Dech Silas, Hellriegel Tom, Kittel René
Department of Sports and Health Sciences, Health Education in Sports, Regulative Physiology and Prevention, University of Potsdam, Potsdam, Germany.
Oberlinklinik, MVZ Luisenplatz, Potsdam, Germany.
Global Spine J. 2025 Sep 18:21925682251370987. doi: 10.1177/21925682251370987.
Study DesignRandomized controlled trial over one year.ObjectivesBouldering as a popular climbing discipline might have a therapeutic potential in adolescent idiopathic scoliosis (AIS). This trial examined the effectiveness of an innovative program compared to standard care.MethodsPatients suffering from mild AIS (13.1 ± 1.5 yrs, ♀ = 68%) were weekly treated by scoliosis- specific exercises (SSEs) during bouldering therapy (BT: n = 20, Potsdam model) or physiotherapy (PT: n = 21, Schroth-Method). After 12 months, changes in group-blinded max and sum score of Cobb-Angles as well as angle of trunk rotations (ATRs) were mainly analyzed by use of a mixed-ANOVA.ResultsDisregarding group, max Cobb: -1.9° ± 4.9°; sum Cobb: -3.7° ± 8.4° (excl. one outlier/group); max ATR: -1.3° ± 1.5°; sum ATR: -2.6° ± 2.7° were reduced significantly (main time effects: < 0.001 to 0.021, f = 0.39 to 1.05). Post-hoc tests revealed significance in both groups for max and sum ATR (p < 0.001 to 0.006, d = 0.56 to 1.03). A significant group-by-time interaction (P = 0.039, f = 0.202) was found in sum ATR (BT: -3.48° vs PT: -1.76°). The improvements in ATR but not Cobb-Angle were below measurement error on group level. In each group, 20% improved and 5% deteriorated to a clinically meaningful extent in max Cobb (≥5°). Regarding max ATR, 15% (BT) and 5% (PT) revealed an improvement ≥4°. No clinically relevant deterioration was seen. 85.7% wanted to continue with BT after intervention period. Most (74%) did not interpret it as a kind of treatment.ConclusionsBoth, SSEs during BT and PT over one year can prevent potential progression of mild AIS and partly improve deformity. The BT program is suitable for youth and might improve adherence to specific exercises until or even beyond skeletal maturity.
研究设计
为期一年的随机对照试验。
目的
抱石作为一项广受欢迎的攀岩项目，可能对青少年特发性脊柱侧凸（AIS）具有治疗潜力。本试验比较了一种创新方案与标准护理的效果。
方法
轻度AIS患者（13.1±1.5岁，女性占68%）每周接受抱石疗法（BT组：n = 20，波茨坦模型）或物理治疗（PT组：n = 21，施罗特方法）中的脊柱侧弯特定运动（SSEs）治疗。12个月后，主要采用混合方差分析来分析Cobb角的组盲法最大和总和评分以及躯干旋转角度（ATR）的变化。
结果
不考虑分组情况，Cobb角最大变化值：-1.9°±4.9°；Cobb角总和变化值：-3.7°±8.4°（每组排除一个异常值）；ATR最大变化值：-1.3°±1.5°；ATR总和变化值：-2.6°±2.7°，均有显著降低（主要时间效应：p<0.001至0.021，f = 0.39至1.05）。事后检验显示两组在ATR最大和总和变化方面均有显著性（p<0.001至0.006，d = 0.56至1.03）。在ATR总和方面发现了显著的组×时间交互作用（P = 0.039，f = 0.202）（BT组：-3.48° vs PT组：-1.76°）。ATR的改善而非Cobb角的改善在组水平上低于测量误差。在每组中，20%的患者Cobb角最大变化值（≥5°）有临床意义上的改善，5%的患者病情恶化。关于ATR最大变化值，15%（BT组）和5%（PT组）有≥4°的改善。干预期后85.7%的患者希望继续接受BT治疗。大多数患者（74%）不将其视为一种治疗方式。
结论
为期一年的BT组和PT组中的SSEs均可预防轻度AIS潜在进展并部分改善畸形。BT方案适合青少年，可能会提高对特定运动的依从性直至骨骼成熟甚至更久。
