Institut des Sciences du Mouvement, UMR 6233 CNRS-Université de la Méditerranée, 163 avenue de Luminy, CP 910, 13288, Marseille Cedex 09, France.
Eur Spine J. 2011 Feb;20(2):247-53. doi: 10.1007/s00586-010-1574-8. Epub 2010 Sep 19.
The aim of this study was to determine the influence of the severity of the spinal curve on the postural regulation when self-imposed disturbances occur in a seated position in anteroposterior (AP) and mediolateral (ML) orientations. Twelve female adolescents with a right thoracic scoliosis (Cobb = 30.4° ± 9.7) were included in this study. The ground reaction forces (GRF) were studied while the subjects were maintaining their sitting on a seesaw (ML or AP destabilisation). Five conditions were tested: eyes open; with additional loads placed onto the subject's right or left shoulder; or onto the subject's right or left pelvis. We tested the correlation between the Cobb angle and the postural parameters (index of performance and GRF variability) for each condition. When the destabilisation was AP, the Cobb angle was significantly correlated with GRF variability and anterior and concavity index of performance. Two conditions showed higher correlations: stabilisation with the concavity pelvis load (GRF variability) and the open eyes (index of performance). In contrast, whatever the condition tested was, no link was found when the destabilisations were applied in ML direction. The destabilisation in a seated position highlights the influence of the curve severity on the postural organisation. In seated position, the postural control strategies specific to the scoliotic patients were always correlated by severity of curve, especially when the destabilisation is applied in AP directions. This study showed that the unstable seating position can be considered as a pertinent paradigm to help finding a postural clinical index for adolescent idiopathic scoliosis.
本研究旨在确定脊柱曲线严重程度对坐姿中自我施加的前后向(AP)和侧向(ML)干扰时姿势调节的影响。12 名患有右胸弯的女性青少年(Cobb = 30.4°±9.7°)被纳入本研究。在受试者坐在跷跷板上时(ML 或 AP 不稳定)研究地面反作用力(GRF)。测试了五种条件:睁眼;在受试者的右肩或左肩上加额外的负荷;或在受试者的右或左骨盆上加负荷。我们测试了 Cobb 角与每个条件的姿势参数(表现指数和 GRF 可变性)之间的相关性。当不稳定是 AP 时,Cobb 角与 GRF 可变性以及前凸和凹度表现指数显著相关。有两种情况显示出更高的相关性:使用凹骨盆负荷(GRF 可变性)和睁眼(表现指数)进行稳定。相比之下,无论测试的条件如何,当不稳定发生在 ML 方向时,都没有发现联系。坐姿不稳定突出了曲线严重程度对姿势组织的影响。在坐姿中,特发性脊柱侧凸患者的特定姿势控制策略始终与曲线严重程度相关,尤其是当不稳定发生在 AP 方向时。这项研究表明,不稳定的坐姿可以被认为是一个恰当的范例,可以帮助找到青少年特发性脊柱侧凸的姿势临床指标。