Yagci Gozde, Demirkiran Gokhan, Yakut Yavuz
1 Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey.
2 Department of Orthopaedics and Traumatology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
Prosthet Orthot Int. 2019 Aug;43(4):434-439. doi: 10.1177/0309364619839856. Epub 2019 Apr 4.
Despite the common use of braces to prevent curve progression in idiopathic scoliosis, their functional effects on respiratory mechanics have not been widely studied.
The objective was to determine the effects of bracing on pulmonary function in idiopathic scoliosis.
A total of 27 adolescents with a mean age of 14.5 ± 1.5 years and idiopathic scoliosis were included in the study. Pulmonary function evaluation included vital capacity, forced expiratory volume, forced vital capacity, maximum ventilator volume, peak expiratory flow, and respiratory muscle strengths, measured with a spirometer, and patient-reported degree of dyspnea. The tests were performed once prior to bracing and at 1 month after bracing (while the patients wore the brace).
Compared with the unbraced condition, vital capacity, forced expiratory volume, forced vital capacity, maximum ventilator volume, and peak expiratory flow values decreased and dyspnea increased in the braced condition. Respiratory muscle strength was under the norm in both unbraced and braced conditions, while no significant difference was found for these parameters between the two conditions.
The spinal brace for idiopathic scoliosis tended to reduce pulmonary functions and increase dyspnea symptoms (when wearing a brace) in this study. Special attention should be paid in-brace effects on pulmonary functions in idiopathic scoliosis.
Bracing seems to mimic restrictive pulmonary disease, although there is no actual disease when the brace is removed. This study suggests that bracing may result in a deterioration of pulmonary function when adolescents with idiopathic scoliosis are wearing a brace.
尽管支具常用于预防特发性脊柱侧凸的曲线进展，但其对呼吸力学的功能影响尚未得到广泛研究。
本研究旨在确定支具对特发性脊柱侧凸患者肺功能的影响。
本研究共纳入27例平均年龄为14.5±1.5岁的特发性脊柱侧凸青少年患者。肺功能评估包括肺活量、用力呼气量、用力肺活量、最大通气量、呼气峰值流速和呼吸肌力量，使用肺活量计进行测量，并由患者报告呼吸困难程度。测试在佩戴支具前进行一次，佩戴支具1个月后（患者佩戴支具时）进行一次。
与未佩戴支具的情况相比，佩戴支具时肺活量、用力呼气量、用力肺活量、最大通气量和呼气峰值流速值下降，呼吸困难加重。在未佩戴支具和佩戴支具的情况下，呼吸肌力量均低于正常水平，且两种情况下这些参数无显著差异。
在本研究中，特发性脊柱侧凸的脊柱支具倾向于降低肺功能并增加呼吸困难症状（佩戴支具时）。应特别关注支具对特发性脊柱侧凸患者肺功能的影响。
支具似乎模拟了限制性肺病，尽管取下支具时并无实际疾病。本研究表明，特发性脊柱侧凸青少年患者佩戴支具时可能导致肺功能恶化。
