Wang Lixia, Li Xin, Song Yuanyuan, Liang Juping, Zhang Yanbin, Zhang Tongtong, Zhou Xuan, Du Qing
Department of Rehabilitation Medicine, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Shanghai University of Sport, Shanghai, China.
BMC Pediatr. 2025 Apr 2;25(1):266. doi: 10.1186/s12887-025-05573-0.
Early-onset idiopathic scoliosis (EOIS) is a spinal deformity that develops before the age of 10 years with unknown etiology. Scoliosis can lead to respiratory muscle weakness and decreased motor function. Nevertheless, the effects of mild EOIS on pulmonary function and functional exercise capacity remain poorly understood. Early detection is crucial to mitigate its impact on children's health and prevent progression. The aim of this study was to investigate the characteristics of pulmonary function and exercise capacity in children with EOIS and to identify influencing factors.
52 children with mild EOIS and 52 healthy controls matched for age and sex were recruited.Participants underwent pulmonary function test, a 6-minute walk test (6MWT) and Borg score assessments to evaluate subjective fatigue before and after 6MWT. Differences in forced vital capacity (FVC), forced expiratory volume in one second (FEV1), FEV1/FVC, peak expiratory flow (PEF) and six-minute walking distance (6MWD) were compared between the two groups. Imaging parameters were measured from full spinal X-ray orthopantomograms taken in the standing position for the case group. Independent samples t-tests were used to analyze differences between the two groups, followed by multiple linear regression analyses to identify the influencing factors.
The case group exhibited significantly lower FEV1/FVC and 6MWD but a higher Borg score compared to the control group (P = 0.009, P = 0.015, P < 0.001). Within the case group, the FEV1/FVC was significantly decreased in the right thoracic scoliosis subgroup compared with the left thoracic scoliosis subgroup (P = 0.006). Height, Cobb's angle and PEF were significant factors affecting the 6MWD of EOIS (P = 0.003, P = 0.005, P = 0.002), FVC was related to the height, side bend position and side bend direction (P < 0.001, P = 0.030, P = 0.013), and FEV1 was affected by age, weight and type of side bend (P = 0.016, P = 0.019, P = 0.016).
Mild pulmonary and exercise capacity restrictions appear early in mild EOIS. Exercise capacity is influenced by lung function and exhibits a negative correlation with the severity of scoliosis. Pulmonary function in right thoracic scoliosis was significantly lower than that in left thoracic scoliosis. Early identification of these functional declines is crucial for implementing timely interventions to prevent further deterioration.
早发性特发性脊柱侧弯（EOIS）是一种在10岁前出现且病因不明的脊柱畸形。脊柱侧弯可导致呼吸肌无力和运动功能下降。然而，轻度EOIS对肺功能和功能运动能力的影响仍知之甚少。早期检测对于减轻其对儿童健康的影响并防止病情进展至关重要。本研究的目的是调查EOIS患儿的肺功能和运动能力特征，并确定影响因素。
招募了52名轻度EOIS患儿和52名年龄及性别匹配的健康对照者。参与者接受肺功能测试、6分钟步行试验（6MWT）以及6MWT前后的Borg评分评估以评估主观疲劳程度。比较两组之间的用力肺活量（FVC）、一秒用力呼气容积（FEV1）、FEV1/FVC、呼气峰值流速（PEF）和6分钟步行距离（6MWD）的差异。对病例组站立位全脊柱X线曲面断层片测量影像学参数。采用独立样本t检验分析两组之间的差异，随后进行多元线性回归分析以确定影响因素。
与对照组相比，病例组的FEV1/FVC和6MWD显著降低，但Borg评分更高（P = 0.009，P = 0.015，P < 0.001）。在病例组中，右胸弯脊柱侧弯亚组的FEV1/FVC与左胸弯脊柱侧弯亚组相比显著降低（P = 0.006）。身高、Cobb角和PEF是影响EOIS患儿6MWD的重要因素（P = 0.003，P = 0.005，P = 0.002），FVC与身高、侧弯位置和侧弯方向有关（P < 0.001，P = 0.030，P = 0.013），FEV1受年龄、体重和侧弯类型影响（P = 0.016，P = 0.019，P = 0.016）。
轻度EOIS早期即出现轻度肺功能和运动能力受限。运动能力受肺功能影响，且与脊柱侧弯严重程度呈负相关。右胸弯脊柱侧弯的肺功能显著低于左胸弯脊柱侧弯。早期识别这些功能下降对于及时实施干预以防止进一步恶化至关重要。
