Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
Physiotherapy. 2019 Jun;105(2):214-234. doi: 10.1016/j.physio.2018.10.004. Epub 2018 Oct 27.
Systematic review and meta-analysis.
To assess the effectiveness of scoliosis-specific exercises (SSE) on adolescent idiopathic scoliosis (AIS) compared with other non-surgical interventions.
AIS is a complex deformity of the spine that develops between the age of 10years and skeletal maturity. SSE are prescribed to patients to reduce or slow curve progression, although their effectiveness is unknown.
Electronic databases were searched for relevant studies. Randomised controlled trials were eligible if they compared SSE with non-surgical interventions for individuals with AIS. Three authors independently extracted data, evaluated methodological quality and assessed the quality of evidence. Meta-analysis was performed where possible; otherwise, descriptive syntheses are reported.
Nine randomised controlled trials were included. Four had a high risk of bias, three had an unclear risk and two had a low risk. Very-low-quality evidence indicated that SSE improved some measures of spinal deformity, function, pain and overall health-related quality of life (HRQoL). Very-low-quality evidence suggested that SSE had no effect on self-image and mental health. Very-low-quality evidence showed that bracing was more effective than SSE on measures of spinal deformity. However, SSE showed greater improvements in function, HRQoL, self-image, mental health and patient satisfaction with treatment. No differences were found for pain or trunk rotation.
SSE may be effective for improving measures of spinal deformity for people with AIS, but the evidence is of very low quality. Future studies should evaluate relevant clinical measures and cost-effectiveness using rigorous methods and reporting standards.
系统评价和荟萃分析。
评估脊柱侧凸特定运动（SSE）与其他非手术干预措施相比，在青少年特发性脊柱侧凸（AIS）中的有效性。
AIS 是一种脊柱的复杂畸形，在 10 岁至骨骼成熟期间发展。SSE 被规定用于患者以减少或减缓曲线进展，尽管其效果尚不清楚。
电子数据库中搜索了相关研究。如果随机对照试验将 SSE 与 AIS 患者的非手术干预进行比较，则符合纳入标准。三位作者独立提取数据、评估方法学质量，并评估证据质量。如果可能，进行荟萃分析；否则，报告描述性综合分析。
纳入了 9 项随机对照试验。其中 4 项研究存在高偏倚风险，3 项研究存在不确定偏倚风险，2 项研究存在低偏倚风险。极低质量证据表明，SSE 改善了一些脊柱畸形、功能、疼痛和整体健康相关生活质量（HRQoL）的测量指标。极低质量证据表明 SSE 对自我形象和心理健康没有影响。极低质量证据表明，支具在脊柱畸形的测量指标上比 SSE 更有效。然而，SSE 在功能、HRQoL、自我形象、心理健康和患者对治疗的满意度方面显示出更大的改善。在疼痛或躯干旋转方面没有发现差异。
SSE 可能对改善 AIS 患者的脊柱畸形测量指标有效，但证据质量极低。未来的研究应使用严格的方法和报告标准，评估相关的临床指标和成本效益。
