背景:传统的3D运动分析通常将脊柱视为刚性实体。然而,先前的单关节模型已被证明不足以评估特发性脊柱侧凸(IS)患者不同脊柱节段间的运动.脊柱侧凸显著损害运动功能,尤其是在活动期间,如上升和下降的楼梯。缺乏专门针对IS患者的楼梯运动模式的研究。
目的:本研究旨在调查具有IS的大学生在楼梯上升和下降任务中的躯干运动学。共有56人参加,28个IS和28个健康对照,被招募用于这项病例对照研究。使用包含多节脊柱模型的运动分析系统分析躯干运动。在楼梯任务中了解多节段脊柱运动学可以为IS患者制定有效的康复计划。
方法:病例对照研究样本大小:28IS和28对照结局指标:Cobb角,脊柱弯曲,脊柱活动范围(ROM),运动学方法:Qualisys系统(哥德堡,瑞典)在这项研究中使用了150Hz的采样频率。它记录了胸部的运动学,腰椎,胸腔,28名IS个体和28名对照参与者在上下楼梯期间的骨盆和骨盆。此外,临床参数,如Cobb角,脊柱的曲率,脊柱活动范围(ROM),和其他相关因素同时在受试者中进行评估。国家自然科学基金项目(批准号:82205306)。作者声明在编写本文时没有利益冲突。
结果:这项研究的结果表明,与对照组相比,IS个体在矢状平面上的后凸曲率降低(P<0.05)。相比之下,与对照组相比,这些IS患者的额平面冠状曲率(Cobb角)更大,胸侧弯曲运动范围的差异更大(P<0.05)。此外,在上升的楼梯活动中,IS患者胸廓屈伸活动度降低(P<0.05),与对照组相比,腰椎旋转运动范围和骨盆前后倾斜运动范围增加(P<0.05)。值得注意的是,在楼梯下降过程中的运动学分析表明,IS患者在胸部屈伸时表现出较大的运动范围,胸侧弯曲,胸廓侧弯,胸部旋转,和胸廓旋转时与对照组比较(P<0.05)。
结论:结果显示,在楼梯上升和下降任务中,两组之间的躯干运动学存在显着差异。“多节段脊柱模型”的利用促进了诊断为IS的患者在脊柱的多个节段上的运动信息的获取,有效地增强从成像信息得出的评估结果。躯干中的三维结构畸形会影响静态和动态活动模式。在不同的活动状态中,IS患者在某些部分表现出僵硬的运动,而在其他部分则表现出代偿性不稳定。在未来,IS的临床康复计划应优先考虑与楼梯相关的活动培训。
BACKGROUND: Traditional 3D motion analysis typically considers the spine as a rigid entity. Nevertheless, previous single-joint models have proven inadequate in evaluating the movement across different spinal segments in patients with idiopathic scoliosis (IS). Scoliosis significantly impairs movement functions, especially during activities such as ascending and descending stairs. There is a lack of research on the patterns of stair movement specifically for patients with IS.
OBJECTIVE: This study aims to investigate trunk kinematics in college students with IS during stair ascent and descent tasks. A total of 56 participants, 28 with IS and 28 with healthy controls, were recruited for this case-control study. The trunk movements were analyzed using a motion analysis system that incorporated a multisegment spine model. Understanding the multi-segment spine kinematics during stair tasks can contribute to the development of effective rehabilitation programs for individuals with IS.
METHODS: Case-control study.
METHODS: 28 IS and 28 controls.
METHODS: Cobb angle, spinal curvature, spinal active range of motion (ROM), Kinematics METHODS: The Qualisys system (Gothenburg, Sweden) was utilized in this study with a sampling frequency of 150 Hz. It recorded the kinematics in the thoracic, lumbar, thoracic cage, and pelvis while ascending and descending stairs for both the 28 IS individuals and the 28 control participants. Additionally, clinical parameters such as the Cobb angle, curvature of the spine, spinal range of motion (ROM), and other relevant factors were concurrently assessed among the subjects. Project supported by the National Natural Science Foundation of China (Grant No. 82205306). The authors declare no conflict of interest in preparing this article.
RESULTS: The findings of this study revealed that IS individuals exhibited reduced kyphotic curvature in the sagittal plane (p<.05) when compared to the control group. In contrast, these IS patients displayed greater coronal curvature (Cobb angle) in the frontal plane and a more substantial difference in thoracic side bending range of motion in comparison to the control group (p.05). Moreover, during the ascending stair activity, IS patients showed reduced thoracic cage flexion-extension range of motion (p<.05), while displaying increased lumbar rotation range of motion and anterior-posterior pelvic tilt range of motion (p<.05) in contrast to the control group. Notably, the kinematic analysis during the descent of stairs indicated that IS patients exhibited a larger range of motion in thoracic flexion-extension, thoracic side bending, thoracic cage side bending, thoracic rotation, and thoracic cage rotation when compared to the control group (p<.05).
CONCLUSIONS: The results showed significant differences in trunk kinematics between the two groups during both stair ascent and descent tasks. The utilization of the \"multisegment spine model\" facilitates the acquisition of motion information across multiple segments of the spine in patients diagnosed with IS, effectively enhancing the assessment outcomes derived from imaging information. The three-dimensional structural deformity in the trunk affects both static and dynamic activity patterns. In different activity states, IS patients demonstrate stiff movements in certain segments while experiencing compensatory instability in others. In the future, clinical rehabilitation programs for IS should prioritize stair-related activity training.