基于人体工程学的任务导向运动计划对青少年特发性脊柱侧弯患者Cobb角及肺功能改善的疗效——一项随机对照试验
Efficacy of Task Oriented Exercise Program Based on Ergonomics on Cobb's Angle and Pulmonary Function Improvement in Adolescent Idiopathic Scoliosis- A Randomized Control Trial.
作者信息
Kumar Arvind, Kumar Santosh, Sharma Vineet, Srivastava R N, Gupta Anil Kumar, Parihar Anit, Verma Vikas, Kumar Dileep
机构信息
Assistant Professor, Department of Physical Medicine and Rehabilitation, King George's Medical University, Lucknow, Uttar Pradesh, India.
Professor, Department of orthopaedic Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India.
出版信息
J Clin Diagn Res. 2017 Aug;11(8):YC01-YC04. doi: 10.7860/JCDR/2017/27497.10335. Epub 2017 Aug 1.
INTRODUCTION
Scoliosis is lateral curvature of the spine greater than 100 accompanied by vertebral rotation. The prime risk factors for curve progression are a large curve magnitude, skeletal immaturity and female gender. The curve progression can be recorded by measuring the curve magnitude using the Cobb's method on radiographs.
AIM
To assess the effect of task oriented exercises based on ergonomics on Cobb's angle and pulmonary functions on one year outcome of Adolescent Idiopathic Scoliosis(AIS) (defined as curves < 150 for thoracolumbar region and < 200 for thoracic region).
MATERIALS AND METHODS
A total of 36 patients were enrolled in the study and 18 patients in each group (experimental and control group) were allocated randomly. The subjects in control group underwent spinal strengthening exercises, active self-correction and breathing exercises, whereas subjects in the experimental group followed task oriented exercises based on ergonomics in addition to exercises for conventional group for one year. Chi square test was used to compare the categorical/ dichotomous variables between the groups. Unpaired t-test was used to compare continuous variables between the groups at pre and post intervention. Paired t-test was used to compare the changes in continuous variables from pre to post intervention within the group.
RESULTS
Forced Vital Capacity (FVC) was found to be significantly (p=0.001) higher in experimental group (2.68±0.37) than control group (2.20±0.41) at post-intervention. Force Expritatory Volume 1 (FEV1) (p=0.01) and Vital Capacity (VC) (p=0.002) were also found to be significantly higher in experimental group compared to control group at postintervention. Also, there was significant (p=0.001) mean reduction in Cobb's angle from pre to post intervention in both the groups being higher in Experimental group than control group.
CONCLUSION
The task oriented exercise protocol benefited patients with AIS which had a significant improvement of their pulmonary functions and Cobb's angle.
引言
脊柱侧弯是指脊柱侧弯超过10°并伴有椎体旋转。侧弯进展的主要危险因素包括侧弯角度大、骨骼未成熟和女性性别。通过在X线片上使用Cobb法测量侧弯角度可以记录侧弯进展情况。
目的
评估基于人体工程学的任务导向性锻炼对青少年特发性脊柱侧弯（AIS）（胸腰段侧弯<15°、胸段侧弯<20°）患者一年期Cobb角和肺功能的影响。
材料与方法
共纳入36例患者，随机分为两组，每组18例（实验组和对照组）。对照组患者进行脊柱强化锻炼、主动自我矫正和呼吸锻炼，而实验组患者除进行常规组锻炼外，还进行基于人体工程学的任务导向性锻炼，为期一年。采用卡方检验比较两组间的分类/二分变量。采用非配对t检验比较干预前后两组间的连续变量。采用配对t检验比较组内干预前后连续变量的变化。
结果
干预后，实验组的用力肺活量（FVC）（2.68±0.37）显著高于对照组（2.20±0.41）（p=0.001）。干预后，实验组的第1秒用力呼气量（FEV1）（p=0.01）和肺活量（VC）（p=0.002）也显著高于对照组。此外，两组干预前后Cobb角均有显著的平均减小（p=0.001），且实验组减小幅度高于对照组。
结论
基于任务导向的锻炼方案对AIS患者有益，可显著改善其肺功能和Cobb角。
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