特定运动疗法对特发性脊柱侧凸青少年患者的影响：一项前瞻性对照队列研究。
Effects of Specific Exercise Therapy on Adolescent Patients With Idiopathic Scoliosis: A Prospective Controlled Cohort Study.
机构信息
Department of Spine Surgery, the 1st Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China.
Physical Education Institute, Chengdu University of Technology, Chengdu, China.
出版信息
Spine (Phila Pa 1976). 2020 Aug 1;45(15):1039-1046. doi: 10.1097/BRS.0000000000003451.
STUDY DESIGN
A prospective controlled cohort study.
OBJECTIVE
The aim of this study was to explore the interventional effect of exercise therapy on idiopathic scoliosis (IS) and identify an optimal intervention window.
SUMMARY OF BACKGROUND DATA
Early conservative treatment is helpful for IS. In addition to bracing, current evidence suggests that exercise can play an important role.
METHODS
We included 99 patients with IS who were treated at the Guangdong Xinmiao Scoliosis Center from August 2013 to September 2017. The inclusion criteria were: new IS diagnosis, Cobb angle 10° to 25°, Risser 0 to 3 grade, only treated with the Xinmiao treatment system (XTS; >3 days/week, >1 h/day), and follow-up >1 year. Patients were divided into three age groups: A, <10 years (n = 29); B, 10 to 12 years (n = 24); and C, 13 to 15 years (n = 46). The percentages of curve improvement (Cobb angle decrease ≥5°), stability (Cobb angle change × ±5°), and progression (Cobb angle increase ≥5°) were compared.
RESULTS
The groups showed significant differences for major curve correction, Risser sign, first referral, and final follow-up of the main curve (all P < 0.05). The major curve in group A decreased significantly by 6.8° (44% correction), compared to 3.1° (18% correction) and 1.5° (9% correction) in groups B and C, respectively. In group A, 69.0% (20/29) had curve improvement, 27.6% (8/29) stabilized and 3.4% (1/29) progressed. In group B, 45.8% (11/24) improved, 50% (12/24) stabilized, and 4.2% (1/24) progressed. In group C, 26.1% (12/46) improved, 63.0% (29/46) stabilized, and 10.9% (5/46) progressed. There was also a significant difference in final Risser grade among the groups (P < 0.05).
CONCLUSION
For IS patients with Cobb angles between 10° and 25°, our exercise protocol can effectively control or improve curve progression. Younger patients with a lower Risser grade are most likely to respond.
LEVEL OF EVIDENCE
研究设计
前瞻性对照队列研究。
目的
本研究旨在探讨运动疗法对特发性脊柱侧凸（IS）的干预效果，并确定最佳的干预窗口。
背景资料概要
早期保守治疗对 IS 有益。除了支具外，目前的证据表明运动也可以发挥重要作用。
方法
我们纳入了 2013 年 8 月至 2017 年 9 月在广东新苗脊柱侧弯中心接受治疗的 99 例 IS 患者。纳入标准为：新诊断的 IS，Cobb 角 10°至 25°，Risser 0 至 3 级，仅接受新苗治疗系统（XTS；>3 天/周，>1 小时/天）治疗，且随访时间>1 年。患者分为三组：A 组，<10 岁（n=29）；B 组，10 至 12 岁（n=24）；C 组，13 至 15 岁（n=46）。比较各组曲线改善（Cobb 角减小≥5°）、稳定性（Cobb 角变化×±5°）和进展（Cobb 角增加≥5°）的百分比。
结果
各组在主曲线的主要曲线矫正、Risser 征、首次就诊和最终随访方面均有显著差异（均 P<0.05）。A 组主曲线明显下降 6.8°（矫正 44%），B 组和 C 组分别下降 3.1°（矫正 18%）和 1.5°（矫正 9%）。A 组中，69.0%（20/29）的患者曲线改善，27.6%（29/29）的患者曲线稳定，3.4%（1/29）的患者曲线进展。B 组中，45.8%（11/24）的患者曲线改善，50%（12/24）的患者曲线稳定，4.2%（1/24）的患者曲线进展。C 组中，26.1%（12/46）的患者曲线改善，63.0%（29/46）的患者曲线稳定，10.9%（5/46）的患者曲线进展。各组最终 Risser 分级也有显著差异（P<0.05）。
结论
对于 Cobb 角在 10°至 25°之间的 IS 患者，我们的运动方案可以有效控制或改善曲线进展。Risser 分级较低的年轻患者最有可能产生反应。
证据水平
2 级。
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