特定运动疗法对特发性脊柱侧弯的效果

doi:10.3969/j.issn.1006-9771.2022.07.016

《中国康复理论与实践》 ›› 2022, Vol. 28 ›› Issue (7): 841-847.doi: 10.3969/j.issn.1006-9771.2022.07.016

特定运动疗法对特发性脊柱侧弯的效果

靳梦蝶¹,周璇¹,李欣¹,岳一鸣²,诸小青¹,袁海燕³,杜青¹()

1.上海交通大学医学院附属新华医院康复医学科,上海市 200092
2.上海理工大学康复工程与技术研究所,上海市 200093
3.上海交通大学医学院附属新华医院崇明分院,上海市 202150

收稿日期:2022-05-08 修回日期:2022-07-07 出版日期:2022-07-25 发布日期:2022-08-08
通讯作者: 杜青 E-mail:duqing@xinhuamed.com.cn
作者简介:靳梦蝶(1991-),女,汉族,上海市人,硕士研究生,技师,主要研究方向：儿童康复。
基金资助:
国家自然科学基金面上项目(81972030);上海申康医院发展中心临床三年行动计划项目(SHDC2020CR3041B);上海市进一步加快中医药传承创新发展三年行动计划项目(ZY(2021-2023)-0201-05);上海市卫生健康委员会卫生行业临床研究专项(202040292);上海市卫生健康委先进适宜技术推广项目(2019SY021)

Effects of scoliosis-specific exercise therapy on idiopathic scoliosis

JIN Mengdie¹,ZHOU Xuan¹,LI Xin¹,YUE Yiming²,ZHU Xiaoqing¹,YUAN Haiyan³,DU Qing¹()

1. Department of Rehabilitation, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
2. Institute of Rehabilitation Engineering and Technology, University of Shanghai for Science and Technology, Shanghai 200093, China
3. Chongming Branch of Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 202150, China

Received:2022-05-08 Revised:2022-07-07 Published:2022-07-25 Online:2022-08-08
Contact: DU Qing E-mail:duqing@xinhuamed.com.cn
Supported by:
National Natural Science Foundation of China (General)(81972030);Shanghai Hospital Development Center Clinical Research Plan(SHDC2020CR3041B);Shanghai Development of Traditional Chinese Medicine Three-year Plan(ZY(2021-2023)-0201-05);Shanghai Health Commission Clinical Research Special(202040292);Shanghai Health Commission Appropriate Technology Promotion(2019SY021)

摘要/Abstract

摘要：

目的观察特定运动疗法对特发性脊柱侧弯畸形和关节松弛的疗效。

方法 2021年4月至10月在新华医院脊柱侧弯康复中心就诊的特发性脊柱侧弯患儿100例,根据患儿意愿分为对照组和试验组各50例,分别接受常规运动疗法和特定运动疗法,共6个月。治疗前后,测量侧弯最大Cobb角和骨密度,采用Beighton量表和中文版脊柱侧凸研究学会22项问卷(SRS-22)进行评定。

结果治疗后,试验组最大Cobb角变化量大于对照组(Z = -2.202, P < 0.05),改善率高于对照组(χ² = -2.405, P < 0.05);试验组骨密度显著下降(|Z| > 2.127, P < 0.05);两组SRS-22总分均提高(F_时间 = 106.57, P < 0.001),试验组高于对照组(F = 4.969, P < 0.05);试验组功能活动和自我形象分提高(|Z| > 2.149, P < 0.05),对照组心理健康分降低(Z = -2.096, P < 0.05);试验组心理健康分高于对照组(Z = -2.260, P < 0.05)。

结论特定运动疗法有利于改善患儿脊柱畸形和生活质量,但对关节松弛和骨密度效果不明显,有待进一步完善。

关键词: 特发性脊柱侧弯, 特定运动疗法, 关节松弛, 骨密度, 生活质量

Abstract:

Objective To observe the effects of specific exercise therapy on spinal deformity and joint hypermobility of idiopathic scoliosis.

Methods From April to October, 2021, 100 children with idiopathic scoliosis in the Scoliosis Rehabilitation Center of Xinhua Hospital were divided into control group (n = 50) and experimental group (n = 50), who accepted routine exercise therapy or scoliosis-specific exercise therapy in accordance with their wishes, for six months. The maximum Cobb angle and bone mineral density were measured, and they were assessed with Beighton Scale and Chinese version of the Scoliosis Research Society-22 Questionnaire Scores (SRS-22) before and after treatment.

Results The change of the maximum Cobb angle was more in the experimental group than in the control group (Z = -2.202, P < 0.05) after treatment, and the incidence of respondent was more (χ² = -2.405, P < 0.05). The bone mineral density decreased in the experimental group after treatment (|Z| > 2.127, P < 0.05). For SRS-22, the total scores increased in both groups after treatment (F_time = 106.57, P < 0.001), and increased more in the experimental group than in the control group (F = 4.969, P < 0.05); the scores of function domain and self-image domain increased in the experimental group (|Z| > 2.149, P < 0.05), while the mental health domain score decreased in the control group (Z = -2.096, P < 0.05); and the mental health domain score was more in the experimental group than in the control group (Z = -2.260, P < 0.05).

