[1]田俊松,吴嘉颖,谢红岩,等.基于足底静态参数探讨“分节段式”脊柱推拿手法治疗青少年特发性脊柱侧凸的临床疗效[J].中医正骨,2024,36(04):15-20.
 TIAN Junsong,WU Jiaying,XIE Hongyan,et al.Outcomes of segmental spinal manipulation for treatment of adolescent idiopathic scoliosis:a static plantar parameters-based clinical study[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2024,36(04):15-20.
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基于足底静态参数探讨“分节段式”脊柱推拿手法治疗青少年特发性脊柱侧凸的临床疗效()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第36卷
期数:
2024年04期
页码:
15-20
栏目:
临床研究
出版日期:
2024-04-20

文章信息/Info

Title:
Outcomes of segmental spinal manipulation for treatment of adolescent idiopathic scoliosis:a static plantar parameters-based clinical study
作者:
田俊松1吴嘉颖1谢红岩1应晓明2叶鑫2
1.余姚市中医医院,浙江 余姚 315402; 2.浙江中医药大学附属第三医院,浙江 杭州 310005
Author(s):
TIAN Junsong1WU Jiaying1XIE Hongyan1YING Xiaoming2YE Xin2
1.Yuyao Hospital of TCM,Yuyao 315402,Zhejiang,China 2.The Third Affiliated Hospital of Zhejiang Chinese Medical University,Hangzhou 310005,Zhejiang,China
关键词:
脊柱侧凸 青少年 推拿脊柱 参数
Keywords:
scoliosis adolescent manipulationspinal foot parameters
摘要:
目的:基于足底静态参数探讨“分节段式”脊柱推拿手法治疗青少年特发性脊柱侧凸(adolescent idiopathic scoliosis,AIS)的临床疗效。方法:将60例符合要求的AIS患者随机分为2组,每组30例。常规推拿组采用常规脊柱推拿手法进行治疗,每周2次,共治疗12周; 联合推拿组在常规脊柱推拿手法治疗的基础上增加“分节段式”脊柱推拿手法,“分节段式”脊柱推拿手法每周1次,共治疗12周。分别于第1次治疗前和治疗结束后当天,采用USOL三维足底扫描仪采集患者足底静态参数,包括长度参数(足长、足弓长)、宽度参数(前掌宽、后跟宽)、高度参数(足弓内侧高度、外踝高度)及角度参数(趾角度)。结果:①长度参数。治疗前及治疗结束后,2组患者双侧足长差值、双侧足弓长差值比较,组间差异均无统计学意义(治疗前:t=1.684,P=0.098; t=0.359,P=0.721; 治疗结束后:t=0.263,P=0.081; t=0.240,P=0.811); 治疗结束后,2组患者双侧足长差值、双侧足弓长差值均较治疗前减小(双侧足长差值:t=5.079,P=0.000; t=21.891,P=0.000; 双侧足弓长差值:t=15.834,P=0.000; t=12.120,P=0.000)。②宽度参数。治疗前,2组患者双侧前掌宽差值、双侧后跟宽差值比较,组间差异均无统计学意义(t=-0.748,P=0.457; t=0.372,P=0.711); 治疗结束后,2组患者双侧前掌宽差值、双侧后跟宽差值均较治疗前减小(双侧前掌宽差值:t=11.522,P=0.000; t=7.369,P=0.000; 双侧后跟宽差值:t=16.745,P=0.000; t=11.486,P=0.000); 治疗结束后,联合推拿组患者双侧前掌宽差值、双侧后跟宽差值均小于常规推拿组(t=-2.351,P=0.022; t=-2.699,P=0.009)。③高度参数。治疗前,2组患者双侧足弓内侧高度差值、双侧外踝高度差值比较,组间差异均无统计学意义(t=-0.595,P=0.554; t=0.082,P=0.935); 治疗结束后,2组患者双侧足弓内侧高度差值、双侧外踝高度差值均较治疗前减小(双侧足弓内侧高度差值:t=9.616,P=0.000; t=10.269,P=0.000; 双侧外踝高度差值:t=7.365,P=0.000; t=6.021,P=0.000); 治疗结束后,联合推拿组患者双侧足弓内侧高度差值、双侧外踝高度差值均小于常规推拿组(t=-2.790,P=0.007; t=-2.455,P=0.017)。④角度参数。治疗前及治疗结束后,2组患者双侧趾角度差值比较,组间差异均无统计学意义(t=0.382,P=0.704; t=0.273,P=0.786); 治疗结束后,2组患者双侧趾角度差值均较治疗前减小(t=6.277,P=0.000; t=12.049,P=0.000)。结论:“分节段式”脊柱推拿手法可有效改善AIS患者的足底静态参数,相较于常规脊柱推拿手法具有一定优势。
Abstract:
Objective:To explore the clinical outcomes of segmental spinal manipulation in treatment of adolescent idiopathic scoliosis(AIS)based on the static plantar parameters.Methods:Sixty AIS patients were enrolled in the study and were randomized into conventional manipulation group and combination manipulation group,30 ones in each group.All patients in the 2 groups were treated with conventional spinal manipulation,twice a week for consecutive 12 weeks; moreover,the ones in combination manipulation group were further treated with segmental spinal manipulation,once a week for consecutive 12 weeks.Before the first treatment and after the end of treatment,the static plantar parameters,including length