| 续彦兵,令碧荣,杨楠,程晓荣.运动疗法对青少年特发性脊柱侧凸患者肺功能改善效果的Meta分析[J].中国康复,2025,40(9):549-559 |
| 运动疗法对青少年特发性脊柱侧凸患者肺功能改善效果的Meta分析 |
| Effect of exercise therapy on pulmonary function in adolescent idiopathic scoliosis patients: a Meta-analysis |
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| DOI：10.3870/zgkf.2025.09.008 |
| 中文关键词: 运动疗法 脊柱侧凸 青少年 肺功能 Meta分析 |
| 英文关键词: exercise therapy scoliosis adolescence pulmonary function Meta-analysis |
| 基金项目:甘肃省自然科学基金（NO.23JRRA0981）；兰州市科技计划项目（科技支撑专项NO.2024-4-14） |
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| 中文摘要: |
| 目的：分析运动疗法对青少年特发性脊柱侧凸（AIS）患者的肺活量（VC）、用力肺活量（FVC）、第一秒用力呼气容量（FEV1）、第一秒用力呼气容量/用力肺活量（FEV1/FVC）、最大呼气峰值呼气流速（PEF）、最大自主通气量（MVV）等肺功能指标的干预疗效。方法：检索Medline、Embase、CINAHL、Cochrane图书馆、PEDro、万方数据和中国知网等数据库，搜集运动疗法干预AIS患者肺功能的随机对照研究。检索时间限制在从建库至2024年10月。两位研究员独立筛选、提取文献资料并使用物理治疗证据数据库量表（PEDro）和Cochrane协作网质量评价工具对纳入研究的文献质量进行评价，采用Rev Man 5.4软件对纳入文献肺功能参数进行分析。结果：共纳入16篇文献，包括968例AIS患者。Meta分析结果显示：与对照组相比，运动疗法能显著改善AIS患者的VC［SMD=0.97, 95%CI（0.76，1.19）,P＜0.001］，FVC［SMD=0.64, 95%CI（0.48，0.79）,P＜0.001］，FEV1［SMD=0.65，95%CI（0.39，0.91），P＜0.001］ ，第一秒用力呼气容量占预估值百分比（FEV1%）［MD=3.66, 95%CI（2.26，5.05），P＜0.001］，FEV1/FVC［SMD=0.81, 95%CI（0.61，1.02），P＜0.001］和MVV［MD=5.69, 95%CI（4.27，7.11），P＜0.001］；运动疗法不能显著改善AIS患者的用力肺活量占预估值百分比（FVC%）［MD=2.85, 95%CI（-0.33，6.03），P=0.08］，PEF［SMD=0.31, 95%CI（-0.11，0.72），P=0.15］和最大呼气峰值呼气流速占预估值百分比（PEF%）［MD=2.70, 95%CI（-6.08，11.49），P=0.55］。运动疗法不能显著改善轻度AIS患者的FEV1［SMD=0.28，95%CI（-0.14，0.70），P=0.20］和FEV1/FVC［SMD=0.37, 95%CI（-0.18，0.92），P=0.19］；运动疗法不能显著改善干预周期＜3个月AIS患者的FEV1［SMD=0.36，95%CI（-0.02，0.74），P=0.07］。结论：运动疗法可以改善AIS患者的VC、FVC、FEV1、FEV1/FVC和MVV，不能改善PEF和FVC%。FEV1的改善可能受患者脊柱侧凸严重程度和干预周期的影响，FEV1/FVC的改善可能受患者脊柱侧凸严重程度的影响。 |
| 英文摘要: |
| Objective: To systematically review the effects of exercise therapy on pulmonary function indexes such as vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), the ratio of forced expiratory volume in the first second to forced vital capacity (FEV1/FVC), peak expiratory flow (PEF), and maximum voluntary ventilation (MVV) in patients with adolescent idiopathic scoliosis (AIS). Methods: Medline, Embase, CINAHL, Cochrane Library, PEDro, Wanfang Data, and China National Knowledge Infrastructure (CNKI) were conducted to collect randomized controlled trials of exercise therapy for the pulmonary function of AIS patients. The search time was from the establishment of the databases to October, 2024. Two researchers screened, extracted data, and used the Physiotherapy Evidence Database (PEDro) scale and the Cochrane Collaboration’s quality assessment tool to assess the quality of the included studies. The Rev Man 5.4 software was used to analyze the pulmonary function parameters of the included literature. Results: A total of 16 literatures were included, including 968 AIS patients. The results of meta-analysis showed that compared with the control group, exercise therapy significantly improved the VC ［SMD=0.97, 95%CI 0.76 to 1.19, P<0.001］, FVC ［SMD=0.64, 95%CI 0.48 to 0.79, P<0.001］, FEV1 ［SMD=0.65, 95%CI (0.39, 0.91), P<0.001］, FEV1% ［MD=3.66, 95%CI 2.26 to 5.05, P<0.001, FEV1/FVC ［SMD=0.81, 95%CI 0.61 to 1.02, P<0.001］, and MVV ［MD=5.69, 95%CI 4.27 to 7.11, P<0.001］ in AIS patients. However, exercise therapy could not significantly improve FVC% ［MD=2.85, 95%CI-0.33 to 6.03, P=0.08］, PEF ［SMD=0.31, 95%CI -0.11 to 0.72, P=0.15］, and PEF% ［MD=2.70, 95%CI -6.08 to 11.49, P=0.55］ in AIS patients. The results of subgroup analysis showed that exercise therapy did not significantly improve FEV1 ［SMD=0.28, 95%CI -0.14 to 0.70, P=0.20］, FEV1/FVC ［SM =0.37, 95%CI -0.18 to 0.92, P=0.19］ in patients with mild AIS. The exercise therapy could not significantly improve FEV1 in AIS patients with intervention period less than 3 months ［SMD=0.36, 95%CI -0.02-0.74, P=0.07］. Conclusion: Exercise therapy can improve VC, FVC, FEV1, FEV1 / FVC, and MVV in AIS patients, but could not improve PEF, PEF% and FVC%. The improvement in FEV1 may be influenced by the severity of scoliosis and the intervention period, and the improvement in FEV1/FVC may be influenced by the severity of scoliosis. |
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