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稳定输入压力矫形背心(基于莱卡的加压矫形器)能否改善脑瘫患儿的躯干姿势并防止髋关节侧移?

Does stabilizing input pressure orthosis vest, lycra-based compression orthosis, improve trunk posture and prevent hip lateralization in children with cerebral palsy?

作者信息

Giray Esra, Keniş-Coşkun Özge, Güngör Sabiha, Karadağ-Saygı Evrim

机构信息

Department of Physical Medicine and Rehabilitation, Marmara University School of Medicine, İstanbul, Turkey.

出版信息

Turk J Phys Med Rehabil. 2017 Dec 15;64(2):100-107. doi: 10.5606/tftrd.2018.1332. eCollection 2018 Jun.

Abstract

OBJECTIVES

This study aims to investigate whether the use of a lycra-based compression orthosis known as stabilizing input pressure orthosis (SPIO) vest improves trunk posture and hip lateralization in children with cerebral palsy (CP) and to compare the effects of two- and six-hours daily wear of the orthosis.

PATIENTS AND METHODS

Between December 2013 and July 2015, a total of 24 children with CP (5 boys, 19 girls; mean age 61.1 months; range 35 to 105 months) with impaired trunk control were included in this single-blind, randomized-controlled study. All were randomized to either of the three groups as the control group (received only conventional exercise therapy), the SPIO 2-hour group (worn orthosis two hours during therapy), and the SPIO 6-hour group (worn orthosis four hours in addition to two hours of wear during therapy). The Sitting Assessment Scale (SAS), Cobb angle, kyphotic angle, and Migration Index were used to evaluate the trunk posture and hip lateralization before treatment and at six months after treatment.

RESULTS

The SAS scores improved compared to baseline in all groups. The Cobb angle and kyphotic angle showed a significant decrease at six months after treatment only in the SPIO groups, while intra-group analysis of the Migration Index did not show a statistically significant difference. Changes in the radiographic assessments were similar among the groups, except for the kyphotic angles. The kyphotic angle showed less change in the control group. Comparison of the SPIO groups showed no significant differences in terms of the variables assessed.

CONCLUSION

The SPIO vest improves the kyphotic posture, but not scoliosis and hip lateralization in children with CP with impaired trunk control when used in combination with the conventional therapy. Using the SPIO vest for two and six hours also yields similar outcomes.

摘要

目的

本研究旨在调查一种名为稳定输入压力矫形器(SPIO)背心的莱卡材质加压矫形器是否能改善脑瘫(CP)患儿的躯干姿势和髋关节侧移,并比较该矫形器每日穿戴两小时和六小时的效果。

患者与方法

在2013年12月至2015年7月期间,本单盲随机对照研究纳入了24名躯干控制受损的CP患儿(5名男孩,19名女孩;平均年龄61.1个月;范围35至105个月)。所有患儿被随机分为三组,即对照组(仅接受传统运动疗法)、SPIO两小时组(在治疗期间穿戴矫形器两小时)和SPIO六小时组(除治疗期间穿戴两小时外,还额外穿戴四小时)。使用坐位评估量表(SAS)、Cobb角、后凸角和移位指数在治疗前及治疗后六个月评估躯干姿势和髋关节侧移情况。

结果

与基线相比,所有组的SAS评分均有所改善。仅在SPIO组中,治疗后六个月时Cobb角和后凸角显著减小,而组内移位指数分析未显示出统计学上的显著差异。除后凸角外,各组间影像学评估的变化相似。对照组的后凸角变化较小。SPIO组之间在评估变量方面无显著差异。

结论

当与传统疗法联合使用时,SPIO背心可改善躯干控制受损的CP患儿的后凸姿势,但不能改善脊柱侧弯和髋关节侧移。使用SPIO背心两小时和六小时也产生相似的结果。

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