Dufvenberg Marlene, Charalampidis Anastasios, Diarbakerli Elias, Öberg Birgitta, Tropp Hans, Ahl Anna Aspberg, Möller Hans, Gerdhem Paul, Abbott Allan
Department of Health, Medicine and Caring Sciences, Unit of Physiotherapy, Linköping University, Linköping, Sweden.
Department of Clinical Science, Intervention and Technology (CLINTEC), Division of Orthopaedics and Biotechnology, Karolinska Institutet, Stockholm, Sweden.
PLoS One. 2025 Apr 21;20(4):e0320581. doi: 10.1371/journal.pone.0320581. eCollection 2025.
To explore secondary outcomes at endpoint comparing treatments with adequate self-mediated physical activity combined with either night-time brace (NB), scoliosis-specific exercise (SSE), or adequate self-mediated physical activity alone (PA) in Adolescent Idiopathic Scoliosis (AIS).
A longitudinal, prospective, multicenter RCT was conducted including 135 girls/boys, Cobb angle 25-40°, 9-17 years, and ≥1-year remaining growth were randomly allocated into NB, SSE, or PA group. Endpoint was curve progression of ≤6° (success) at skeletal maturity or >6° (failure). Outcomes included angle of trunk rotation (ATR), major curve Cobb angle, Spinal Appearance Questionnaire (pSAQ), Scoliosis Research Society-22r (SRS-22r), EQ-5Dimensions Youth 3Levels (EQ-5D-Y-3L), and EQ-Visual-Analogue-Scale (EQ-VAS), adherence to treatment and International Physical Activity Questionnaire (IPAQ-SF).
At endpoint, 122 patients were analyzed per protocol, mean age 12.7 (±1.4) years, and mean Cobb angle 31° (±4.3). A significant difference in change for ATR favored NB group compared to SSE group -2.0º (95% CI -3.7 to -0.3). EQ-5D-Y-3L dimensions showed a significant difference in change with decrease in mobility (p=0.031), and usual activities (p=0.003) for SSE compared to NB and PA groups. Treatment adherence was adequate but slightly better in NB and PA groups compared to SSE on self-report (p=0.012), and health care provider (HCP) report was better in PA compared to SSE group (p=0.013). Higher motivation and capability explained 53% of the variability and gave better odds for higher adherence (OR = 11.12, 95% CI = 1.5 to 34.4; OR = 7.23, 95% CI = 2.9 to 43.3), respectively.
Night-time brace, scoliosis-specific exercise or physical activity interventions for adolescents with idiopathic scoliosis showed small differences between groups in trunk rotation, spinal deformity and appearance, health-related quality of life, and treatment adherence but not likely reaching clinical relevance.
探讨在青少年特发性脊柱侧凸（AIS）中，将充分的自主体育活动与夜间支具（NB）、脊柱侧弯特定运动（SSE）或仅进行充分的自主体育活动（PA）相结合的治疗方法在终点时的次要结局。
进行了一项纵向、前瞻性、多中心随机对照试验，纳入135名年龄在9 - 17岁、Cobb角为25 - 40°且剩余生长时间≥1年的女孩/男孩，随机分为NB组、SSE组或PA组。终点指标为骨骼成熟时曲线进展≤6°（成功）或>6°（失败）。结局指标包括躯干旋转角度（ATR）、主弯Cobb角、脊柱外观问卷（pSAQ）、脊柱侧弯研究学会-22r问卷（SRS - 22r）、EQ - 5维度青年3水平问卷（EQ - 5D - Y - 3L）、EQ视觉模拟量表（EQ - VAS）、治疗依从性以及国际体力活动问卷（IPAQ - SF）。
在终点时，按照方案分析了122例患者，平均年龄12.7（±1.4）岁，平均Cobb角31°（±4.3）。与SSE组相比，NB组的ATR变化有显著差异，为-2.0°（95%置信区间-3.7至-0.3）。与NB组和PA组相比，SSE组的EQ - 5D - Y - 3L维度在活动能力下降（p = 0.031）和日常活动方面（p = 0.003）的变化有显著差异。自我报告显示，NB组和PA组的治疗依从性良好，但略优于SSE组（p = 0.012），医疗服务提供者（HCP）报告显示，PA组的治疗依从性优于SSE组（p = 0.013）。较高的动机和能力分别解释了53%的变异性，且具有更高依从性的几率更高（OR = 11.12，95%置信区间 = 1.5至34.4；OR = 7.23，95%置信区间 = 2.9至43.3）。
对于特发性脊柱侧弯青少年，夜间支具、脊柱侧弯特定运动或体育活动干预在躯干旋转、脊柱畸形和外观、健康相关生活质量以及治疗依从性方面，组间差异较小，但可能未达到临床意义。