parameters(foot length,foot arch length),width parameters(forefoot width,heel width),height parameters(medial arch height,lateral malleolus height),and angle parameter(big toe angle)were collected,respectively,by using a USOL three-dimensional plantar scanner.Results:①Length parameters.The difference between the bilateral foot length and difference between the bilateral foot arch length were compared between the 2 groups before the treatment and after the end of the treatment,and the results revealed no significant differences(pretreatment:t=1.684,P=0.098; t=0.359,P=0.721; after the end of the treatment:t=0.263,P=0.081; t=0.240,P=0.811); the difference between the bilateral foot length and difference between the bilateral foot arch length decreased in the 2 groups after the end of treatment compared to pretreatment(the difference between the bilateral foot length:t=5.079,P=0.000; t=21.891,P=0.000; the difference between the bilateral foot arch length:t=15.834,P=0.000; t=12.120,P=0.000).②Width parameters.The difference between the bilateral forefoot width and the difference between the bilateral heel width were compared between the 2 groups before the treatment,and the results revealed no significant differences(t=-0.748,P=0.457; t=0.372,P=0.711).The difference between the bilateral forefoot width and the difference between the bilateral heel width decreased in the 2 groups after the end of treatment compared to pretreatment(the difference between the bilateral forefoot width:t=11.522,P=0.000; t=7.369,P=0.000; the difference between the bilateral heel width:t=16.745,P=0.000; t=11.486,P=0.000),and they were smaller in combination manipulation group compared to conventional manipulation group(t=-2.351,P=0.022; t=-2.699,P=0.009).③Height parameters.The difference between the bilateral medial arch height and the difference between the bilateral lateral malleolus height were compared between the 2 groups before the treatment,and the results revealed no significant differences(t=-0.595,P=0.554; t=0.082,P=0.935).The difference between the bilateral medial arch height and the difference between the bilateral lateral malleolus height decreased in the 2 groups after the end of treatment compared to pretreatment(the difference between the bilateral medial arch height:t=9.616,P=0.000; t=10.269,P=0.000; the difference between the bilateral lateral malleolus height:t=7.365,P=0.000; t=6.021,P=0.000),and they were smaller in combination manipulation group compared to conventional manipulation group(t=-2.790,P=0.007; t=-2.455,P=0.017).④Angle parameter.The difference between the bilateral big toe angle was compared between the 2 groups before the treatment and after the end of the treatment,and the result revealed no significant difference(t=0.382,P=0.704; t=0.273,P=0.786),and it decreased in the 2 groups after the end of treatment compared to pretreatment(t=6.277,P=0.000; t=12.049,P=0.000).Conclusion:The segmental spinal manipulation can effectively improve the static plantar parameters in AIS patients.It has certain advantages over the conventional spinal manipulation.

