Muscle dysfunction and exercise limitation in adolescent idiopathic scoliosis
Muscle dysfunction and exercise limitation in adolescent idiopathic scoliosis
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DOI：
10.1183/09031936.00025509
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发表时间：
2010-08-01
影响因子：
24.3
通讯作者：
Gea, J.
中科院分区：
文献类型：
--
作者：
Martinez-Llorens, J.;Ramirez, M.;Gea, J.
青少年特发性脊柱侧凸（AIS）可导致排尿受限、呼吸肌无力和运动受限。然而，肌肉功能障碍的原因和程度仍不清楚。本研究的目的是描述AIS患者的肌无力及其与肺功能和运动耐受性的关系。对60例明显脊柱畸形（>40度）的患者和25例健康志愿者的肺和肌肉功能以及运动能力进行了评估。AIS患者只有轻度至中度的异常运动模式，其中最常见的是限制性异常。AIS患者的呼吸功能、肢体肌肉功能和运动能力低于正常人，且明显低于对照组。运动能力与吸气肌、呼气肌、上肢肌、下肢肌的功能密切相关。多因素分析显示，下肢肌肉功能是运动不耐受的主要因素。脊柱畸形和肺功能、肌肉功能或运动能力之间似乎没有联系，我们得出结论，AIS患者表现出全身性肌肉功能障碍，这导致他们的运动能力降低，即使没有严重的运动障碍。
Adolescent idiopathic scoliosis (AIS) can lead to ventilatory restriction, respiratory muscle weakness and exercise limitation. However, both the causes and the extent of muscle dysfunction remain unclear. The aim of our study is to describe muscle weakness and its relationship to lung function and tolerance to exercise in AIS patients.Lung and muscle function, together with exercise capacity, were assessed in 60 patients with pronounced spinal deformity (>40 degrees) and in 25 healthy volunteers.Patients with AIS had only mild to moderate abnormal ventilatory patterns, the most frequent of which were restrictive abnormalities. The function of respiratory and limb muscles and exercise capacity were below normal limits in AIS patients, and were significantly lower than in controls. Exercise capacity was found to correlate with the function of inspiratory, expiratory, upper limb and lower limb muscles which, in addition, were reciprocally interrelated. Multivariate analysis showed that lower limb muscle function is the main contributor to exercise intolerance. There appeared to be no connection between spinal deformity and lung function, muscle function or exercise capacity.We conclude that AIS patients show generalised muscle dysfunction which contributes to the reduction in their exercise capacity, even in the absence of severe ventilatory impairment.