Šarčević Zoran, Tepavčević Andreja
Novi Sad Health Care Centre, Sports Medicine Centre.
University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia.
Medicine (Baltimore). 2019 Apr;98(15):e15161. doi: 10.1097/MD.0000000000015161.
Adolescent idiopathic scoliosis (AIS) is the most common form of scoliosis, a 3-dimensional deviation in the axis of the spine. Etiology of AIS is unclear and the general belief is that AIS is multifactorial disorder possibly caused by different factors. It would be worthwhile to reveal new factors associated with AIS. The present study aimed to investigate association between sacroiliac joint (SIJ) dysfunction and AIS in young athletes.This case-control study included 196 children athletes (basketball, football, volleyball, handball, ballet, and others), 82 males and 114 females aged 8 to 17, 98 of them with the diagnosis of AIS. The case group consisted of young athletes examined at a regular checkup by a sport physician and diagnosed with AIS. The control group consisted of athletes matched to the case group according to sex, age, sports, number of training years and number of training hours per week, but without AIS.The scoliosis was diagnosed with Adams' forward bend test and the scoliometer measurement. The SIJ dysfunction was determined using the palpation meter (PALM) measuring the sagittal pelvic position in standing position and in standing position with the hip flexion angle of 90°. The data were analyzed using Student t test, Mann-Whitney U test, contingency coefficients, and logistic regression.The average difference in pelvic position in the sagittal plane (in standing position), with and without hip flexion 90° was found to be statistically different in the case and the control groups (t = 13.88, P = .00). There was a strong positive association between variables representing presence of AIS and SIJ dysfunction (determined by contingency coefficient C = 0.62, coefficient Phi = 0.79 and tetrachoric correlation coefficient 0.95).The logistic regression indicated that the average difference in pelvic position in the sagittal plane (in standing position), with and without hip flexion 90° was significantly associated with the probability of scoliosis in young athletes (P = .00, Wald test).There was a strong positive association between SIJ dysfunction and AIS in young athletes.
青少年特发性脊柱侧凸(AIS)是脊柱侧凸最常见的形式,即脊柱轴线的三维偏差。AIS的病因尚不清楚,普遍认为AIS是一种多因素疾病,可能由不同因素引起。揭示与AIS相关的新因素将是有价值的。本研究旨在调查年轻运动员骶髂关节(SIJ)功能障碍与AIS之间的关联。
这项病例对照研究纳入了196名儿童运动员(篮球、足球、排球、手球、芭蕾舞等项目),年龄在8至17岁之间,其中男性82名,女性114名,其中98人被诊断为AIS。病例组由在定期体检中接受运动医生检查并被诊断为AIS的年轻运动员组成。对照组由根据性别、年龄、运动项目、训练年限和每周训练小时数与病例组匹配,但无AIS的运动员组成。
脊柱侧凸通过亚当斯前屈试验和脊柱侧凸测量仪测量进行诊断。SIJ功能障碍通过触诊仪(PALM)确定,该仪器测量站立位以及髋关节屈曲90°站立位时骨盆的矢状位。数据采用学生t检验、曼-惠特尼U检验、列联系数和逻辑回归进行分析。
在病例组和对照组中,发现站立位时以及髋关节屈曲90°时矢状面骨盆位置的平均差异具有统计学意义(t = 13.88,P = 0.00)。代表AIS存在的变量与SIJ功能障碍之间存在强正相关(由列联系数C = 0.62、Phi系数 = 0.79和四分相关系数0.95确定)。
逻辑回归表明,站立位时以及髋关节屈曲90°时矢状面骨盆位置的平均差异与年轻运动员脊柱侧凸的概率显著相关(P = 0.00,Wald检验)。年轻运动员中SIJ功能障碍与AIS之间存在强正相关。