参考文献/References:

[1] GARGANO G,OLIVA F,MIGLIORINI F,et al.Melatonin and adolescent idiopathic scoliosis:the present evidence[J].Surgeon,2022,20(6):e315-e321.
[2] 宋冰,刘佳易.关注和推动中国青少年特发性脊柱侧弯筛查[J].中国学校卫生,2023,44(8):1121-1124.
[3] 楼斐,王伟,谢罗军,等.青少年特发性脊柱侧弯的生物力学研究进展[J].中国现代医生,2023,61(15):118-121.
[4] XU L,CHEN J,WANG F,et al.Machine-learning-based children's pathological gait classification with low-cost gait-recognition system[J].Biomed Eng Online,2021,20(1):62.
[5] 朱飞龙,张明,吴宇,等.青少年特发性脊柱侧弯患者足部姿势和步态特征的3D形态分析及生物力学评价[J].中国组织工程研究,2021,25(33):5294-5300.
[6] 贾品茹,成慧,张静,等.青少年特发性脊柱侧弯矢状位平衡与足底压力的相关性[J].医用生物力学,2022,37(5):846-850.
[7] 田俊松,应晓明,李晓,等.“分节段式”脊柱推拿手法对青少年特发性脊柱侧凸患者脊柱三维结构的影响[J].中医正骨,2022,34(7):15-21.
[8] NEGRINI S,DONZELLI S,AULISA A G,et al.2016 SOSORT guidelines:orthopaedic and rehabilitation treatment of idiopathic scoliosis during growth[J].Scoliosis Spinal Disord,2018,13:3.
[9] 范炳华.推拿治疗学[M].北京:中国中医药出版社,2017:40-42.
[10] ZHENG Q,HE C,HUANG Y,et al.Can computer-aided design and computer-aided manufacturing integrating with/without biomechanical simulation improve the effectiveness of spinal braces on adolescent idiopathic scoliosis?[J].Children(Basel),2023,10(6):927.
[11] ZHU F,HONG Q,GUO X,et al.A comparison of foot posture and walking performance in patients with mild,moderate,and severe adolescent idiopathic scoliosis[J].PLoS One,2021,16(5):e0251592.
[12] CHEN P Q,WANG J L,TSUANG Y H,et al.The postural stability control and gait pattern of idiopathic scoliosis adolescents[J].Clin Biomech(Bristol,Avon),1998,13(1 Suppl 1):S52-S58.
[13] KASTRINIS A,KOUMANTAKIS G,TSEKOURA M,et al.The effect of Schroth method on postural control and balance in patients with adolescent idiopathic scoliosis:a literature review[J].Adv Exp Med Biol,2023,1425:469-476.
[14] XIA Q,CHEN X,WEI H,et al.Static sitting posture control during writing tasks in idiopathic scoliosis among freshmen[J].J Orthop Surg Res,2023,18(1):735.
[15] BRUYNEEL A V,CHAVET P,BOLLINI G,et al.Dynamical asymmetries in idiopathic scoliosis during forward and lateral initiation step[J].Eur Spine J,2009,18(2):188-195.
[16] MAHAUDENS P,DETREMBLEUR C,MOUSNY M,et al.Gait in thoracolumbar/lumbar adolescent idiopathic scoliosis:effect of surgery on gait mechanisms[J].Eur Spine J,2010,19(7):1179-1188.
[17] 应晓明,石国庆,王晓东,等.治疗特发性脊柱侧凸的分节段脊柱推拿术[J].中医正骨,2020,32(8):49-51.
[18] 田俊松,应晓明,叶鑫.“分节段式”脊柱推拿手法联合改良Schroth体操治疗青少年特发性脊柱侧凸的临床研究[J].中医正骨,2021,33(7):23-27.
[19] 赵杰.脊柱生物力学专栏论著评述[J].医用生物力学,2023,38(1):1-3.
[20] 刘柏杰,周红海,何心愉,等.三维有限元法分析脊柱推拿手法的生物力学特征[J].中国组织工程研究,2023,27(27):4385-4392.

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备注/Memo

备注/Memo:
基金项目:宁波市卫生健康科技计划项目(2022Y50); 余姚市卫生健康科技计划项目(2022YYB08); 浙江中医药大学附属第三医院院级课题(YJKY-2020-01)
更新日期/Last Update: 1900-01-01