| Background: At present,adolescent idiopathic scoliosis(AIS)has become one of the more common clinical orthopedic diseases,and its epidemiological characteristics are more female patients than male patients,and the scoliosis Angle is mostly mild.In May 2020,the Chinese Agricultural and Labor Party pointed out in the "Proposal on The Prevention and Control of Scoliosis in Children and Adolescents as soon as possible" at the National Two Sessions that scoliosis has become the third "killer" affecting the health of children and adolescents in China after obesity and myopia.Clinical treatment of the disease is challenging due to its unknown etiology,insidious onset and no obvious physical symptoms at the early stage.In recent years,China has issued relevant policies,proposing to attach importance to screening and prevention of juvenile scoliosis,and strengthening spinal health education,aiming to improve the awareness rate of parents and students on spinal health problems and strengthen the knowledge of related aspects.The etiology of AIS is unknown,and clinical treatment is challenging to some extent.At this time,convenient and effective rehabilitation means are very necessary.Physiotherapeutic Scoliosis-Specific exercises(PSSE)are designed by professional therapists according to the type of scoliosis curve,severity and bone development of each patient.They follow the principle of individualization.It is more targeted and scientific.PSSE is also recognized as one of the conservative treatments for scoliosis,including seven schools,and BSPTS is one of them.BSPTS therapy is a training method for AIS patients to achieve the best overall posture of the pelvis and trunk through asymmetric self-correction of their own trunk,and to strengthen the muscle training in specific areas and assist specific breathing skills.At present,most scholars at home and abroad are not clear about the therapeutic mechanism of specific exercise therapy for AIS,and the evaluation indicators are mostly in imaging.Although the scoliosis Angle(Cobb Angle)is the primary criterion for the diagnosis of scoliosis,the clinical manifestations are also accompanied by posture abnormalities,back pain and other problems,so the changes in the patient's body appearance,muscle function and quality of life cannot be ignored.Objective: To explore the efficacy analysis of scoliosis specific exercise-BSPTS therapy in patients with mild AIS,and to conduct multidimensional evaluation through imaging,muscle function,body appearance,quality of life and other indicators.Methods: The subjects of this study were 45 patients with mild AIS in rehabilitation Department of Tianjin Hospital,which were divided into experimental group(n=23)and control group(n=22).The experimental group received scoliosis specific exercise therapy-BSPTS therapy,and the control group received regular follow-up observation and daily life health management.The intervention lasted for 24 weeks.Body indicators(ATR,middle vertical line of sacrum)and muscle function(RMS em G ratio and muscle activation rate)were evaluated in 2 groups before,12 and 24 weeks after intervention.Imaging indicators(Cobb Angle,AVR,TK Angle,LL Angle)and quality of life questionnaire(SRS-22,SAQ)were evaluated in 2 groups before intervention and 24 weeks after intervention.Results:1.There was no statistical difference in basic information between the two groups(P > 0.05),indicating comparability.2.There was no statistical difference in the coronal Cobb Angle of image parameters between the two groups before intervention(P > 0.05),but the change of Cobb Angle between the two groups after intervention was statistically significant(P < 0.05).The Cobb Angle of the experimental group decreased by 2.49 degrees on average.There was no statistical significance before and after Cobb Angle intervention in the control group(P > 0.05).3.Compared with the two groups before intervention,there was no statistical difference in the number of AVR cases in the horizontal plane of image parameters(P > 0.05),but after intervention,the changes in the number of AVR cases in the two groups were statistically significant(P < 0.05).The number of cases in the experimental group was statistically significant(P > 0.05),showing an improvement trend.There was no statistical significance in the number of AVR in control group(P< 0.05).4.There were no statistically significant differences in sagittal thoracic kyphosis Angle(TK)and lumbar lordosis Angle(LL)between the two groups before intervention(P > 0.05).After the intervention,the change of TK Angle was statistically significant(P < 0.05),but the change of LL was not significant(P > 0.05).In the experimental group,TK Angle increased by 2.08 degrees on average.There was no statistical significance before and after TK Angle intervention in the control group(P > 0.05).5.There were no statistically significant differences in baseline ATR and sacrum vertical between the two groups of patients(P > 0.05).After the intervention,the ATR and sacrum vertical line in the experimental group decreased gradually with the change of intervention time.Among them,ATR changes were statistically significant in the two groups after 12 weeks of intervention(P < 0.05).After 24 weeks of intervention,the changes in the middle vertical line of sacrum in the two groups were statistically significant(P < 0.05).6.There was no statistical difference in baseline parameters of paravertebral muscle function between 2 groups(P > 0.05).After the intervention,the RMS ratio of the parietal vertebra in the experimental group decreased gradually with the change of the intervention time(P < 0.05),while the change of the control group had no statistical significance during the intervention period(P > 0.05),and the change of the RMS ratio of the parietal vertebra in the two groups had statistical significance after 24 weeks of intervention(P < 0.05).The activation rate of parietal fovea in the experimental group gradually increased with the change of intervention time(P <0.05),while the change in the control group had no statistical significance during the intervention period(P > 0.05).The activation rate of parietal fossa in both groups was statistically significant after 24 weeks(P < 0.05).7.After treatment,there were significant differences in self-image,mental health and treatment satisfaction in SRS-22 scores between the two groups(P < 0.05),and the self-image and mental health scores of the experimental group were better than those of the control group(P > 0.05).SAQ scores of the two groups showed significant differences in the two dimensions of back hump and shoulder level(P < 0.05).In the experimental group,there were significant differences in SAQ score of back eminence,trunk displacement,shoulder level,chest deformity and other 5 dimensions(P < 0.05).There was only significant difference in shoulder level in control group(P < 0.05).Research Conclusions: The results showed that the application of scoliosis specific exercise-BSPTS therapy in patients with mild AIS could reduce the scoliosis Angle Cobb Angle,reduce back hump,improve posture asymmetry,strengthen muscle function and improve quality of life to a certain extent.There were no significant differences in pain,functional activity,total,trunk displacement,lumbar,chest deformity,and other factors in SRS-22 compared with the follow-up health management control group.In conclusion,scoliosis specific exercise-BSPTS therapy has a positive impact on patients with mild AIS and is simple and easy to administer,making it an effective option for early rehabilitation. |
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