功能性康复训练改善青少年特发性脊柱侧弯的研究

摘要

BACKGROUND:Various methods are involved in the treatment of adolescent idiopathic scoliosis (AIS),and functional rehabilitation training can provide support for clinical rehabilitation.OBJECTIVE:To explore the ipositive effects of exercise on the weak links of spinal mechanical disturbance,and to fully improve AIS through sport rehabilitation.METHODS:Nineteen AIS patients were randomly divided into experimental (n=10) and control (n=9) groups,followed by given manual reduction combined with functional rehabilitation training,or manual reduction combined with conventional strength training.The shape of the spine was acquired under different postures using X-ray and Spinalmouse.The spinal lateral flexion strength was assessed by Back-Check tester.The range of motion of the waist was measured by joint angle measurement apparatus.The patients' subjective feeling was measured through Scoliosis Research Society-22 questionnaire.All data underwent t-test.RESULTS AND CONCLUSION:After 32-week intervention,the Cobb angle and distance of top cone deviating from the midline of sacrum had significant difference between experimental and control groups (F ＜ 0.05).The experimental group patients had the sagittal spinal joint angle that was closer to the physiological curve.There was a significant difference in the muscle strength between experimental and control groups (P ＜ 0.05).The range of motion of the waist under anteflexion,as well as posterior extension and right lateroflexion showed significant difference between experimental and control groups (P ＜0.01,P ＜ 0.05).The Scoliosis Research Society-22 Questionnaire scores in the experimental group were significantly higher than those in the control group (P ＜ 0.05).These results indicate that functional rehabilitation training can improve the control ability of deep muscle groups and muscle strength and endurance.%背景:青少年特发性脊柱侧弯(AIS)的康复手段众多,功能性康复训练可为临床康复治疗提供支持和可操作性建议.目的:分析运动对脊柱力学紊乱薄弱环节的积极作用,通过运动康复全面改善脊柱侧弯.方法:将19例青少年特发性脊柱侧弯患者随机分成试验组10人,采用手法复位+功能性康复方案,对照组9人,采用手法复位+常规肌力训练.用X射线摄片,脊柱测量仪测量青少年特发性脊柱侧弯患者不同姿势下的脊柱形态,用Back-Check等长肌力测试仪测量躯干侧屈力,用关节角度尺测量腰部活动度,用SRS-22问卷测量患者的主观感觉,所得数据进行f检验.结果与结论:①通过32周的干预,干预后试验组与对照组相比在Cobb角,顶锥偏离骶骨中线距离差异有显著性意义(P＜0.05);矢状面脊柱关节角度更接近于生理曲线;②在肌力方面,试验组和对照组在干预前后的差值有显著性意义(P＜0.05);③试验组与对照组相比,在腰部活动度前屈有非常显著性意义(P＜0.01),在后伸、右侧屈方面有显著性意义(P＜0.05):④在主观感觉功能活动、疼痛、自我形象、心理健康和治疗满意程度5个维度的问卷上试验组分值均高于对照组(P＜0.05);⑤结果说明,功能性康复运动提高了脊柱深层肌群对腰椎的控制能力和脊柱凸侧肌肉的力量和耐力,促进其健康成长.