Kim Dong-Ki, Kim Chang-Yong, Lee Byoung-Kwon, Seo Dongkwon
Rehabilitation and Pain Clinic, Daejeon, Korea.
Facilities and Equipment Policy Team, National Research Facilities and Equipment Center, Korea Basic Science Institute, Daejeon, Korea.
J Back Musculoskelet Rehabil. 2018 Feb 6;31(1):65-74. doi: 10.3233/BMR-169667.
Many studies have shown asymmetric behavior of the surface and deep layers of spine muscles in scoliosis patients, compared to normal individuals. However, there is a lack of research on the transversus abdominal (TA) muscle, which plays an important role in trunk stabilization.
To assess symmetry in subjects with adolescent idiopathic scoliosis (AIS) by measuring the thickness of abdominal muscles, and to investigate characteristic features through a comparative analysis of the data with healthy aged-matched group.
Subjects consisted of 33 AIS and 32 healthy subjects of similar ages between 11-28 years old. We measured TA, internal abdominal oblique (IO), and external abdominal oblique (EO) muscles were measured using ultrasonography imaging. Three repeat measurements of the thickness of each muscle were performed during rest and contraction.
For the healthy subjects, the intra-class correlation coefficients (ICCs) for the muscle thickness measures ranged from 0.70 to 0.99, standard error of measurement (SEM) was 0.38 cm, and minimal detectable change (MDC) was 1.07 cm. The ICCs for the muscle thickness measures in the AIS group ranged from 0.90 to 0.98, SEM was 0.45 cm, and MDC was 1.24 cm. The symmetry of the two groups was compared, and showed significant difference only in TA in AIS patient group (P< 0.01).
In conclusion, treatment should be focused on exercises that emphasize symmetry, to induce normal action of the TA and structural changes in the spine because AIS induces asymmetry in TA, which plays an important role in trunk stability.
许多研究表明,与正常人相比,脊柱侧弯患者脊柱肌肉表层和深层存在不对称行为。然而,对在躯干稳定中起重要作用的腹横肌(TA)的研究较少。
通过测量腹部肌肉厚度评估青少年特发性脊柱侧弯(AIS)患者的对称性,并通过与年龄匹配的健康组数据进行对比分析来研究其特征。
研究对象包括33例AIS患者和32例年龄在11至28岁之间的年龄匹配的健康受试者。我们使用超声成像测量TA、腹内斜肌(IO)和腹外斜肌(EO)。在休息和收缩期间对每块肌肉的厚度进行三次重复测量。
对于健康受试者,肌肉厚度测量的组内相关系数(ICC)范围为0.70至0.99,测量标准误差(SEM)为0.38厘米,最小可检测变化(MDC)为1.07厘米。AIS组肌肉厚度测量的ICC范围为0.90至0.98,SEM为0.45厘米,MDC为1.24厘米。比较两组的对称性,发现仅AIS患者组的TA存在显著差异(P<0.01)。
总之,治疗应侧重于强调对称性的锻炼,以诱导TA的正常作用和脊柱的结构变化,因为AIS会导致TA不对称,而TA在躯干稳定中起重要作用。