfunction remain unclear. The aim of our study is to describe muscle weakness and its relationship to lung function and tolerance to exercise in AIS patients. Lung and muscle function, together with exercise capacity, were assessed in 60 patients with pronounced spinal deformity (>40 degrees) and in 25 healthy volunteers. Patients with AIS had only mild to moderate abnormal ventilatory patterns, the most frequent of which were restrictive abnormalities. The function of respiratory and limb muscles and exercise capacity were below normal limits in AIS patients, and were significantly lower than in controls. Exercise capacity was found to correlate with the function of inspiratory, expiratory, upper limb and lower limb muscles which, in addition, were reciprocally interrelated. Multivariate analysis showed that lower limb muscle function is the main contributor to exercise intolerance. There appeared to be no connection between spinal deformity and lung function, muscle function or exercise capacity. We conclude that AIS patients show generalised muscle dysfunction which contributes to the reduction in their exercise capacity, even in the absence of severe ventilatory impairment.
青少年特发性脊柱侧凸（AIS）可导致通气受限、呼吸肌无力和运动受限。然而，肌肉功能障碍的原因和程度仍不清楚。我们的研究目的是描述 AIS 患者的肌肉无力及其与肺功能和运动耐量的关系。在 60 名脊柱畸形明显（>40 度）的患者和 25 名健康志愿者中评估了肺和肌肉功能以及运动能力。AIS 患者仅有轻度至中度异常通气模式，最常见的是限制性异常。AIS 患者的呼吸肌和肢体肌肉功能以及运动能力均低于正常范围，且明显低于对照组。运动能力与吸气、呼气、上肢和下肢肌肉的功能相关，此外，这些肌肉的功能也相互关联。多变量分析显示，下肢肌肉功能是运动不耐受的主要原因。脊柱畸形与肺功能、肌肉功能或运动能力之间似乎没有联系。我们的结论是，AIS 患者表现出全身性肌肉功能障碍，这导致其运动能力下降，即使在没有严重通气障碍的情况下也是如此。
