Research shows that China's primary and secondary school students scoliosis rate of 4.40%, the high incidence of age 13-15 years old, 79.5% of students with mild scoliosis, the number of incidence and the degree of scoliosis with the time of the annual trend, prevention and control of the situation is grim.

To investigate the efficacy of 3-times-weekly proprioceptive neuromuscular facilitation (PNF) technique combined with spiral stabilizing muscle chain training (SPS) on adolescent idiopathic scoliosis (AIS), which can promote the high quality of adolescent spinal health management work and provide a reference to achieve multifaceted screening and monitoring and precise scoliosis prevention and control.

The experiment was designed to screen 1 060 primary and middle school students in Nanjing from January to March 2024. A total of 32 AIS students aged 10 to 18 years with an angle of trunk rotation (ATR) of 5°to <10° were finally included as study subjects, and the students were randomly and equally grouped into the SPS, PNF, combined, and control groups of 8 students each based on electronic spinal measurements selected from previous subjects and surface electromyography measurements in Sorensen test. The 4 groups of students underwent a period of 12-week exercise intervention with 3 training sessions per week: the SPS group used only SPS, the PNF group used only PNF, the combined group used SPS combined with PNF, and the control group used traditional core stabilization training. The primary outcome measures will include the degree of scoliosis and the angle of trunk inclination angle (ATI), and the secondary outcome measures will include the body balance parameters of head deflection, shoulder height, hip height, and the surface electromyographic indices of root mean square (RMS), integrated electromyography (IEMG), median frequency (MF), and mean power frequency (MPF). Spine morphology and surface EMG indexes before and after the intervention were compared among the four groups, and correlation analysis was used to explore the correlation between electronic spine measurements and surface EMG values before and after the exercise intervention.

The results showed that Comparison of baseline age, BMI, type of column scoliosis, direction of scoliosis, site of scoliosis, degree of scoliosis, ATI, head deflection, shoulder height, hip height among the students in the 4 groups showed no statistically significant differences (P>0.05). The degree of scoliosis, ATI, head deflection, shoulder height of students in the combined group were lower than those in the control group after the intervention (P<0.05) ; compared with the pre-intervention period, the degree of scoliosis, ATI, head deflection, shoulder height, and hip height of the students in the SPS group, the PNF group, and the combined group were all lower after the intervention (P<0.05). The results of correlation analysis showed that ATI and RMS ratio (RMSR) before and after the intervention were positively correlated with the degree of scoliosis before and after the intervention (P<0.05) ; ATI after the intervention was positively correlated with head deflection, shoulder height after the intervention (P<0.05) ; and RMSR after the intervention was positively correlated with head deflection and hip height after the intervention (P<0.05). The RMS and IEMG of the trapezius muscle on both sides were higher than those of the PNF group and those of the multifidus muscle on both sides were higher than those of the control group in the combined group after the intervention (P<0.05) ; compared with the pre-intervention period, the RMS and IEMG of the trapezius, erector spinae, and multifidus muscles on both sides were higher after the intervention in the students of the SPS group, the PNF group, and the combined group, and the overall RMSR was lower after the intervention (P<0.05). Compared with pre-intervention, SlopeMF was elevated in both trapezius, erector spinae, and multifidus muscles in the SPS group and combined group of students after intervention; and in both trapezius, erector spinae, and left multifidus muscles in the PNF group of students after intervention (P<0.05). Compared with the pre-intervention period, SlopeMPF of the trapezius, erector spinae, and left multifidus muscles on both sides were elevated after intervention for students in the SPS, PNF, and combined groups; SlopeMPF of the right multifidus muscle was elevated after intervention for students in the SPS and combined groups (P<0.05). Shoulder height after intervention was negatively correlated with the RMS of both trapezius and right multifidus muscles, the SlopeMPF of left erector spinae muscle, and the SlopeMF of right multifidus muscle (P<0.05) ; hip height was negatively correlated with the RMS of both trapezius and both multifidus muscles (P<0.05) .

Our findings suggest that ATI, body balance, and surface EMG values improved significantly in all test groups (SPS, PNF, and combined groups) after treatment, with the combined group showing a particularly strong treatment effect in shoulder and hip balance, and fatigue resistance of the paravertebral muscles on both sides of the joint group after treatment. The PNF combined with the SPS intervention can benefit AIS students through the activation of more muscle fibers for exercise and improved muscle fatigue.

