The Uticaj indeksa tjelesne mase na inicijalnu korekciju u mideru kod pacijenata sa idiopatskom skoliozom

  • Samra Pjanić Zavod za fizikalnu medicinu i rehabilitaciju "Dr Miroslav Zotović", Banjaluka
  • Goran Talić Zavod za fizikalnu medicinu i rehabilitaciju "Dr MIroslav Zotović"
  • Dragana Bojinović-Rodić Zavod za fizikalnu medicinu i rehabilitaciju "Dr MIroslav Zotović"
DOI: https://doi.org/10.5937/scriptamed52-29309
Ključne reči: Skolioza, Indeks tjelesne mase, Mider, Ispravka

Sažetak


Uvod/Cilj: Mnogi faktori utiču na inicijalnu korekciju u mideru i ishod liječenja kod pacijenata sa idipatskom skoliozom. Dosadašnja istraživanja su pokazala kontradiktorne rezultate o ulozi indeksa tjelesne mase (BMI) u ortotičkom tretmanu. Cilj ove studije je ispitati uticaj BMI na incijalnu korekciju u mideru, izolovano i u odnosu na druge prediktivne faktore (veličina primarne krivine, lokalizacija primarne krivine, Riserov znak).  

Metode: Retrospektivna studija je obuhvatila pacijente sa idiopatskom skoliozom koji su liječeni Cheneau – Sobernheim miderom, a da prethodno nisu bili u tretmanu. Pored demografskih podataka pacijenata, analizirali smo BMI, veličinu i lokaciju primarne krivine i Riserov znak na korekciju u mideru. Inicijalna korekcija u  mideru prikazana je kao postotak redukcije Cobbovog ugla u mideru. Pacijenti su podijeljeni u grupe prema BMI u percentilima: pacijenti sa niskim BMI (< 5 percentila), pacijenti sa srednjim BMI (5-85 percentila) i pacijenti sa visokim BMI (> 85 percentila). Za testiranje statističke značajnosti i korelacija između testiranih varijabli korišteni su test varijanse, t test za nezavisne uzorke i Pirsonov koeficijent korelacije.

Rezultati: U istraživanje je uključeno 213 pacijenata (170 djevojčica i 43 dječaka), prosječne dobi od 13,5 godina pri propisivanju midera. Nizak BMI je bio prisutan kod 10%, srednji BMI kod 78% i visok BMI kod 12% pacijenata. Nije utvrđena značajna razlika u korekciji u mideru između BMI grupa, niti značajna korelacija između BMI i korekcije u mideru. U odnosu na druge faktore, značajna razlika u korekciji u mideru utvrđena je između BMI grupa u odnosu na lokaciju krivine i Riserov znak.  Lumbalne krivine imale su statistički značajno bolju korekcij u mideru u odnosu na torakalne krivine. Značajne korelacije su utvrđene između korekcije u mideru i veličine krivine, lokacije krivine i Riserovog znaka.

Zaključak: Rezultati našeg istraživanja pokazuju da BMI kao neovisan faktor ne utiče na korekciju u mideru. Drugi faktori, kao što je veličina krivine, lokacija krivine i Riserov znak igraju značajniju ulogu u ortotičkom liječenju pacijenata sa idipatskom skoliozom.

 

