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四周联合支具和施罗特疗法治疗中度青少年特发性脊柱侧凸对足底压力分布的影响。

No effects of four weeks of combined brace and Schroth therapy in moderate adolescent idiopathic scoliosis on plantar pressure distribution.

机构信息

Institute of Occupational, Social and Environmental Medicine, Goethe University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9a, 60596, Frankfurt/Main, Germany.

Clinic for Trauma Surgery, Orthopedics University Hospital Frankfurt, Goethe University, Frankfurt, Germany.

出版信息

BMC Musculoskelet Disord. 2024 Sep 11;25(1):728. doi: 10.1186/s12891-024-07841-z.

Abstract

BACKGROUND

Positive effects of brace treatments in adolescent idiopathic scoliosis patients on gait were proven.

AIM

Therefore, this study examined whether the influence of brace therapy in combination with Schroth therapy influencing the plantar pressure distribution, pre and post intensive rehabilitative inpatient treatment.

DESIGN

Prospective cohort study, longitudinal.

SETTING

Scoliosis rehabilitation clinic "Asklepios Katharina-Schroth-Klinik" (Bad Sobernheim, Germany).

POPULATION

Twenty (14f/6m) patients (12-16 years) had a medically diagnosed moderate idiopathic scoliosis (Cobb angle 20-50°, Median 30°) and an indication for combined brace and Schroth therapy with an inpatient stay (4 weeks) at the Asklepios Katharina Schroth Clinic (Germany).

METHODS

At the beginning (T1) and at the end of the stay (T2), the plantar pressure distribution with (A) and without wearing a brace (B) was recorded (walking distance 10 m).

RESULTS

No significant differences between the left and right foot were found at baseline (T1). The T1 - T2 comparison of one foot revealed significant differences (p ≤ 0.05 - 0.001, respectively) for (A): mean pressure right midfoot, loaded area total left foot, left midfoot, left inner ball of foot, right midfoot, impulse total right foot, right midfoot and for (B): mean pressure right midfoot, right outer ball of foot, loaded area total right foot, right heel, right midfoot, impulse right heel, right midfoot, right outer ball of foot.

CONCLUSIONS

A combined brace and Schroth therapy maintains the initial symmetrical plantar pressure distribution over the duration of four weeks since the significant differences fall within the range of measurement error.

CLINICAL REHABILITATION IMPACT

The insole measuring system can be used to objectively support therapeutic gait training as part of rehabilitation and to assess insole fitting based on foot shape. Due to its convenient handling and rapid data acquisition, it may be a suitable method for interim or follow-up diagnostics in the treatment of idiopathic scoliosis.

摘要

背景

brace 治疗在青少年特发性脊柱侧凸患者的步态中表现出积极影响。

目的

因此,本研究旨在探讨 brace 治疗与 Schroth 治疗相结合是否会影响足底压力分布,在密集康复住院治疗前后。

设计

前瞻性队列研究,纵向研究。

地点

脊柱侧凸康复诊所“Asklepios Katharina-Schroth-Klinik”(德国巴特索恩海姆)。

人群

二十名(14 名女性/6 名男性)患有医学诊断为中度特发性脊柱侧凸(Cobb 角 20-50°,中位数 30°)的患者,并且有指征接受结合 brace 和 Schroth 治疗,在 Asklepios Katharina Schroth 诊所(德国)住院 4 周。

方法

在开始(T1)和住院结束时(T2),在穿着 brace(A)和不穿 brace(B)的情况下记录足底压力分布(行走距离 10 米)。

结果

在基线(T1)时,左右脚之间没有发现显著差异。一只脚的 T1-T2 比较显示出显著差异(p≤0.05-0.001,分别),对于(A):右中足平均压力、左足总负荷面积、左中足、左内足球、右中足、总右足冲量、右中足,对于(B):右中足平均压力、右外足球、右足总负荷面积、右跟、右中足、右跟冲量、右中足、右外足球。

结论

结合 brace 和 Schroth 治疗在四周的时间内保持了初始对称的足底压力分布,因为显著差异落在测量误差范围内。

临床康复影响

鞋垫测量系统可用于客观支持康复治疗中的治疗性步态训练,并根据足形评估鞋垫适配。由于其操作方便、数据采集快速,可能是特发性脊柱侧凸治疗中治疗期间或随访诊断的合适方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/527d/11389353/d5c4454c76ee/12891_2024_7841_Fig1_HTML.jpg

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