2016 SOSORT guidelines: orthopaedic and rehabilitation treatment of idiopathic scoliosis during growth.
2016 SOSORT guidelines: orthopaedic and rehabilitation treatment of idiopathic scoliosis during growth.
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DOI：
10.1186/s13013-017-0145-8
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发表时间：
2018
影响因子：
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通讯作者：
Zaina F
中科院分区：
文献类型：
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作者：
Negrini S;Donzelli S;Aulisa AG;Czaprowski D;Schreiber S;de Mauroy JC;Diers H;Grivas TB;Knott P;Kotwicki T;Lebel A;Marti C;Maruyama T;O'Brien J;Price N;Parent E;Rigo M;Romano M;Stikeleather L;Wynne J;Zaina F
国际脊柱侧凸矫形与康复治疗科学学会（SOSORT）于2005年制定了第一份指南，并于2011年更新。最近发表的关于特发性脊柱侧凸保守治疗方法（支具和锻炼）效果的高质量临床试验促使我们更新了最新版本的指南。目的是使指南与新的科学证据保持一致，以确保更快地将知识转移到特发性脊柱侧凸（CTIS）保守治疗的临床实践中。在CTIS领域工作的医生，研究人员和专职医疗从业人员参与了2016年指南的制定。进行了多项文献综述，审查了CTIS（评估、支具、物理治疗、脊柱侧凸特定物理治疗练习（PSSE）和其他CTIS）的证据。使用德尔菲程序编制了文件、建议和实际方法流程图。2016年5月在加拿大班夫举行的第一次SOSORT/IRSSD联合会议期间举行的共识会议完成了这一过程。2016年新指南的内容包括：特发性脊柱侧凸的背景，对不同人群CTIS方法的描述，临床实践流程图，以及文献综述和评估，支具，PSSE和其他CTIS的建议。目前的指南共包括68项建议，分为以下主题：支具（n = 25），PSSE以防止生长期间脊柱侧凸进展（n = 12），支具治疗和手术治疗期间的PSSE（n = 6），其他保守治疗（n = 2），呼吸功能和锻炼（n = 3），一般体育活动（n = 6）;评估（n = 14）。根据商定的强度和证据等级评定量表，2项关于支具的建议和1项关于PSSE的建议达到建议等级"I"和证据等级"II"。根据证据等级I，3项建议达到了建议A的强度（2项用于支具，1项用于评估）; 39项建议达到了建议B的强度（20项用于支具，13项用于PSSE，6项用于评估）。每种治疗的每种证据等级的论文数量见表8。2016年SOSORT指南是根据CTIS的现有证据制定的。在过去的5年中，高质量的证据开始出现，特别是在支具有效性（一项大型多中心试验）和PSSE（三项单中心随机对照试验）方面。提出了若干A级建议。尽管有越来越多的高质量证据，研究方案的异质性限制了建议的普遍性。正如SOSORT和脊柱侧凸研究协会（SRS）非手术管理委员会所承认的那样，保守治疗有效性的研究方法需要标准化。本文的在线版本（10.1186/s13013 - 017 - 0145 - 8）包含补充材料，可供授权用户使用。
The International Scientific Society on Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT) produced its first guidelines in 2005 and renewed them in 2011. Recently published high-quality clinical trials on the effect of conservative treatment approaches (braces and exercises) for idiopathic scoliosis prompted us to update the last guidelines’ version. The objective was to align the guidelines with the new scientific evidence to assure faster knowledge transfer into clinical practice of conservative treatment for idiopathic scoliosis (CTIS). Physicians, researchers and allied health practitioners working in the area of CTIS were involved in the development of the 2016 guidelines. Multiple literature reviews reviewing the evidence on CTIS (assessment, bracing, physiotherapy, physiotherapeutic scoliosis-specific exercises (PSSE) and other CTIS) were conducted. Documents, recommendations and practical approach flow charts were developed using a Delphi procedure. The process was completed with the Consensus Session held during the first combined SOSORT/IRSSD Meeting held in Banff, Canada, in May 2016. The contents of the new 2016 guidelines include the following: background on idiopathic scoliosis, description of CTIS approaches for various populations with flow-charts for clinical practice, as well as literature reviews and recommendations on assessment, bracing, PSSE and other CTIS. The present guidelines include a total of 68 recommendations divided into following topics: bracing (n = 25), PSSE to prevent scoliosis progression during growth (n = 12), PSSE during brace treatment and surgical therapy (n = 6), other conservative treatments (n = 2), respiratory function and exercises (n = 3), general sport activities (n = 6); and assessment (n = 14). According to the agreed strength and level of evidence rating scale, there were 2 recommendations on bracing and 1 recommendation on PSSE that reached level of recommendation “I” and level of evidence “II”. Three recommendations reached strength of recommendation A based on the level of evidence I (2 for bracing and one for assessment); 39 recommendations reached strength of recommendation B (20 for bracing, 13 for PSSE, and 6 for assessment).The number of paper for each level of evidence for each treatment is shown in Table 8. The 2016 SOSORT guidelines were developed based on the current evidence on CTIS. Over the last 5 years, high-quality evidence has started to emerge, particularly in the areas of efficacy of bracing (one large multicentre trial) and PSSE (three single-centre randomized controlled trials). Several grade A recommendations were presented. Despite the growing high-quality evidence, the heterogeneity of the study protocols limits generalizability of the recommendations. There is a need for standardization of research methods of conservative treatment effectiveness, as recognized by SOSORT and the Scoliosis Research Society (SRS) non-operative management Committee. The online version of this article (10.1186/s13013-017-0145-8) contains supplementary material, which is available to authorized users.