康复物理疗法联合矫形支具矫正对脑瘫性轻度至中度脊柱侧凸的疗效。
Efficacy of rehabilitation physiotherapy combined with brace correction in patients with mild to moderate scoliosis secondary to cerebral palsy.
机构信息
Department of Surgery, Minhang Hospital, Fudan University, Shanghai, China.
Department of Ultrasound, Minhang Hospital, Fudan University, Shanghai, China.
出版信息
J Back Musculoskelet Rehabil. 2024;37(6):1499-1506. doi: 10.3233/BMR-230336.
BACKGROUND
Scoliosis secondary to cerebral palsy is one of the common complications of cerebral palsy in children with cerebral palsy.
OBJECTIVE
This study aimed to explore the efficacy of rehabilitation combined with brace correction in patients with scoliosis secondary to cerebral palsy.
METHODS
A total of 52 patients with scoliosis secondary to cerebral palsy were selected from our hospital from April 2019 to April 2022 and divided into the control group and experimental group according to the statistical randomization method (n= 26 in each group). Control group: mean age (14.28 ± 2.31) years; 16 males and 10 females. Experimental group: average age (14.24 ± 2.35) years; 15 males and 11 females. The control group wore scoliosis orthopedic brace, while the experimental group was treated with rehabilitation manipulation and rehabilitation training (including gymnastic training and weight training) on the basis of the control group for 1 year. The clinical efficacy of the two groups was compared and observed; the number of degrees of scoliosis (Cobb angle), the angle of vertebral rotation (AVR) and the distance of the parietal vertebrae from the sacral midline (AVT) were compared before and after treatment; the incidence of adverse events during treatment was observed in the two groups.
RESULTS
After treatment, both groups showed significant improvement in the overall effectiveness of treatment, Cobb's angle, AVR and AVT compared with those before treatment (P< 0.05). The experimental group had a significantly higher overall effective rate of treatment than the control group (P< 0.05), a significantly smaller Cobb's angle and AVR than the control group (P< 0.05) and a significantly shorter AVT than the control group (P< 0.05). The incidence of adverse events during treatment was lower in both groups and was not significantly different (P> 0.05).
CONCLUSION
The combination of rehabilitation physiotherapy and bracing is effective in optimizing the clinical outcome of patients with scoliosis secondary to cerebral palsy, improving their scoliosis dysfunction and providing a high level of safety in treatment.
背景
脑瘫继发脊柱侧凸是脑瘫儿童的常见并发症之一。
目的
本研究旨在探讨康复联合支具矫形治疗脑瘫继发脊柱侧凸的疗效。
方法
选取 2019 年 4 月至 2022 年 4 月我院收治的 52 例脑瘫继发脊柱侧凸患者，按统计随机化法分为对照组和实验组，每组 26 例。对照组：平均年龄（14.28±2.31）岁；男 16 例，女 10 例。实验组：平均年龄（14.24±2.35）岁；男 15 例，女 11 例。对照组佩戴脊柱侧弯矫形支具，实验组在对照组的基础上采用康复手法及康复训练（包括体操训练和负重训练）治疗 1 年。比较两组临床疗效；比较两组治疗前后脊柱侧凸度数（Cobb 角）、椎体旋转角（AVR）和顶椎距骶中线距离（AVT）；观察两组治疗期间不良反应发生情况。
结果
治疗后，两组治疗总有效率及 Cobb 角、AVR、AVT均较治疗前改善（P<0.05），实验组治疗总有效率高于对照组（P<0.05），Cobb 角和 AVR 小于对照组（P<0.05），AVT 短于对照组（P<0.05）。两组治疗期间不良反应发生率均较低，且差异无统计学意义（P>0.05）。
结论
康复物理疗法联合支具矫形治疗脑瘫继发脊柱侧凸可优化患者的临床疗效，改善其脊柱侧凸功能障碍，且治疗安全性高。
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