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动态神经肌肉稳定化方法对特发性脊柱侧凸患者腰骨盆稳定性和步态参数的有效性:一项随机对照试验。

Effectiveness of dynamic neuromuscular stabilization approach in lumbopelvic stability and gait parameters in individuals with idiopathic scoliosis: A randomized controlled trial.

作者信息

Ong Roberta Yi Li, Thazhakkattu Vasu Deepak, Jun Liow Kai, Yuet Ng Jia, Isaac Fernandez Mark, Selvakumar Kiruthika, Ming Zi Goh Joyce

机构信息

Department of Physiotherapy, M. Kandiah Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Kajang, Selangor, Malaysia.

出版信息

Medicine (Baltimore). 2025 Mar 21;104(12):e41905. doi: 10.1097/MD.0000000000041905.

Abstract

BACKGROUND

Adolescent idiopathic scoliosis (AIS) is a common spinal deformity that leads to impaired lumbopelvic stability, gait dysfunction, and associated pain and psychological distress. This study evaluates the effectiveness of dynamic neuromuscular stabilization (DNS) in improving lumbopelvic stability and gait in AIS patients, comparing it to core stability exercises (CSE). This study evaluates the effectiveness of DNS in improving lumbopelvic stability and gait in AIS patients, comparing it to CSE.

METHODS

This randomized controlled trial involved participants aged 18 to 25 years with mild to moderate idiopathic scoliosis, who were randomly assigned to either the control or experimental group. Both groups received 12 sessions of supervised exercises over 6 weeks, with the experimental group also incorporating DNS exercises alongside CSE. Lumbopelvic stability was assessed using the single leg squat, while core stability was evaluated with the stabilizer pressure Biofeedback in combination with the Sahrmann core stability test. Additionally, gait spatiotemporal parameters and pelvic dynamics were analyzed using the BTS-G-WALK system.

RESULTS

Of 30 participants, 28 completed the study, comprising 12 males and 16 females, with 26 having mild right-sided thoracic scoliosis. Both groups showed improvement in the left single leg squat, with the control group reaching 93.3% "Good" performance and the experimental group achieving 69.2%. Gait analysis showed a significant reduction in duration for both groups, with the control group improving from 112.98 to 71.41 seconds (P = .005) and the experimental group improving from 112.33 to 67.68 seconds (P = .021).

CONCLUSION

This ongoing 12-week study shows that the combined DNS and CSE approach significantly improves lumbopelvic stability in individuals with idiopathic scoliosis. However, the impact on gait parameters was minimal, possibly due to the short duration of the intervention and the similar walking strategies of those with single-curve scoliosis and healthy individuals. These findings highlight the potential of integrating DNS into scoliosis rehabilitation and underscore the need for further research to optimize treatment duration and assess long-term functional outcomes.

摘要

背景

青少年特发性脊柱侧凸(AIS)是一种常见的脊柱畸形,会导致腰骨盆稳定性受损、步态功能障碍以及相关疼痛和心理困扰。本研究评估动态神经肌肉稳定化(DNS)在改善AIS患者腰骨盆稳定性和步态方面的有效性,并将其与核心稳定性训练(CSE)进行比较。

方法

这项随机对照试验纳入了年龄在18至25岁、患有轻度至中度特发性脊柱侧凸的参与者,他们被随机分配到对照组或实验组。两组均在6周内接受12节有监督的训练课程,实验组除了CSE外还纳入了DNS训练。使用单腿深蹲评估腰骨盆稳定性,同时结合稳定器压力生物反馈和Sahrmann核心稳定性测试评估核心稳定性。此外,使用BTS-G-WALK系统分析步态时空参数和骨盆动力学。

结果

30名参与者中,28名完成了研究,包括12名男性和16名女性,其中26名患有轻度右侧胸段脊柱侧凸。两组在左侧单腿深蹲方面均有改善,对照组达到“良好”表现的比例为93.3%,实验组为69.2%。步态分析显示两组的持续时间均显著缩短,对照组从112.98秒改善至71.41秒(P = .005),实验组从112.33秒改善至67.68秒(P = .021)。

结论

这项正在进行的为期12周的研究表明,DNS和CSE相结合的方法能显著改善特发性脊柱侧凸患者的腰骨盆稳定性。然而,对步态参数的影响很小,这可能是由于干预时间较短以及单曲线脊柱侧凸患者与健康个体的行走策略相似。这些发现凸显了将DNS纳入脊柱侧凸康复的潜力,并强调需要进一步研究以优化治疗持续时间并评估长期功能结果。

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本文引用的文献

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[Gait Analysis in Patients with Adolescent Idiopathic Scoliosis].[青少年特发性脊柱侧弯患者的步态分析]
Acta Chir Orthop Traumatol Cech. 2024;91(3):137-142. doi: 10.55095/achot2024/022.
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J Child Orthop. 2023 Feb 3;17(2):126-140. doi: 10.1177/18632521221149058. eCollection 2023 Apr.

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