Department of Sports Medicine, Sichuan Provincial Orthopedics Hospital, Chengdu, China.
Department of Emergency Medicine, Nanchong Hospital of Traditional Chinese Medicine, Nanchong, China.
Medicine (Baltimore). 2023 Dec 8;102(49):e36528. doi: 10.1097/MD.0000000000036528.
To clarify the differences in biomechanical characteristics present in adolescent idiopathic scoliosis (AIS) patients during walking.
Cross-sectional studies related to the biomechanical characteristics of AIS were included by searching 7 major databases and analyzed using RevMan 5.4 software.
There were a total of 15 trials involving 377 AIS patients. The results showed that during walking, AIS had increased pelvic coronal tilt (effect size [ES] = -1.34, 95% confidence intervals [CI] = -2.41 to -0.27, P = .01), knee and ankle sagittal mobility were reduced (ES = -5.22, 95% CI = -7.51 to -2.94, P < .001; ES = -3.58, 95% CI = -5.93 to -1.22, P = .003). The duration of electromyogram activity was prolonged in the gluteus medius (ES = 7.65, 95% CI = 5.33-9.96, P < .001), lumbar square (ES = 10.73, 95% CI = 6.97-14.49, P < .001), and erector spinae (ES = 14.35, 95% CI = 6.94-21.76, P < .001) muscles. The results of subgroup analysis showed that the step length of the concave side of the spine was reduced (ES = -0.36, 95% CI = -0.71 to -0.01, P = .04).
AIS has characteristic biomechanical changes in spatiotemporal, phase kinematics, motor mechanics, and electromyographic signatures. Further comprehensive studies are required in the future to analyze the biomechanical and electromyographic differences among different degrees and types of scoliosis, as well as the differences between the concave and convex sides of scoliosis during walking.
明确青少年特发性脊柱侧凸(AIS)患者在行走时的生物力学特征差异。
通过检索 7 个主要数据库,纳入与 AIS 生物力学特征相关的横断面研究,并使用 RevMan 5.4 软件进行分析。
共纳入 15 项试验,包含 377 例 AIS 患者。结果显示,在行走时,AIS 患者骨盆冠状面倾斜增加(效应量[ES]=-1.34,95%置信区间[CI]为-2.41 至-0.27,P=.01),膝关节和踝关节矢状面活动度降低(ES=-5.22,95%CI 为-7.51 至-2.94,P<.001;ES=-3.58,95%CI 为-5.93 至-1.22,P=.003)。臀中肌(ES=7.65,95%CI 为 5.33-9.96,P<.001)、腰椎四方肌(ES=10.73,95%CI 为 6.97-14.49,P<.001)和竖脊肌(ES=14.35,95%CI 为 6.94-21.76,P<.001)的肌电图活动时间延长。亚组分析结果显示,脊柱凹侧的步长减小(ES=-0.36,95%CI 为-0.71 至-0.01,P=.04)。
AIS 在时空、时相运动学、运动力学和肌电图特征方面具有特征性的生物力学变化。未来需要进一步开展综合研究,分析不同程度和类型脊柱侧凸以及脊柱侧凸凹侧和凸侧在行走时的生物力学和肌电图差异。