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Orthotic Devices to Treat Scoliosis?

Discussion in 'Biomechanics, Sports and Foot orthoses' started by WYSIWYG, Feb 12, 2008.

  1. PodAus

    PodAus Active Member

    footwear toe-box accommodation?
     
  2. PodAus

    PodAus Active Member

    footwear toe-box accommodation?
     
  3. Dieter Fellner

    Dieter Fellner Well-Known Member

    So happens, I am spending a month in the Pediatric Orthopedic clinic and was discussing this topic with the Chief of Spinal Surgery. Orthopedic convention has it the body can comfortably accept a LLD of 2cm. This information is derived from studies that evaluate spinal motion in the presence of LLD.

    The LLD / scoliosis child is evaluated clinically. A heel lift is used to determine if the scoliosis presentation is reducible. If there is doubt, the XR is reviewed for the degree of torsional component. In many cases, when indicated, braces are used 23/24 hours in an attempt to inhibit progression of scoliosis. With deformity >40 degrees surgery is likely.

    As an aside, the Chief of surgery here performs over 100 cases each year and has pioneered a new MIS technique. Commonly 20 screws are used, costing $30,000 for screws alone. But I digress. So, LLD of less than 2 cm does not arouse much cause for concern in the orthopedic profession.
     
  4. Bruce Williams

    Bruce Williams Well-Known Member

    "The body can accommodate 2 cm or 1 inch," is the common orthopedic response.
    While I appreciate that it "is written" in their literature, I think you will find that there is no RCT or any real study to back that up.
    The literature is rife with studies that show kinematic and kinetic changes with LLD as little as 3mm or less.
    That said, often the LLD is actually an effect of AJE or ankle joint equines. I have found that adding a 3mm lift bilateral will often eliminate a unilateral LLD in many patients.
    Cheers,
    Bruce
     
  5. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Raster-stereographic evaluation of the effects of biomechanical foot orthoses in patients with scoliosis.
    Park SM et al
    J Phys Ther Sci. 2016 Jul;28(7):1968-71. doi: 10.1589/jpts.28.1968
     
  6. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Effect of the Cavus and Planus Foot on
    Biomechanics Aspect of the Plantar Pressure in
    Adolescents With Idiopathic Scoliosis

    Carlos Eduardo Gonçalves Barsotti et al
    Research Square
     
  7. Brian A. Rothbart

    Brian A. Rothbart Active Member

    I published a paper discussing the link between the direction of the thoracic (scoliotic) curve (right or left) and the greater pronated foot.
    • Rothbart BA 2006. Asymmetrical Pronation Patterns linked to Thoracic Curves. Biomechanics - The Foot Blog. PICOMM/PIJ Editors, Oct.
    So as my compeers would say, the Snake Oil Salesman has struck again!! But what is interesting is that so many Snake Oil Salesman are lately popping out of the wood works.

    By the way, a heel lift should never be used to treat a scoliotic curve. Any disagreements? If so, let's start a thread discussion.

    Just food (or should I say foot) for thought.
     
  8. Stanley

    Stanley Well-Known Member

    I agree 100% with you. Another way to look at it is that this is a descending issue.
     
  9. Stanley

    Stanley Well-Known Member

    Depends on the amount of equinus. The more the equinus, the less the sole lift.
     
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