脊柱侧弯特定运动对缓解青少年特发性脊柱侧弯的效果：系统评价。
Effectiveness of scoliosis-specific exercises for alleviating adolescent idiopathic scoliosis: a systematic review.
机构信息
Department of Orthopaedics and Traumatology, The University of Hong Kong - Shenzhen Hospital, 1 Haiyuan 1st Road, Futian District, Shenzhen, Guangdong, China.
Department of Physiotherapy, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong province, China.
出版信息
BMC Musculoskelet Disord. 2020 Jul 27;21(1):495. doi: 10.1186/s12891-020-03517-6.
BACKGROUND
Adolescent idiopathic scoliosis (AIS) is the most common pediatric spinal deformity with reported complications including pain, mental health concern and respiratory dysfunction. The scoliosis-specific exercise (SSE) is prescribed throughout pubertal growth to slow progression although effects are unclear. This review aims to establish the effectiveness of SSE for alleviating AIS in terms of reducing Cobb angle, improving trunk asymmetry and quality of life (QoL). Additionally, it aims to define the effects of age, skeletal maturity, curve magnitude and exercise compliance on the outcomes of SSE.
METHODS
A systematic reviewed was conducted to net SSE articles. Searched databases included PubMed, MEDLINE, Cochrane Library, Scopus, CINAHL and Google scholar. The quality of study was critically appraised according to the PEDro scale.
RESULTS
A total of ten trials with an average PEDro score of 6.9/10 were examined in this study. Two randomized controlled trials (RCTs) and two clinical controlled trials suggested that SSE alone and with bracing or traditional exercise had clinical significance in reducing Cobb angle more than 5°. One RCT specifically implicated no comparable effects between bracing and SSE in prevention of curve progression for moderate scoliosis. There was insufficient evidence to support the positive effects of SSE on improving truck asymmetry (n = 4) and QoL (n = 3). Five studies evaluated the interaction effects of age (n = 2), skeletal maturity (n = 1) and curve magnitude (n = 2) with SSE in reducing Cobb angle yet without drawing any firm conclusions.
CONCLUSIONS
Insufficient evidence is available to prove that SSE with or without other conservative treatments can reduce Cobb angle, improve trunk balance and QoL. The interaction effects of age, skeletal maturity, curve magnitude, and exercise compliance with SSE in reducing Cobb angle are not proven. Future studies should investigate the relationship of influencing factors and SSE in treating AIS but not only testing its effectiveness.
TRIAL REGISTRATION
INPLASY202050100 .
背景
青少年特发性脊柱侧凸（AIS）是最常见的儿科脊柱畸形，据报道其并发症包括疼痛、心理健康问题和呼吸功能障碍。脊柱侧凸特定运动（SSE）在整个青春期生长过程中被规定用于减缓进展，尽管其效果尚不清楚。本综述旨在确定 SSE 在减轻 AIS 方面的有效性，包括降低 Cobb 角、改善躯干不对称和生活质量（QoL）。此外，它旨在确定年龄、骨骼成熟度、曲线幅度和运动依从性对 SSE 结果的影响。
方法
进行了系统评价，以获取 SSE 相关文章。搜索的数据库包括 PubMed、MEDLINE、Cochrane 图书馆、Scopus、CINAHL 和 Google Scholar。根据 PEDro 量表对研究质量进行了批判性评估。
结果
本研究共检查了 10 项试验，平均 PEDro 评分为 6.9/10。两项随机对照试验（RCT）和两项临床对照试验表明，SSE 单独使用和与支具或传统运动结合使用在降低 Cobb 角方面具有临床意义，超过 5°。一项 RCT 特别表明，在预防中度脊柱侧凸的曲线进展方面，支具和 SSE 之间没有可比的效果。没有足够的证据支持 SSE 对改善躯干不对称（n=4）和生活质量（n=3）的积极影响。五项研究评估了年龄（n=2）、骨骼成熟度（n=1）和曲线幅度（n=2）与 SSE 降低 Cobb 角之间的相互作用效应，但没有得出任何明确的结论。
结论
目前没有足够的证据证明 SSE 结合或不结合其他保守治疗方法可以降低 Cobb 角、改善躯干平衡和 QoL。年龄、骨骼成熟度、曲线幅度和运动依从性与 SSE 降低 Cobb 角之间的相互作用效应尚未得到证实。未来的研究应该调查影响因素与 SSE 在治疗 AIS 中的关系，而不仅仅是测试其有效性。
试验注册
INPLASY202050100 。
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