Physiotherapy Research Unit, Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
Physiotherapy Research Unit, Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
Arch Phys Med Rehabil. 2023 Aug;104(8):1314-1330. doi: 10.1016/j.apmr.2023.01.019. Epub 2023 Feb 9.
To investigate the associations between adolescent idiopathic scoliosis (AIS) and physical activity (PA).
MEDLINE, EMBASE, AMED, SPORTDiscus, Cochrane Library, and CINAHL electronic databases were searched from inception to August 2022/plus citation tracking.
Observational studies of participants with radiographically confirmed AIS with ≥10° lateral spinal curvature (Cobb method) and comparator groups without AIS that measured PA were selected by 2 reviewers.
Data were extracted independently and cross-checked by 2 reviewers. Risk of bias was evaluated using Newcastle Ottawa Scales and overall confidence in the evidence using the GRADE approach.
Sixteen studies with 9627 participants (9162, 95% women) were included. A history of vigorous PA significantly reduced the odds of being newly diagnosed with AIS by 24% (odds ratio [OR] 0.76, 95% confidence interval [CI] 0.65-0.89) (high certainty). Moderate PA reduced odds by 13% (moderate certainty) and light PA increased odds by 9% (low certainty), but neither analysis was statistically significant. Ballet or gymnastics (OR 1.47, 95% CI 3.08 (1.90, 5.00) were the only individual sports significantly associated with AIS diagnosis (moderate certainty). Case-control studies of people with and without AIS provided greater evidence that having AIS reduces vigorous PA and sports participation, and less evidence light PA and walking are affected.
Adolescents who participate in more vigorous PA are less likely to be diagnosed with AIS. Ballet and gymnastics are associated with AIS diagnosis, but the direction of this association is uncertain. People with AIS are likely to do less vigorous physical and sporting activity compared with those without AIS, which could negatively affect health and quality of life. Further research is warranted into the inter-relations between PA and AIS, studies need to be of sufficient size, include men, and evaluate vigorous including higher-impact PA compared with moderate or light PA.
探讨青少年特发性脊柱侧凸（AIS）与体力活动（PA）之间的关联。
从建库到 2022 年 8 月，通过 MEDLINE、EMBASE、AMED、SPORTDiscus、Cochrane 图书馆和 CINAHL 电子数据库搜索了经影像学证实的 AIS 患者（Cobb 法≥10°侧凸）和无 AIS 对照患者的观察性研究，并由 2 名评审员进行选择。
通过 2 名评审员独立提取数据并交叉核对。使用纽卡斯尔-渥太华量表评估偏倚风险，使用 GRADE 方法评估证据的总体可信度。
共纳入 16 项研究，9627 名参与者（9162 名，95%女性）。剧烈体力活动史使新诊断为 AIS 的几率降低 24%（比值比[OR]0.76，95%置信区间[CI]0.65-0.89）（高可信度）。中等强度体力活动使几率降低 13%（中度可信度），低强度体力活动使几率增加 9%（低可信度），但两者均无统计学意义。只有芭蕾舞或体操（OR 1.47，95%CI 3.08（1.90，5.00）与 AIS 诊断显著相关（中度可信度）。有 AIS 和无 AIS 的病例对照研究提供了更多证据表明，AIS 会减少剧烈体力活动和运动参与，而对低强度体力活动和行走的影响证据较少。
参加更多剧烈体力活动的青少年不太可能被诊断为 AIS。芭蕾舞和体操与 AIS 诊断相关，但这种关联的方向不确定。与无 AIS 的人相比，AIS 患者可能进行的剧烈体力活动和运动较少，这可能对健康和生活质量产生负面影响。需要进一步研究 PA 和 AIS 之间的相互关系，研究需要有足够的规模，包括男性，并评估与中度或轻度 PA 相比，剧烈包括高冲击力的 PA。
