University of Sao Paulo, School of Medicine, Physical Therapy Department, Sao Paulo, Brazil; Clinical Center in Scoliosis, São Paulo, SP, Brazil.
Clinical Center in Scoliosis, São Paulo, SP, Brazil.
J Rehabil Med. 2024 Feb 26;56:jrm5343. doi: 10.2340/jrm.v56.5343.
Telerehabilitation has become increasingly popular since the SARS-CoV-2 (COVID-19) outbreak. However, studies are needed to understand the effects of remote delivery of spine treatment approaches.
To verify and compare the effects of traditional rehabilitation programmes (in-person) and telerehabilitation (online) on the progression of scoliotic curvature in adolescents with idiopathic scoliosis during the COVID-19 pandemic, and to verify the acceptability, appropriateness, and feasibility among patients and physiotherapists regarding both treatments.
This is a cohort study (prospective analysis of 2 intervention groups: telerehabilitation (online) and traditional rehabilitation (in-person). A total of 66 adolescents with idiopathic scoliosis were included. Recruitment was conducted through the Clinical Center in Scoliosis Care (January-December 2020). Participants were divided into 2 intervention groups: telerehabilitation (online) (n = 33) and traditional rehabilitation programme (in-person) (n = 33). Both groups also were supplied with a spinal orthopaedic brace. Scoliosis was confirmed by a spine X-ray examination (Cobb angle). Radiographic parameters measured were: Cobb angles (thoracic and lumbar). The method of Nash and Moe (thoracic and lumbar) was also evaluated based on the relationship between the vertebral pedicles and the centre of the vertebral body in the X-rays. Assessments were performed at baseline (T0) and after 6 months of the intervention protocol (T6). Patient and physiotherapist reports were evaluated on the acceptability, appropriateness, and feasibility of the interventions.
Adolescents with idiopathic scoliosis showed a significant decrease in the Cobb angle (main scoliotic curvature), with a 4.9° for the traditional rehabilitation programme and 2.4° for the telerehabilitation. Thoracic and lumbar Cobb angles did not show significant changes after the intervention in both groups or between groups. Thoracic and lumbar Nash and Moe scores scores also did not show significant differences after 6 months of in-person or telerehabilitation intervention, or between groups. The intervention by telerehabilitation was acceptable, appropriate, and feasible for patients and physiotherapists.
Use of the rehabilitation programme for adolescents with idiopathic scoliosis, delivered via telerehabilitation during the COVID-19 pandemic, was encouraging for future applications due to the improved effect on reducing the Cobb angle, preventing progression of scoliosis. In addition, telerehabilitation showed good acceptability among patients and physiotherapists. Traditional rehabilitation programmes (in-person) in adolescents with idiopathic scoliosis also showed a reduction in the Cobb angle.
自 SARS-CoV-2（COVID-19）爆发以来，远程康复已经变得越来越流行。然而，需要研究来了解远程提供脊柱治疗方法的效果。
验证和比较传统康复方案（面对面）和远程康复（在线）在 COVID-19 大流行期间对青少年特发性脊柱侧凸脊柱治疗进展的影响，并验证两种治疗方法在患者和物理治疗师中的可接受性、适当性和可行性。
这是一项队列研究（对 2 个干预组进行前瞻性分析：远程康复（在线）和传统康复（面对面））。共纳入 66 名青少年特发性脊柱侧凸患者。招募是通过脊柱侧凸护理临床中心（2020 年 1 月至 12 月）进行的。参与者分为 2 个干预组：远程康复（在线）（n=33）和传统康复方案（面对面）（n=33）。两组均配备脊柱矫形支具。脊柱侧凸通过脊柱 X 射线检查（Cobb 角）确诊。测量的影像学参数包括：Cobb 角（胸椎和腰椎）。还根据 X 射线中椎弓根与椎体中心之间的关系评估了 Nash 和 Moe（胸椎和腰椎）方法。在基线（T0）和干预方案 6 个月后（T6）进行评估。评估患者和物理治疗师对干预措施的可接受性、适当性和可行性的报告。
青少年特发性脊柱侧凸患者的 Cobb 角（主要脊柱侧凸曲率）显著下降，传统康复方案组为 4.9°，远程康复组为 2.4°。两组干预后胸椎和腰椎 Cobb 角均无明显变化，组间亦无明显差异。胸椎和腰椎 Nash 和 Moe 评分在 6 个月的面对面或远程康复干预后也没有显著差异，两组之间也没有差异。远程康复干预对患者和物理治疗师来说是可以接受的、适当的和可行的。
在 COVID-19 大流行期间，使用远程康复为青少年特发性脊柱侧凸患者提供康复方案，由于对降低 Cobb 角、预防脊柱侧凸进展的效果改善，对于未来的应用具有鼓励作用。此外，远程康复在患者和物理治疗师中具有良好的可接受性。传统康复方案（面对面）在青少年特发性脊柱侧凸患者中也降低了 Cobb 角。