Conclusion The scoliosis-specific exercise therapy is effective on spinal deformity and quality of life for children with idiopathic scoliosis, but less helpful for joint hypermobility and bone mineral density, which need to further improve.

Key words: idiopathic scoliosis, scoliosis-specific exercises, joint hypermobility, bone mineral density, quality of life

中图分类号:

R682.3

靳梦蝶,周璇,李欣,岳一鸣,诸小青,袁海燕,杜青. 特定运动疗法对特发性脊柱侧弯的效果[J]. 《中国康复理论与实践》, 2022, 28(7): 841-847.

JIN Mengdie,ZHOU Xuan,LI Xin,YUE Yiming,ZHU Xiaoqing,YUAN Haiyan,DU Qing. Effects of scoliosis-specific exercise therapy on idiopathic scoliosis[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(7): 841-847.

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项目	对照组(n = 50)	试验组(n = 50)	χ²/t/Z值	P值
性别(男/女)/n	11/39	18/32	2.380	0.186
年龄/岁	12.69±1.40	12.61±1.35	0.293	0.770
身高/cm	159.60(154.45,163.23)	158.60(154.00,165.00)	-0.055	0.956
体质量/kg	44.80(39.60,54.25)	46.95(39.93,52.08)	-0.462	0.644
BMI/kg·m^-2	18.00(16.45,19.95)	18.35(16.98,20.30)	-0.823	0.411
Risser征/n			2.575	0.631
0级	15	16
1级	6	4
2级	10	15
3级	10	10
4级	9	5
握力/kg
左	15.22±4.15	16.95±4.73	-1.929	0.057
右	16.44±4.68	18.31±5.60	-1.811	0.060

组别	n	治疗前	治疗后	变化量	Z值^a	P值^a
对照组	50	19.80(14.15, 26.60)	21.00(13.95, 27.70)	-0.25(-3.98, 3.70)	-0.271	0.786
试验组	50	18.65(14.18, 27.00)	16.00(13.76, 20.63)	-2.20(-6.35, -0.08)	-3.775	< 0.001
Z值		-0.303	-2.114	-2.202
P值		0.762	0.035	0.028

组别	n	治疗前	治疗后	Z值	P值
对照组	50	2.00(0.00, 3.25)	2.00(0.75, 4.00)	-0.770	0.441
试验组	50	3.00(1.00, 4.00)	2.00(0.00, 4.00)	-1.422	0.155
Z值		-1.549	-0.880
P值		0.121	0.379

组别	n	治疗前	治疗后	Z值	P值
对照组	50	3758.00(3659.50, 3868.50)	3814.00(3703.00, 3896.00)	-1.229	0.219
试验组	50	3816.00(3747.00, 2931.00)	3722.00(3646.50, 3886.00)	-2.127	0.033
Z值		-1.771	-1.154
P值		0.077	0.248

组别	n	治疗前	治疗后	Z值	P值
对照组	50	0.15(-0.80, 0.825)	0.10(-0.60, 0.90)	-0.121	0.904
试验组	50	0.70(-0.30, 2.00)	-0.10(-1.45, 0.90)	-3.117	0.002
Z值		-2.479	-0.748
P值		0.013	0.454

特定运动疗法对特发性脊柱侧弯的效果

Effects of scoliosis-specific exercise therapy on idiopathic scoliosis

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组别	n	治疗前	治疗后	Z值	P值
对照组	50	57.00(26.50, 79.25)	53.00(27.00, 81.00)	-0.420	0.674
试验组	50	73.00(32.00, 96.50)	47.00(11.50, 77.00)	-2.709	0.007
Z值		-2.135	-0.726
P值		0.033	0.468

组别	n	治疗前	治疗后
对照组	50	85.86±7.42	92.46±8.85
试验组	50	86.28±8.34	96.20±7.90
F值		0.071	4.969
P值		0.790	0.028

维度	组别	n	治疗前	治疗后	Z值	P值
疼痛	对照组	50	25.00(23.00, 25.00)	24.00(23.00, 25.00)	-0.821	0.412
	试验组	50	25.00(23.00, 25.00)	25.00(23.00, 25.00)	-0.035	0.972
功能活动	对照组	50	22.00(21.00, 23.00)	22.00(21.00, 32.00)	-0.191	0.848
	试验组	50	22.00(21.00, 32.00)	23.00(21.00, 23.00)	-2.247	0.025
自我形象	对照组	50	19.00(16.00, 21.00)	18.00(16.00, 20.00)	-1.347	0.178
	试验组	50	17.50(15.75, 21.00)	19.00(17.00, 21.00)	-2.149	0.032
心理健康	对照组	50	22.00(20.00, 24.50)	21.00(19.00, 24.00)	-2.096	0.036
	试验组	50	23.00(21.00, 24.25)	22.00(20.75, 25.00)	-0.066	0.947
	Z值^a		-1.549	-1.261
	P值^a		0.604	0.207
	Z值^b		-0.317	-1.264
	P值^b		0.752	0.206
	Z值^c		-0.995	-1.856
	P值^c		0.320	0.064
	Z值^d		-0.644	-2.260
	P值^d		0.520	0.024

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