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脊柱畸形康复——最新综述

Spinal deformities rehabilitation - state of the art review.

作者信息

Weiss Hans-Rudolf

机构信息

Orthopedic Rehabilitation Services, D-55457 Gensingen, Alzeyerstr, 23, Germany.

出版信息

Scoliosis. 2010 Dec 24;5:28. doi: 10.1186/1748-7161-5-28.

Abstract

BACKGROUND

Medical rehabilitation aims at an improvement in function, capacity and participation. For the rehabilitation of spinal deformities, the goal is to maintain function and prevent secondary symptoms in the short- and long-term. In patients with scoliosis, predictable signs and symptoms include pain and reduced pulmonary function.

MATERIALS AND METHODS

A Pub Med review was completed in order to reveal substantial evidence for inpatient rehabilitation as performed in Germany. No evidence has been found in general to support claims for actual inpatient rehabilitation programmes as used today. Nevertheless, as there is some evidence that inpatient rehabilitation may be beneficial to patients with spinal deformities complicated by certain additional conditions, the body of evidence there is for conservative treatment of spinal deformities has been reviewed in order to allow suggestions for outpatient conservative treatment and inpatient rehabilitation.

DISCUSSION

Today, for both children and adolescents, we are able to offer intensive rehabilitation programmes lasting three to five days, which enable the patients to acquire the skills necessary to prevent postures fostering scoliosis in everyday life without missing too much of school teaching subjects at home. The secondary functional impairments adult scoliosis patients might have, as in the opinion of the author, still today require the time of 3-4 weeks in the clinical in-patient setting. Time to address psychosocial as well as somatic limitations, namely chronic pains and cardiorespiratory malfunction is needed to preserve the patients working capability in the long-term.

CONCLUSION

Outpatient treatment/rehabilitation is sufficient for adolescents with spinal deformities.Inpatient rehabilitation is recommended for patients with spinal deformities and pain or severe restrictive ventilation disorder.

摘要

背景

医学康复旨在改善功能、能力和参与度。对于脊柱畸形的康复,目标是在短期和长期内维持功能并预防继发症状。在脊柱侧弯患者中,可预测的体征和症状包括疼痛和肺功能下降。

材料与方法

完成了一项PubMed综述,以揭示德国住院康复的实质性证据。总体而言,未找到支持当今所用实际住院康复计划主张的证据。然而,由于有一些证据表明住院康复可能对合并某些其他病症的脊柱畸形患者有益,因此对脊柱畸形保守治疗的证据进行了综述,以便为门诊保守治疗和住院康复提供建议。

讨论

如今,对于儿童和青少年,我们能够提供为期三到五天的强化康复计划,使患者能够掌握在日常生活中预防导致脊柱侧弯姿势所需的技能,而不会错过太多家中的学校教学科目。作者认为,成年脊柱侧弯患者可能存在的继发功能障碍,如今在临床住院环境中仍需要三到四周的时间。需要时间来解决心理社会以及躯体限制,即慢性疼痛和心肺功能障碍,以长期保持患者的工作能力。

结论

门诊治疗/康复对脊柱畸形青少年足够。对于伴有疼痛或严重限制性通气障碍的脊柱畸形患者,建议进行住院康复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/09a4/3023759/1ae949ae4ece/1748-7161-5-28-1.jpg

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