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骨盆旋转矫正联合施罗特练习治疗轻度青少年特发性脊柱侧凸的骨盆和脊柱畸形:一项随机对照试验。

Pelvic rotation correction combined with Schroth exercises for pelvic and spinal deformities in mild adolescent idiopathic scoliosis: A randomized controlled trial.

机构信息

Department of Rehabilitation Medicine, Aerospace Center Hospital, Beijing, China.

出版信息

PLoS One. 2024 Jul 30;19(7):e0307955. doi: 10.1371/journal.pone.0307955. eCollection 2024.

Abstract

INTRODUCTION

Individualized treatment of spinal deformity is needed for adolescent idiopathic scoliosis (AIS), and the integration of pelvic rotation correction based on proprioceptive neuromuscular facilitation (PNF) into regular physiotherapy may be a promising approach. However, few high-quality studies have investigated its effects. This study aimed to evaluate the efficacy of pelvic rotation correction combined with Schroth exercises in the treatment of mild AIS.

METHODS

This was a randomized controlled trial. Forty-two AIS patients were randomly divided into experimental and control groups. Both groups underwent 20 therapeutic sessions over 24 weeks. All patients (n = 42) performed Schroth exercises at each session. In addition, the experimental group (n = 21) also participated in a pelvic rotation correction program based on PNF at each session. The primary outcome was the concave/convex ratio of hipbone widths, and the secondary outcomes included the Cobb angle, trunk rotation angle, self-perception, apical vertebral translation, and apical vertebral rotation. Patients were evaluated before and after 24 weeks of intervention.

RESULTS

There was a significant between-group difference in the change from baseline between the experimental and control groups for the following parameters: concave/convex ratio 2.89% (95% confidence interval [CI], 1.58 to 4.20, P<0.001), trunk rotation angle -1.26° (95% CI, -2.20 to -0.32; P = 0.01), and apical vertebral rotation improved by at least one class from baseline in 3 patients (14.3%) in the control group and 9 patients (42.9%) in the experimental group (P = 0.04). While Cobb angle -1.60° (95% CI, -7.75 to 0.54; P = 0.14), self-image 0.149 (95% CI, 0.001 to 0.297; P = 0.049), apical vertebral translation -0.58 mm (95% CI, -3.83 to 2.67; P = 0.72), and pelvic obliquity 0.10° (95% CI, -0.21 to 0.41; P = 0.52) did not differ significantly.

CONCLUSIONS

Pelvic rotation correction combined with Schroth exercises more effectively improved pelvic axial rotation and other spinal deformities, including trunk rotation and apical vertebral rotation, than Schroth exercises alone in the treatment of mild AIS.

摘要

简介

青少年特发性脊柱侧凸(AIS)需要个体化治疗,将基于本体感觉神经肌肉促进法(PNF)的骨盆旋转矫正纳入常规物理治疗可能是一种有前途的方法。然而,很少有高质量的研究调查其效果。本研究旨在评估骨盆旋转矫正结合施罗特运动治疗轻度 AIS 的疗效。

方法

这是一项随机对照试验。42 例 AIS 患者随机分为实验组和对照组。两组均接受 24 周 20 次治疗。所有患者(n=42)每次治疗均进行施罗特运动。此外,实验组(n=21)每次还进行基于 PNF 的骨盆旋转矫正。主要结局为髋骨宽度的凹/凸比,次要结局包括 Cobb 角、躯干旋转角度、自我感知、顶椎椎体平移和顶椎椎体旋转。患者在干预后 24 周进行评估。

结果

实验组与对照组在以下参数的基线变化方面存在显著的组间差异:凹/凸比 2.89%(95%置信区间[CI],1.58 至 4.20,P<0.001)、躯干旋转角度-1.26°(95%CI,-2.20 至-0.32;P=0.01),对照组有 3 名患者(14.3%)和实验组有 9 名患者(42.9%)至少有 1 个等级的顶椎椎体旋转改善(P=0.04)。而 Cobb 角-1.60°(95%CI,-7.75 至 0.54;P=0.14)、自我形象 0.149(95%CI,0.001 至 0.297;P=0.049)、顶椎椎体平移-0.58mm(95%CI,-3.83 至 2.67;P=0.72)和骨盆倾斜度 0.10°(95%CI,-0.21 至 0.41;P=0.52)差异无统计学意义。

结论

骨盆旋转矫正结合施罗特运动治疗轻度 AIS 比单纯施罗特运动更有效地改善骨盆轴向旋转和其他脊柱畸形,包括躯干旋转和顶椎椎体旋转。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6d1d/11288462/31a1ea5e8233/pone.0307955.g001.jpg

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