研究显示我国中小学生脊柱侧弯率为4.40%，高发年龄在13~15岁，有79.5%的学生为轻度脊柱侧弯，发病人数和侧弯程度随时间呈现增长趋势，防控形势严峻。

探讨每周3次的本体感觉神经肌肉促进技术（PNF）联合螺旋稳定肌链训练（SPS）对青少年特发性脊柱侧弯（AIS）的疗效，以促进青少年脊柱健康管理工作高质量发展，为实现多方位筛查监测和脊柱侧弯精准防控提供参考。

2024年1~3月筛查江苏省南京市中小学生1 060名，最终共纳入年龄10~18岁、躯干旋转角（ATR）为5°~<10°的32名AIS学生作为研究对象，根据先前受试者选取的电子脊柱测量指标和Sorense测试（BST）中表面肌电的测量，将学生随机均等分为SPS组、PNF组、联合组和对照组，每组各8名。4组学生进行为期12周的运动干预，每周进行3次训练：SPS组只采用SPS，PNF组只采用PNF，联合组采用SPS联合PNF，对照组采用传统的核心稳定训练。主要结果测量包括脊柱侧弯程度和躯干倾斜角度（ATI），次要结果测量包括身体平衡参数头部偏转度、肩部高低程度、臀部高低程度和表面肌电图指标均方根肌电值（RMS）、积分肌电值（IEMG）、中频（MF）和平均功率频谱（MPF）。比较4组干预前后的脊柱形态学和表面肌电图指标，采用相关性分析探讨电子脊柱测量值与运动干预前后表面肌电图值的相关性。

4组学生基线年龄、BMI、脊柱侧弯类型、脊柱侧弯方向、脊柱侧弯部位、脊柱侧弯程度、ATI、头部偏转度、肩部高低程度、臀部高低程度比较，差异均无统计学意义（P>0.05）。干预后联合组学生脊柱侧弯程度、ATI、头部偏转度、肩部高低程度均低于对照组（P<0.05）；与干预前相比，SPS组、PNF组、联合组学生干预后脊柱侧弯程度、ATI、头部偏转度、肩部高低程度、臀部高低程度均降低（P<0.05）。相关性分析结果显示，干预前后ATI、RMS比值（RMSR）与干预前后脊柱侧弯程度均呈正相关（P<0.05）；干预后ATI与干预后头部偏转度、肩部高低程度呈正相关（P<0.05）；干预后RMSR与干预后头部偏转度、臀部高低程度呈正相关（P<0.05）。联合组学生干预后两侧斜方肌的RMS、IEMG高于PNF组，两侧多裂肌的RMS、IEMG高于对照组（P<0.05）；与干预前相比，SPS组、PNF组、联合组学生干预后两侧斜方肌、竖脊肌、多裂肌的RMS、IEMG均升高，干预后总体RMSR均降低（P<0.05）。与干预前相比，SPS组和联合组学生干预后两侧斜方肌、竖脊肌、多裂肌的中频斜率（SlopeMF）均升高；PNF组学生干预后两侧斜方肌、竖脊肌、左侧多裂肌的SlopeMF升高（P<0.05）。与干预前相比，SPS组、PNF组、联合组学生干预后两侧斜方肌、竖脊肌、左侧多裂肌的平均功率斜率（SlopeMPF）均升高；SPS组、联合组学生干预后右侧多裂肌的SlopeMPF均升高（P<0.05）。干预后肩部高低程度与两侧斜方肌RMS、右侧多裂肌RMS、左侧竖脊肌SlopeMPF、右侧多裂肌SlopeMF呈负相关（P<0.05）；臀部高低程度与两侧斜方肌、两侧多裂肌RMS呈负相关（P<0.05）。

各试验组（SPS组、PNF组、联合组）的ATI、身体平衡度及表面肌电图值在治疗后均显著改善，联合组在肩部和臀部平衡度方面的治疗效果尤为突出，治疗后联合组两侧椎旁肌的抗疲劳能力也得到了提升。PNF联合SPS的干预方式能够通过激活更多的运动肌纤维并提高肌肉疲劳耐受力，进而使AIS学生受益。