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肌肉骨骼系统的参与及其对囊性纤维化儿童和青年患者姿势稳定性的影响。

The involvement of musculoskeletal system and its influence on postural stability in children and young adults with cystic fibrosis.

机构信息

Semsi Denizer Cad Dr Lutfi Kirdar Kartal Research and Training Hospital, Physical Medicine and Rehabilitation Department Istanbul, 34890, Istanbul, Turkey.

Marmara University Medical Faculty Physical Medicine and Rehabilitation Department Istanbul, Istanbul, Turkey.

出版信息

Ital J Pediatr. 2017 Nov 21;43(1):106. doi: 10.1186/s13052-017-0426-0.

Abstract

BACKGROUND

Cystic fibrosis (CF) affects the musculoskeletal system via a multifactorial pathway that includes vitamin D deficiency and involvement of respiratory muscles such as intercostals due to recurrent upper and lower respiratory tract infections. Eventual result is the deterioration of musculoskeletal health and posture in CF patients. Postural stability is directly affected by posture and can be compromised in every musculoskeletal problem. The aim of this study is to evaluate musculoskeletal system and postural stability in patients with CF.

METHODS

Patients with CF over six years of age and age and sex-matched control groups were included in the study. Cobb angle and thoracic kyphosis angles were measured on the spine radiographs. Both patients and control group were examined with pediatric gait, arms, legs and spine scale (pGALS). They also were evaluated with a NeuroCom Balance Master for their postural stability.

RESULTS

Fifty-one patients with CF and 94 healthy controls participated in the study. In results of the pGALS examination, CF group had significantly more pathological findings than the control group in lower extremity appearance and movement (p = 0.006 and p = 0.01) and spine appearance and movement (p = 0.001 and p = 0.022) domains. The tandem walking speed was significantly higher in controls with a mean of 24.45 ± 7.79 while it was 20.47 ± 6.95 in the CF group (p = 0.03). Various limits of stability parameters also showed significant differences. Medium correlations were found between musculoskeletal examination and postural stability parameters.

CONCLUSION

In patients with CF, a systematic but simple musculoskeletal examination can detect pathologies, which are more frequent than the normal population. These pathologies show a medium correlation with the involvement of postural stability.

摘要

背景

囊性纤维化(CF)通过多因素途径影响肌肉骨骼系统,包括维生素 D 缺乏以及由于反复的上下呼吸道感染而导致呼吸肌(如肋间肌)受累。最终结果是 CF 患者的肌肉骨骼健康和姿势恶化。姿势稳定性直接受到姿势的影响,并且在每个肌肉骨骼问题中都可能受到影响。本研究旨在评估 CF 患者的肌肉骨骼系统和姿势稳定性。

方法

将年龄超过 6 岁的 CF 患者和年龄、性别匹配的对照组纳入研究。在脊柱 X 光片上测量 Cobb 角和胸椎后凸角。对患者和对照组均进行儿科步态、手臂、腿部和脊柱评分(pGALS)检查。他们还使用 NeuroCom Balance Master 评估他们的姿势稳定性。

结果

51 名 CF 患者和 94 名健康对照组参加了这项研究。在 pGALS 检查结果中,CF 组在下肢外观和运动(p=0.006 和 p=0.01)和脊柱外观和运动(p=0.001 和 p=0.022)领域的病理性发现明显多于对照组。对照组的并足行走速度明显更高,平均值为 24.45±7.79,而 CF 组为 20.47±6.95(p=0.03)。各种稳定性参数的限制也显示出显著差异。肌肉骨骼检查与姿势稳定性参数之间存在中等相关性。

结论

在 CF 患者中,系统但简单的肌肉骨骼检查可以发现比正常人群更常见的病变。这些病变与姿势稳定性的参与呈中度相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1bb9/5696729/dae15bea9eae/13052_2017_426_Fig1_HTML.jpg

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