FACTORS INFLUENCING WORK CAPACITY IN ADOLESCENT IDIOPATHIC THORACIC SCOLIOSIS
FACTORS INFLUENCING WORK CAPACITY IN ADOLESCENT IDIOPATHIC THORACIC SCOLIOSIS
复制标题
DOI：
10.1164/ajrccm/148.2.295
复制
发表时间：
1993-08-01
期刊：
影响因子：
--
通讯作者：
KILLIAN, KJ
中科院分区：
文献类型：
--
作者：
KEARON, C;VIVIANI, GR;KILLIAN, KJ
导致青少年特发性胸椎侧凸患者工作能力下降（残疾）的因素知之甚少。我们使用多变量分析进行了一项横断面研究，以确定脊柱畸形、肺损伤和肌肉功能对79名特发性脊柱侧凸受试者（脊柱侧凸角度45 +/- 18.5度，SD）工作能力的个体和叠加影响。采用递增循环试验测定做功能力，并与正常受试者的心肺反应进行比较。工作能力降低（% Wcap，86%; 95% CI 81.9至89.7），表明严重残疾。% Wcap与脊柱畸形的性质和程度无关（p > 0.05）。腿部肌肉发达和肺功能障碍有相加作用的工作能力的影响，与肌肉发达的关系是两个强。独立于肌肉发达和肺损伤，次最大工作率下的高心率反应也与工作能力降低相关。通气正常，可满足代谢需求。在运动过程中，脊柱侧凸受试者的潮气量与肺活量成比例地减少。我们的结论是，残疾发生在轻度至中度特发性脊柱侧凸，并似乎与减少的解释能力，减少肌肉，和心血管失调的组合。这些发现表明，应鼓励特发性脊柱侧凸受试者进行体力活动，以维持外周肌肉和心血管条件反射，从而最大限度地减少残疾。
The factors contributing to reduced work capacity (disability) in adolescent idiopathic thoracic scoliosis are poorly understood. We performed a cross-sectional study using multivariate analysis to identify the individual and additive influence of spinal deformity, pulmonary impairment, and muscular function on work capacity in 79 subjects with idiopathic scoliosis (angle of scoliosis 45 +/- 18.5-degrees, SD). Work capacity was measured using an incremental cycle test, and the cardiorespiratory response to exercise was compared with that of normal subjects. Work capacity was reduced (% Wcap, 86%; 95% Cl 81.9 to 89.7), indicating significant disability. The % Wcap was unrelated to the nature and extent of spinal deformity (p > 0.05). Leg muscularity and pulmonary impairment had an additive influence on work capacity, the relationship with muscularity being the stronger of the two. Independently of muscularity and pulmonary impairment, a high heart rate response at submaximal work rates was also associated with a reduced work capacity. Ventilation was normal for metabolic demands. During exercise, the tidal volumes of scoliotic subjects were reduced in proportion to the vital capacity. We conclude that disability occurs with mild to moderate idiopathic scoliosis and appears to be related to a combination of reduced ventilatory capacity, reduced muscularity, and cardiovascular deconditioning. These findings suggest that physical activity should be encouraged in subjects with idiopathic scoliosis to maintain peripheral muscle and cardiovascular conditioning, thereby minimizing disability.