Fan Yunli, To Michael Kt, Kuang Guan-Ming, Cheung Jason Pui Yin
Department of Orthopaedics, The University of Hong Kong - Shenzhen Hospital, Shenzhen, People's Republic of China.
Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong SAR, China.
Global Spine J. 2024 Mar;14(2):447-457. doi: 10.1177/21925682221109565. Epub 2022 Jun 28.
Retrospective Case-control Study.
To determine the requisite exercise compliance (EC) of physiotherapeutic scoliosis-specific exercise (PSSE) for achieving curve regression; to analyze whether the apical translation (AT), apical wedging (AW), and apical rotation (AR) of the major curve improve with regression effect.
Between 2019 and 2021, a total of 763 patients undertook a 6-month PSSE treatment. This resulted 426 compliable and 302 uncompliable patients remained available for analysis. For compliable patients, 213 with curve regression and 213 age-/sex-matched with curve stabilization/deterioration at the 6-month, were eligible for regression analysis to detect the relationship between EC and regression effect at the 6-month; receiver operating characteristic (ROC) curve analysis and Youden's index were applied to identify the threshold of EC leading to curve regression at the 6-month. The AT, AW, and AR of the major curve were compared before and after 6-month PSSE to investigate the radiographic parameters that improved with regression effect.
EC was correlated with regression effect (odds ratio: 19.9, 95% confidence interval: 11.3-35.0, P < .001) and the cutoff threshold of EC was 4.4 h/week for 6 months to realize such an effect. AT was improved by 47.6% with curve regression, in which 152 cases remained curve regression and no case progressed into the operative threshold at the 1.5- to 2-year.
A 6-month PSSE protocol of 4.4 hours per week was potentially leading to curve regression in treating mild to moderate scoliosis. An improvement in AT of the major curve was observed with the regression effect.
回顾性病例对照研究。
确定物理治疗性脊柱侧弯特定运动（PSSE）实现曲线改善所需的运动依从性（EC）；分析主弯的顶椎平移（AT）、顶椎楔形变（AW）和顶椎旋转（AR）是否随改善效果而改善。
2019年至2021年期间，共有763例患者接受了为期6个月的PSSE治疗。这导致426例依从性患者和302例不依从性患者可供分析。对于依从性患者，213例曲线改善患者和213例年龄/性别匹配的6个月时曲线稳定/恶化患者，有资格进行回归分析，以检测6个月时EC与改善效果之间的关系；应用受试者工作特征（ROC）曲线分析和尤登指数来确定6个月时导致曲线改善的EC阈值。比较6个月PSSE前后主弯的AT、AW和AR，以研究随改善效果而改善的影像学参数。
EC与改善效果相关（优势比：19.9，95%置信区间：11.3 - 35.0，P <.001），6个月实现该效果的EC截止阈值为每周4.4小时。曲线改善时AT改善了47.6%，其中152例在1.5至2年时仍保持曲线改善，无病例进展至手术阈值。
每周4.4小时的6个月PSSE方案可能导致轻至中度脊柱侧弯的曲线改善。观察到主弯的AT随改善效果而改善。
