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施罗斯体操结合夏托吊带治疗青少年特发性脊柱侧凸的疗效:一项回顾性对照研究。

The efficacy of Schroth exercises combined with the Chêneau brace for the treatment of adolescent idiopathic scoliosis: a retrospective controlled study.

机构信息

Department of Orthopaedics Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.

Molecular Pharmacology Research Center, School of Pharmaceutical Science, Wenzhou Medical University, Wenzhou, China.

出版信息

Disabil Rehabil. 2022 Sep;44(18):5060-5068. doi: 10.1080/09638288.2021.1922521. Epub 2021 May 13.

Abstract

PURPOSE

We aimed to determine the global effects of the Chêneau brace combined with Schroth exercises on adolescent idiopathic scoliosis (AIS).

METHODS

We analyzed 192 patients with AIS who underwent the Chêneau brace treatment alone or combined with Schroth best practice (SBP) from June 2013 to October 2019. There were 138 patients in the Brace group and 54 patients in the Brace + SBP group. Radiographs were obtained at various treatment durations. Answers to the health-related quality of life (HRQoL) questionnaire were recorded before the intervention and at the time of treatment wean.

RESULTS

The Cobb angle (-3.55°;  < 0.001) and C7-CSVL (-3.03 mm;  < 0.001) significantly decreased in the Brace + SBP group. Thoracic kyphosis (TK) decreased in both the Brace + SBP group (-1.85°;  = 0.0152) and the Brace group (-5.06;  < 0.001). Changes before and after treatment of TK were significantly different between groups ( < 0.001). The 22-item Scoliosis Research Society function score, self-image, mental health, and EuroQol 5-Dimension scores were significantly higher in the Brace + SBP group. The satisfaction score was higher in the Brace + SBP group (3.77 ± 0.63 vs. 3.13 ± 0.79;  < 0.001).

CONCLUSIONS

Compared to bracing alone, the Schroth exercises plus bracing had a better effect on coronal balance. Schroth exercises improve flatback deformity caused by bracing and positively influence the HRQoL in AIS patients who received the Chêneau brace treatment.Implications for RehabilitationBracing and physiotherapy are common treatments for adolescent idiopathic scoliosis (AIS).The Chêneau brace treatment causes flatback deformity and muscle stiffness in AIS patients.The Schroth method helps patients increase muscle strength, halt curve progression, increase vital capacity, and maintain improved posture.The Schroth exercises could improve flatback deformity caused by bracing and positively influence the health-related quality of life in AIS patients who received the Chêneau brace treatment.

摘要

目的

本研究旨在评估夏托吊带联合施罗特疗法对青少年特发性脊柱侧凸(AIS)的全球疗效。

方法

我们分析了 2013 年 6 月至 2019 年 10 月期间 192 例接受夏托吊带治疗的 AIS 患者,其中 138 例仅接受夏托吊带治疗(吊带组),54 例接受夏托吊带联合施罗特最佳实践(SBP)治疗(吊带+SBP 组)。在不同的治疗阶段均拍摄 X 线片,在干预前和治疗减荷时记录健康相关生活质量(HRQoL)问卷的答案。

结果

与吊带组相比,吊带+SBP 组的 Cobb 角(-3.55°;<0.001)和 C7 铅垂线距脊柱侧凸椎体最高点距离(C7-CSVL)(-3.03 mm;<0.001)明显减小。吊带+SBP 组的胸腰椎后凸角(TK)(-1.85°;=0.0152)和吊带组(-5.06°;<0.001)也减小。两组治疗前后 TK 的变化差异有统计学意义(<0.001)。吊带+SBP 组的 22 项脊柱侧凸研究协会功能评分、自我形象、心理健康和欧洲五维健康量表评分显著升高,满意度评分也更高(3.77 ± 0.63 比 3.13 ± 0.79;<0.001)。

结论

与单纯支具治疗相比,施罗特运动联合支具治疗在冠状面平衡方面效果更好。施罗特运动可改善支具治疗引起的平背畸形,对接受夏托支具治疗的 AIS 患者的 HRQoL 产生积极影响。

康复意义

支具和物理疗法是青少年特发性脊柱侧凸(AIS)的常见治疗方法。夏托支具治疗会导致 AIS 患者出现平背畸形和肌肉僵硬。施罗特方法有助于患者增加肌肉力量、阻止曲线进展、增加肺活量并保持姿势改善。施罗特运动可改善支具治疗引起的平背畸形,并对接受夏托支具治疗的 AIS 患者的健康相关生活质量产生积极影响。

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