A randomized controlled trial on clinical effect of Proprioceptive Neuromuscular Facilitation combined with Spiral Stabilization of Spine in the treatment of children with adolescent idiopathic scoliosis

BACKGROUND: The exercise intervention therapy has been shown to relieve mild idiopathic scoliosis and address the paravertebral muscle imbalance on both sides of the spine. However, further studies are needed to validate proprioceptive facilitation technique (PNF) and spiral muscle chain training (SPS) effectiveness in addressing other spinal abnormalities, and to explore their stacked benefits in the treatment of scoliosis.AIM:The aim of this study was to investigate the effects of proprioceptive facilitation technique (PNF) and spiral muscle chain training (SPS), which were administered three times per week, on children diagnosed with adolescent idiopathic scoliosis.DESIGN: Four-group parallel randomized controlled trial.SETTING:School exercise.POPULATION:This four-arm randomized controlled trial will recruit 32 adolescent patients who have been diagnosed with idiopathic scoliosis.METHODS: Thirty-two participants (n.=8 in each group).PNF, SPS, combination therapy and control group will receive their respective intervention three times weekly for a duration of 12 weeks. Angle of trunk inclination (ATI),body balance parameters, root mean square (RMS) values, integrated electromyography (IEMG) values, median frequency(MF) and mean power frequency(MPF) were collected to evaluate the degree of scoliosis.RESULTS:Effect of 12-week PNF combined with SPS were examined using one-way ANOVA and multiple comparisons before and after the experiment. The combined group had better effects in head deflection difference (d) and shoulder height difference (d). Significant effects pre- and post-intervention were found for each electromyography indexes of each experimental group, better improvement in RMS and IEMG were observed for each muscles in the SPS group, while fatigue resistance improved for both right trapezius muscle and erector spinae muscle in the combined group.CONCLUSIONS: In each test, we discovered increased levels of ATI, body balance parameters and surface electromyography values in each experimental group but not in the control group. These findings suggested that PNF combined with SPS could benefit adolescent idiopathic scoliosis(AIS) patients through activated a maximum number of motor muscle fibers and enhanced muscle fatigue tolerance levels. CLINICAL REHABILITATION IMPACT: The results are anticipated to consolidate the therapeutic efficacy of proprioceptive neurosensory facilitation techniques and spiral muscle chain training in children with adolescent idiopathic scoliosis, while also providing comparative information on the adherence, feasibility, and applicability of rehabilitation methods as exercise strategies for scoliosis prevention.

背景：研究表明，锻炼干预疗法可有效缓解轻度特发性脊柱侧弯，并纠正脊柱两侧的椎旁肌肉失衡。然而，为进一步验证本体感觉促进技术（PNF）和螺旋肌肉链训练（SPS）在处理其他脊柱异常方面的有效性，并探索其在脊柱侧弯治疗中的叠加效益，仍需进行进一步研究。研究目的：本研究的目的是探究每周三次实施的本体感觉促进技术（PNF）和螺旋肌肉链训练（SPS）对被诊断为青少年特发性脊柱侧弯的儿童的影响。研究设计：一项四组平行随机对照试验。研究场所：学校运动场所。研究人群：本四臂随机对照试验将招募32名被诊断为特发性脊柱侧弯的青少年患者。研究方法：32名参与者（每组n=8）。PNF组、SPS组、联合治疗组和对照组将分别接受其相应的干预措施，每周三次，持续12周。收集躯干倾斜角（ATI）、身体平衡参数、均方根（RMS）值、综合肌电图（IEMG）值、中频（MF）和平均功率频率（MPF）等数据，以评估脊柱侧弯的程度。研究结果：通过单因素方差分析和实验前后多重比较，考察了12周PNF联合SPS的效果。联合组在头部偏移差（d）和肩部高度差（d）方面显示出更好的效果。每个实验组的电肌电图指标在干预前后均显示出显著效果，SPS组观察到各肌肉的RMS和IEMG均有所改善，而联合组中右侧斜方肌和竖脊肌的耐疲劳能力均有所提高。研究结论：在各项测试中，我们发现实验组中的躯干倾斜角、身体平衡参数和表面肌电图值均有所提高，而对照组则无显著变化。这些发现表明，PNF联合SPS可通过激活最大数量的运动肌纤维和增强肌肉耐疲劳能力，从而有助于青少年特发性脊柱侧弯（AIS）患者的治疗。临床康复影响：预期这些结果将巩固本体感觉神经感觉促进技术和螺旋肌肉链训练在青少年特发性脊柱侧弯儿童中的治疗疗效，同时提供有关康复方法作为脊柱侧弯预防运动策略的依从性、可行性和适用性的比较信息。