骨盆矫正手法干预特发性脊柱侧弯的下肢生物力学机制分析  

Effect of Pelvic Correction Manipulation on Lower Extremity Biomechanics of Idiopathic Scoliosis

作　　者：孙漪凡 陈少清[1] 王宇[1] 陈柏瑞 苟艳芸 SUN Yifan;CHEN Shaoqing;WANG Yu;CHEN Bairui;GOU Yanyun(Fujian University of Chinese Medicine,Fuzhou,Fujian 350122)

机构地区：[1]福建中医药大学,福建福州350122

出　　处：《中医康复》2025年第2期46-50,共5页Traditional Chinese Medicine Rehabilitation

基　　金：国家自然科学基金青年项目(82205306);福建省财政专项(X20210003)。

摘　　要：目的:观察骨盆矫正手法合并Schroth运动训练治疗特发性脊柱侧弯的疗效,并分析其生物力学机制。方法:将80例特发性脊柱侧弯患者随机分为试验组和对照组各40例,试验组采用骨盆矫正手法合并Schroth运动训练,对照组仅给予Schroth运动训练,干预前后测量Cobb角、步态时空参数、动力学参数、运动学参数以分析临床疗效和生物力学机制。结果:干预后,试验组脊柱Cobb角减小程度优于对照组(P<0.05);干预前后,两组患者步态时空参数差异均无统计学意义(P>0.05);干预后,试验组凹侧髋关节力矩最大值较干预前和对照组减小(P<0.05)、凸侧膝关节力矩最大值较干预前和对照组增大(P<0.05);干预后,试验组膝关节凹侧的屈伸活动度显著减少,踝关节凹侧的背跖屈活动度显著增加(P<0.05)。结论:在Schroth运动训练基础上,骨盆矫正手法可显著改善特发性脊柱侧弯的脊柱畸形,其疗效机制可能是通过调整髋关节负荷,使受力平衡,进而间接改善脊柱侧弯角度,延缓侧弯进展。Objective:To observe the efficacy of pelvic corrective manipulation combined with Schroth exercise training in the treatment of idiopathic scoliosis and analyze its biomechanical mechanisms.Methods:Eighty patients with idiopathic scoliosis were randomly divided into 40 cases each in the experimental group and the control group.In the experimental group,pelvic corrective manipulation was combined with Schroth's exercise training,while in the control group,only Schroth's exercise training was given,and Cobb's angle,gait spatialtemporal parameters,kinetic parameters,and kinematic parameters were measured before and after the interventions in order to analyze the clinical efficacy and biomechanical mechanisms.Results:After intervention,the Cobb Angle of spine in both groups decreased compared with that before intervention(P<0.05).Before and after intervention,there was no statistical significance in spatio-temporal parameters between the two groups(P>0.05).After intervention,the maximum hip moment of experimental group was lower than that of control group(P<0.05).After intervention,the flexion-extension mobility of the concave side of the knee joint was significantly reduced and the dorsal plantarflexion mobility of the concave side of the ankle joint was significantly increased in the experimental group(P<0.05).Conclusions:On the basis of Schroth exercise training,pelvic corrective manipulation can significantly improve the spinal deformity of idiopathic scoliosis,and its therapeutic mechanism may be to adjust the load of the hip joint to make the force balanced,and then indirectly improve the angle of scoliosis and slow down the progression of scoliosis.

关 键 词：特发性脊柱侧弯 骨盆矫正手法 Schroth运动训练 生物力学 青少年 作用机制 

分 类 号：R682.3[医药卫生—骨科学]