不同侧弯类型对青少年脊柱生理曲度及骨盆运动学特征影响
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深圳市自然科学基金项目(JCYJ20210324103010029)


Effects of Different Scoliosis Curves on Physiological Curvature of Spine and Kinematic Characteristics of Pelvis in Adolescents
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    摘要:

    目的 探讨不同弯形青少年特发性脊柱侧凸(adolescent idiopathic scoliosis, AIS)患者站立位及行走时脊柱、骨盆运动学特征,为康复形体训练提供可参考建议。 方法 使用 Diers 4D motion 模块测量 45 名单弯、45 名双弯AIS 患者及 27 名健康青少年站立位及行走状态下胸曲角、腰曲角,以及骨盆旋转和骨盆倾斜参数。 结果 站立位健康组胸曲角(40. 67°)和腰曲角(39. 68°)角度最大,步行时双弯组胸曲增大角度(6. 1°)最大,健康组胸曲增大角度(-10. 37°)最小;站立位下单弯组的骨盆倾斜方向与主弯同向。 结论 相对于站立位,步行时 3 组胸曲角运动趋势主要以减少为主,且受到侧弯类型的影响,腰曲角则在 3 组中均表现为减少;两侧弯组站立位骨盆三维形态受腰椎代偿弯影响,且步行时骨盆旋转功能与腰椎代偿弯和骨盆初始位置有关。 建议治疗师在进行患者骨盆功能评估和训练时,应充分考虑侧弯弯形可能带来对结果的影响,并有针对性地对盆活动度不足侧进行松解和功能训练,提高骨盆运动功能的对称性。

    Abstract:

    Objective To explore kinematic characteristics of the spine and pelvis for adolescent idiopathic scoliosis ( AIS) patients with different scoliosis curves during standing and walking, and provide reference suggestions for body training in rehabilitation. Methods The thoracic and lumbar angles, as well as pelvic rotation and pelvic tilt parameters of 45 patients with single curve, 45 patients with double-curve and 27 healthy adolescents were measured in standing position and during walking by using Diers 4D motion module. Results The thoracic angle (40. 67°) and lumbar angle (39. 68°) in healthy group in standing position were the largest, the thoracic enlargement angle (6. 1°) in double-curve group was the largest, and the thoracic enlargement angle (-10. 37°) in healthy group was the smallest. The rotation direction of the pelvis in scoliosis group was the same as that of the main curve, and the direction of the pelvis in single curve group was the same as the main curve. Conclusions Compared with the standing position, the motion trend of the thoracic angle in three groups during walking was mainly reduced, and affected by the scoliosis curve. The lumbar angle decreased in three groups. The three-dimensional (3D) pelvic morphology of scoliosis groups in standing position was affected by compensatory curve of the lumbar, and the dynamic rotation function of the pelvis was related to compensatory curve of the lumbar and initial position of the pelvis during walking. It is suggested that therapists should fully consider the potential impact of scoliosis curves on the results when evaluating and training the patient’ s pelvic function, and provide targeted relaxation and functional training on the side with insufficient pelvic mobility to improve the symmetry of pelvic motor function.

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刘 杨,王伟君,陆昕海,韩宗萍,汝首杭,陈晓生,朱智祥,卓挺宇,杨 雷,颜 滨.不同侧弯类型对青少年脊柱生理曲度及骨盆运动学特征影响[J].医用生物力学,2023,38(6):1160-1166

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  • 收稿日期:2023-03-13
  • 最后修改日期:2023-04-19
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  • 在线发布日期: 2023-12-25
  • 出版日期: 2023-12-25
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