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主动自我矫正和以任务为导向的锻炼可减少轻度青少年特发性脊柱侧弯患者的脊柱畸形并改善其生活质量。一项随机对照试验的结果。

Active self-correction and task-oriented exercises reduce spinal deformity and improve quality of life in subjects with mild adolescent idiopathic scoliosis. Results of a randomised controlled trial.

作者信息

Monticone Marco, Ambrosini Emilia, Cazzaniga Daniele, Rocca Barbara, Ferrante Simona

机构信息

Physical Medicine and Rehabilitation Unit, Scientific Institute of Lissone, Salvatore Maugeri Foundation, Institute of Care and Research, IRCCS, Via Monsignor Bernasconi, 16, Lissone, 20035, Milan, Italy,

出版信息

Eur Spine J. 2014 Jun;23(6):1204-14. doi: 10.1007/s00586-014-3241-y. Epub 2014 Feb 28.

Abstract

PURPOSE

To evaluate the effect of a programme of active self-correction and task-oriented exercises on spinal deformities and health-related quality of life (HRQL) in patients with mild adolescent idiopathic scoliosis (AIS) (Cobb angle <25°).

METHODS

This was a parallel-group, randomised, superiority-controlled study in which 110 patients were randomly assigned to a rehabilitation programme consisting of active self-correction, task-oriented spinal exercises and education (experimental group, 55 subjects) or traditional spinal exercises (control group, 55 subjects). Before treatment, at the end of treatment (analysis at skeletal maturity), and 12 months later (follow-up), all of the patients underwent radiological deformity (Cobb angle), surface deformity (angle of trunk rotation) and HRQL evaluations (SRS-22 questionnaire). A linear mixed model for repeated measures was used for each outcome measure.

RESULTS

There were main effects of time (p < 0.001), group (p < 0.001) and time by group interaction (p < 0.001) on radiological deformity: training in the experimental group led to a significant improvement (decrease in Cobb angle of >5°), whereas the control group remained stable. Analysis of all of the secondary outcome measures revealed significant effects of time, group and time by group interaction in favour of the experimental group.

CONCLUSIONS

The programme of active self-correction and task-oriented exercises was superior to traditional exercises in reducing spinal deformities and enhancing the HRQL in patients with mild AIS. The effects lasted for at least 1 year after the intervention ended.

摘要

目的

评估主动自我矫正和任务导向性锻炼方案对轻度青少年特发性脊柱侧凸(AIS)(Cobb角<25°)患者脊柱畸形及健康相关生活质量(HRQL)的影响。

方法

这是一项平行组、随机、优效性对照研究,110例患者被随机分配至一个康复方案,该方案包括主动自我矫正、任务导向性脊柱锻炼和教育(实验组,55例受试者)或传统脊柱锻炼(对照组,55例受试者)。在治疗前、治疗结束时(骨骼成熟时分析)以及12个月后(随访),所有患者均接受了放射学畸形(Cobb角)、体表畸形(躯干旋转角)和HRQL评估(SRS-22问卷)。对每个结局指标使用重复测量的线性混合模型。

结果

时间(p<0.001)、组间(p<0.001)以及时间与组间交互作用(p<0.001)对放射学畸形均有主要影响:实验组的训练导致显著改善(Cobb角减小>5°),而对照组保持稳定。对所有次要结局指标的分析显示,时间、组间以及时间与组间交互作用均有显著影响,有利于实验组。

结论

主动自我矫正和任务导向性锻炼方案在减轻轻度AIS患者的脊柱畸形和提高HRQL方面优于传统锻炼。干预结束后,效果持续至少1年。

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