Wnuk Bartosz, Blicharska Irmina, Błaszczak Edward, Durmała Jacek
School of Health Sciences in Katowice, Department of Rehabilitation, Medical University of Silesia in Katowice, Poland.
Department of Medical Biophysics, Medical University of Silesia in Katowice, Poland.
Ortop Traumatol Rehabil. 2015 Jul-Aug;17(4):343-50. doi: 10.5604/15093492.1173376.
The use of manual therapy in the treatment of scoliosis has been controversial. Scientific reports do not clearly indicate its effectiveness or harmfulness. The aim of this study was to determine the effectiveness of passive and active derotation techniques of manual therapy according to Kaltenborn-Evjent on the reduction of the angle of trunk rotation in patients with idiopathic scoliosis.
The study enrolled 33 female patients from the Department of Rehabilitation who were diagnosed with adolescent idiopathic scoliosis. The patients were divided into two groups according to the curve location (SRS classification). Group A consisted of 17 women, aged 14.±2.4 years, with single-curve scoliosis in the thoracolumbar segment and group B was composed of 16 women, aged 15±2.24 years, with double-curve scoliosis in the thoracic and lumbar segments. In both groups, the angle of trunk rotation, the magnitude of thoracic kyphosis and lumbar lordosis were measured twice, before and after each session of derotation techniques.
Both groups demonstrated a positive impact of active and passive derotation techniques on the angle of trunk inclination. The greatest difference was observed after a session of active derotation in the patients with lumbar scoliosis. The angle of trunk rotation decreased on average by 4.5°±1.14°. No correlations were found between the curve angle values and the degree of thoracic derotation after the application of these techniques.
Derotational mobilization techniques may be a valuable complement to scoliosis treatment methods as they increase their effectiveness.
手法治疗在脊柱侧弯治疗中的应用一直存在争议。科学报告并未明确表明其有效性或危害性。本研究的目的是根据卡尔滕伯恩 - 埃文特手法，确定手法治疗的被动和主动旋转技术对特发性脊柱侧弯患者躯干旋转角度减小的有效性。
本研究纳入了康复科的33名女性患者，她们被诊断为青少年特发性脊柱侧弯。根据侧弯位置（SRS分类）将患者分为两组。A组由17名女性组成，年龄为14.±2.4岁，患有胸腰段单曲线脊柱侧弯；B组由16名女性组成，年龄为15±2.24岁，患有胸段和腰段双曲线脊柱侧弯。在两组中，在每次旋转技术治疗前后，均测量两次躯干旋转角度、胸段后凸和腰段前凸的大小。
两组均显示主动和被动旋转技术对躯干倾斜角度有积极影响。在腰段脊柱侧弯患者进行一次主动旋转治疗后观察到最大差异。躯干旋转角度平均降低了4.5°±1.14°。应用这些技术后，曲线角度值与胸段旋转程度之间未发现相关性。
旋转松动技术可能是脊柱侧弯治疗方法的一种有价值的补充，因为它们提高了治疗效果。
