Zimoń Michalina, Matusik Edyta, Kapustka Bartosz, Durmała Jacek, Doroniewicz Iwona, Wnuk Bartosz
Wydział Nauk o Zdrowiu, Katedra i Klinika Rehabilitacji Medycznej, Śląski Uniwersytet Medyczny w Katowicach.
Oddział Neurochirurgii, Szpital Wojewódzki nr 2 w Jastrzębiu Zdroju.
Psychiatr Pol. 2018 Apr 30;52(2):355-369. doi: 10.12740/PP/OnlineFirst/68744. Epub 2017 May 4.
The objective of the study was to evaluate the stress level in children and adolescents with idiopathic scoliosis (IS) treated conservatively using the Dobosiewicz Method (DoboMed) approach in correlation with the clinical parameters and brace therapy.
The study group (SG) comprised 63 patients (54 girls), in mean age 14.7 years. DoboMed approach was used in all studied patients (31 of them had also a brace (orhosis)). The clinical analysis included also body mass index (BMI) z-scores, age at diagnosis, spinal curvature location and the duration of brace correction. The patients completed the Bad Sobernheim Stress Questionnaire Deformity (BSSQ-Deformity) and Bad Sobernheim Stress Questionnaire Brace (BSSQ-Brace) questionnaires twice, ie., at the beginning and at the end of the hospitalization.
IS patients experienced low or moderate deformity-related stress (58.7% and 36.5% respectively). A significantly higher stress level (BSSQ-Deformity) was revealed in the combination therapy group compared to kinesiotherapy group (p<0.05). In brace wearers, the orthosis-related was higher than the deformity-related stress (p<0.0001). A significant correlation was observed between the BSSQ-Deformity score vs. age, BMI z-score and number of hospitalizations (p<0.05). Deformity stress level was significantly related to the Cobb's angle in both analyzing subgroups.
Stress level in IS patients is related to the severity of the disease irrespectively to the method of treatment. Brace wearing is a factor provoking and increasing stress level. Stress level related to bracing is higher than trunk deformity related. Higher stress levels were significantly correlated with age, BMI z-score and number of hospitalizations. Complex therapy should include also psychological support for young patients with IS.
本研究的目的是评估采用多博谢维奇方法（DoboMed）保守治疗的特发性脊柱侧凸（IS）儿童和青少年的压力水平，并将其与临床参数和支具治疗相关联。
研究组（SG）由63名患者（54名女孩）组成，平均年龄14.7岁。所有研究患者均采用DoboMed方法（其中31人还佩戴了支具）。临床分析还包括体重指数（BMI）z评分、诊断年龄、脊柱弯曲位置和支具矫正持续时间。患者在住院开始和结束时分别完成两次巴特索伯恩海姆压力问卷畸形版（BSSQ-Deformity）和巴特索伯恩海姆压力问卷支具版（BSSQ-Brace）。
IS患者经历的畸形相关压力较低或中等（分别为58.7%和36.5%）。与运动疗法组相比，联合治疗组的压力水平（BSSQ-Deformity）显著更高（p<0.05）。在佩戴支具的患者中，支具相关压力高于畸形相关压力（p<0.0001）。观察到BSSQ-Deformity评分与年龄、BMI z评分和住院次数之间存在显著相关性（p<0.05）。在两个分析亚组中，畸形压力水平均与Cobb角显著相关。
IS患者的压力水平与疾病严重程度相关，与治疗方法无关。佩戴支具是引发和增加压力水平的一个因素。支具相关压力水平高于躯干畸形相关压力水平。较高的压力水平与年龄、BMI z评分和住院次数显著相关。综合治疗还应包括为IS青少年患者提供心理支持。
