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腰椎峡部裂患儿的身体特征及康复效果

Physical features of pediatric patients with lumbar spondylolysis and effectiveness of rehabilitation.

作者信息

Iwaki Koichi, sakai Toshinori, Hatayama Daisuke, Hayashi Yohei, Inoue Nanae, Mitsumoto Miyuki, Hattori Yusuke, Goto Tsuyoshi, Sairyo Koichi, Tsuji Shuichiro

机构信息

Department of Rehabilitation, Tsuji Hideki Orthopedics.

Department of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School.

出版信息

J Med Invest. 2018;65(3.4):177-183. doi: 10.2152/jmi.65.177.

Abstract

The purpose of this study was to evaluate the physical features of pediatric patients with lumbar spondylolysis (LS), factors that increase the load during compensatory movements at the lumbar spine, and the outcomes of rehabilitation. Twenty patients were included. Fifteen items were used:fingertip-to-floor distance (FFD), straight leg raising (SLR), heel-to-buttock distance (HBD), tightness of the rectus femoris, the lateral and medial rotator muscles, iliopsoas, tensor fascia lata, adductor muscles, soleus muscle, and latissimus dorsi, and trunk rotation, sit-ups and endurance of the abdominal and back muscles. Initial findings were judged as positive or negative using previously reported cut-off values and were re-evaluated 2 or 3 months later. Positive tests were found for HBD and tightness of the rectus femoris in 85% of the patients, for endurance of the abdominal muscles in 75%, SLR and sit-ups in 70%, and FFD and tightness of the external rotator muscles in 60%. The physical features varied according to the type of sport played, and some patients were refractory to rehabilitation. Only 17.6%, 33.3%, and 40.0% of patients with initially positive findings for HBD, tightness of the external rotator muscles, and endurance of the abdominal muscles, respectively, achieved improvements after rehabilitation. J. Med. Invest. 65:177-183, August, 2018.

摘要

本研究旨在评估腰椎峡部裂(LS)患儿的身体特征、腰椎代偿运动时增加负荷的因素以及康复效果。共纳入20例患者。采用了15项指标:指尖至地面距离(FFD)、直腿抬高(SLR)、足跟至臀部距离(HBD)、股直肌、外旋肌和内旋肌、髂腰肌、阔筋膜张肌、内收肌、比目鱼肌和背阔肌的紧张度,以及躯干旋转、仰卧起坐和腹部及背部肌肉耐力。根据先前报道的临界值将初始结果判定为阳性或阴性,并在2或3个月后重新评估。85%的患者HBD和股直肌紧张度检查呈阳性,75%的患者腹部肌肉耐力检查呈阳性,70%的患者SLR和仰卧起坐检查呈阳性,60%的患者FFD和外旋肌紧张度检查呈阳性。身体特征因所从事的运动类型而异,部分患者对康复治疗反应不佳。最初HBD、外旋肌紧张度和腹部肌肉耐力检查呈阳性的患者,康复后分别仅有17.6%、33.3%和40.0%有所改善。《医学调查杂志》65:177 - 183,2018年8月。

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