Reference

1. Negrini S, Donzelli S, Aulisa Angelo Gabriele et al. 2016 SOSORT guidelines: orthopaedic and rehabilitation treatment of idiopathic scoliosis during growth. Negrini et al. Scoliosis and Spinal Disorders (2018) 13:3.
2. Grivas TB, Vasiliadis E, Mouzakis V, Mihas C, Koufopoulos G. Association between adolescent idiopathic scoliosis prevalence and age at menarche in different geographic latitudes. Scoliosis. 2006;1:9.
3. Negrini S, Atanasio S, Fusco C, Zaina F. Effectiveness of complete conservative treatment for adolescent idiopathic scoliosis (bracing and exercises) based on SOSORT management criteria: results according to the SRS criteria for bracing studies - SOSORT award 2009 winner. Scoliosis. 2009;4:19.
4. Upadhyay SS, Nelson IW, Ho EK, Hsu LC, Leong JC. New prognostic factors to predict the final outcome of brace treatment in adolescent idiopathic scoliosis. Spine. 1995;20(5):537–45.
5. Katz DE, Herring JA, Browne RH, Kelly DM, Birch JG. Brace wear control of curve progression in adolescent idiopathic scoliosis. J Bone Joint Surg Am. 2010;92(6):1343–52.
6. Zaina F, Donzelli S, Luisini M, Negrini S. Correlation between in-brace radiographic correction and short time brace results. Stud Health Technol Inform.2012;176:342-5.
7. Clin J, Aubin C-É, Parent S. Biomechanical simulation and analysis of scoliosis correction using a fusionless intravertebral epiphyseal device. Spine. 2015;40(6):369–76.
8. Chuandong Lang , Zifang Huang , Wenyuan Sui , Muping Di , Shaofu He et al. Factors That Influence In-Brace Correction in Patients with Adolescent Idiopathic Scoliosis. World Neurosurg 2019 Mar;123:e597-e603.
9. Weinstein LS, Dolan L, Wright JG, Dobbs MB. Effects of bracing in adolescents with idiopathic scoliosis. N Engl J Med 2013. 369:1512-21.
10. El Hawary R, Zaaroor-Regev D, Floman Y, Loonner BS, Alkhalife YI, Betz RR. Brace treatment in adolescent idiopathic scoliosis: risk factors for failure—a literature review. Spine J. 2019 Dec;19(12):1917-25.
11. Emans JB, Kaelin A, Bancel P, Hall JE, Miller ME. The Boston bracing system for idiopathic scoliosis. Follow-up results in 295 patients. Spine (Phila Pa 1976). 1986. 11(8):792-801.
12. Landauer F, Wimmer C, Behensky H: Estimating the final outcome of brace treatment for idiopathic thoracic scoliosis at 6-month follow-up. Pediatr Rehabil. 2003, 6 (3–4): 201-7.
13. Van den Bogaart M, Van Royen J Barend, Tsjitske M Haanstra, De Kleuver M, Sayf S, A Faraj: Predictive factors for brace treatment outcome in adolescent idiopathic scoliosis: a best-evidence synthesis. Eur Spine J. 2019 Mar;28(3):511-25.
14. Chuandong Lang , Zifang Huang , Wenyuan Sui , Muping Di, Shaofu He, Hengwei Fan et al. Factors That Influence In-Brace Correction in Patients with Adolescent Idiopathic Scoliosis. World Neurosurg. 2019 Mar;123:e597-e603.
15. O'Neill, Patrick J, Karol, Lori A., Shindle, Michael K. et al. Decreased orthotic effectiveness in overweight patients with adolescent idiopathic scoliosis. The Journal of Bone and Joint Surgery 87(5):1069-74
16. Goodbody CM, Asztalos IB, Sankar WN, Flynn JM. It's not just the big kids: both high and low BMI impact bracing success for adolescent idiopathic scoliosis. J Child Orthop 2016 ;10(5):395-404.
17. Weixiang Sun, Minghui Sun, Xiaodong Qin, Zhou Jin. Low body mass index can be predictive of bracing failure in patients with adolescent idiopathic scoliosis: a retrospective study. Eur Spine J 2017 Jun;26(6):1665-69.
18. Lori A.Karol, Wingfield Jessica J, Virostek Donald, Felton Kevin, ChanHee Jo. The Influence of Body Habitus on Documented Brace Wear and Progression in Adolescents With Idiopathic Scoliosis. J Pediatr Orthop. 2020 Mar;40(3):e171-e175.
19. Clin J, Aubin C-É, Parent S. Biomechanical simulation and analysis of scoliosis correction using a fusionless intravertebral epiphyseal device. Spine. 2015;40(6):369–76.
20. Zaina Fabio, Donzelli Sabrina, Negrini Stefano. Overweight is not predictive of bracing failure in adolescent idiopathic scoliosis: results from a retrospective cohort study. Eur Spine J. 2017 Jun;26(6):1670-1675.
21. Katz Donald E, Herring J Anthony, Browne Richard H, Kelly Derek M, Birch John G. Brace wear control of curve progression in adolescent idiopathic scoliosis. J Bone Joint Surg Am. 2010 Jun;92(6):1343-52.
22. Rahman T, Borkhuu B, Littleton AG, Sample W, Moran E, Campbell S, et al. Electronic monitoring of scoliosis brace wear compliance. J Child Orthop. 2010;4(4):343–7.
Objavljeno
2021/03/26
Broj časopisa
Vol. 52 Br. 1 (2021): Q1/Mart
Rubrika
Stručni članak
Authors who publish with this journal agree to the following terms:

  1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.

  2. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.

  3. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).