Gait in scoliosis

NewsBot · Jun 6, 2013

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Asymmetrical gait in adolescents with idiopathic scoliosis.
Yang JH, Suh SW, Sung PS, Park WH.
Eur Spine J. 2013 Jun 4.

PURPOSE:
This study investigated side-to-side gait asymmetry in subjects with adolescent idiopathic scoliosis.

METHODS:
There were 20 adolescents with idiopathic scoliosis and 20 age-matched control subjects, who participated in the study. To minimize confounding effects, we recruited patients with similar spinal curvature for the scoliosis group, and all participants are right hand dominant. The participants were instructed to ambulate on a 10 m walkway while barefoot. There were two force plates in the middle of the walkway. The ground reaction force (GRF) and angular displacements of six segments (foot, shank, thigh, pelvis, trunk, and head) were measured during one gait cycle based on the right and left lower extremities. To remove the positional information in the kinematic data, the derivative of angular displacement in each segment was calculated. To evaluate the side-to-side gait symmetry, we calculated the cross-correlation of each bilateral gait parameter.

RESULTS:
In the kinematics, the scoliosis group demonstrated asymmetrical gait in the frontal and transverse planes compared to the control group. In the GRF data, the scoliosis group demonstrated asymmetrical gait in the medial-lateral (M/L) direction compared to the control group.

CONCLUSIONS:
These results indicated that the scoliosis group produced an asymmetrical rotation pattern of the segments bilaterally in the frontal and transverse planes, resulting in asymmetrical GRF patterns in the M/L direction. This asymmetrical gait may be produced by changes in global postural control during gait and not simply by changes in control of only one or two specific segments.
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Admin2 · Jun 6, 2013

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NewsBot · Aug 12, 2014

Comparison of static plantar foot pressure between healthy subjects and patients with adolescent idiopathic scoliosis
Jeong-Uk Lee, Mee-Young Kim, Junghwan Kim
Toxicology and Environmental Health Sciences; June 2014, Volume 6, Issue 2, pp 127-132

The objective of the present study was to compare changes in plantar foot pressure parameters during quiet standing between patients with adolescent idiopatic scoliosis (AIS) and healthy subjects. Twenty-one volunteers (AIS, n=10; healthy, n=11) were recruited for a simple blinded study. Using X-ray imaging, Cobb’s angle and pelvic height were measured in the monitor. Using a force plate, plantar foot pressure parameters were measured during quiet standing. In the analysis of Cobb’s angle and pelvic height, the AIS patients showed a significant increase compared to the healthy subjects. Furthermore, the regional plantar foot pressure of the AIS patients was significantly increased compared to that of the healthy subjects. These results suggest that AIS affects plantar foot pressure parameters. Therefore, the present data may contribute to our understanding of the body alignment of patients undergoing orthopedic physiotherapy.
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NewsBot · Aug 30, 2021

Foot posture and gait in adolescent idiopathic scoliosis patients: three-dimensional morphological
analysis and biomechanics evaluation
Zhu Feilong et al
Source

BACKGROUND: The current studies of walking performance in adolescent idiopathic scoliosis patients lack comparison among groups with different severity
levels and have ignored the impact of foot posture on walking.
OBJECTIVE: To explore the differences in foot posture and walking performance of patients with mild, moderate, and severe adolescent idiopathic scoliosis
compared with healthy peers and provide scientific basis for the function assessment and rehabilitation in the future.
METHODS: A total of 96 subjects were included in the study, including 64 adolescent idiopathic scoliosis patients and 32 healthy voluntary adolescents as
the healthy group. Adolescent idiopathic scoliosis patients were subdivided into mild, moderate, and severe grades according to the Cobb angle, including
18 mild cases, 32 moderate cases and 14 severe cases. An experienced physiotherapist assessed a subject's foot posture according to the Foot Posture
Index. A 3D foot morphology scanner was used to scan for morphological parameters of the foot and GaitScan instrument for gait and plantar pressure data
collection. Comparative analysis was conducted between mild, moderate, and severe adolescent idiopathic scoliosis patients and healthy adolescents, and the
characteristics of foot posture, balance, gait, and plantar pressure distribution were summarized.
RESULTS AND CONCLUSION: (1) In terms of foot morphology and posture, the foot arch index of the moderate and severe adolescent idiopathic scoliosis
groups was significantly higher than the healthy group, and the foot posture index of the severe adolescent idiopathic scoliosis group was significantly higher
than the healthy group (P < 0.05). (2) Regarding gait parameters, the severe adolescent idiopathic scoliosis group had advanced loading response, and a
delayed terminal stance as compared with the healthy group (P < 0.05). The walking speed of the moderate and severe adolescent idiopathic scoliosis group
was slower than the healthy group, and the center of pressure excursion index increased significantly (P < 0.05). (3) Regarding plantar pressure distribution, the
pressure percentages of the medial and lateral heel of the severe adolescent idiopathic scoliosis groups were significantly higher and lower than the healthy
group (P < 0.05). The percentage of the first metatarsal pressure in the severe adolescent idiopathic scoliosis group was significantly higher than the healthy
group, and the percentage of the third, fourth and fifth metatarsal pressure was significantly lower than the healthy group (P < 0.05). (4) For the static balance,
the load ratio of the forefoot of severe adolescent idiopathic scoliosis patients was significantly lower than the rear foot, and the load ratio of the left foot was
significantly lower than the right foot (P < 0.05). (5) It is concluded that the walking efficiency and stability of patients with moderate to severe adolescent
idiopathic scoliosis decreased significantly. Future studies on walking of adolescent idiopathic scoliosis patients should consider foot posture as an accompanied
factor, because foot posture may affect walking performance.
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NewsBot · Oct 31, 2021

A comparison of foot posture and walking performance in patients with mild, moderate, and severe adolescent idiopathic scoliosis
Feilong Zhu,Qianqin Hong,Xiaoqi Guo,Dan Wang,Jie Chen,Qian Zhu,Chong Zhang,Wei Chen ,Ming Zhang
May 17, 2021

Background
Adolescent idiopathic scoliosis (AIS) is the most common form of scoliosis. However, the underlying mechanisms linking spinal curvature in AIS to foot characteristics and walking performance remain unclear.

Objective
This study aimed to compare walking performance between adolescents with mild, moderate, and severe scoliosis and matched healthy peers with foot posture as covariates.

Methods
This cross-sectional study of 96 adolescents was conducted between April 2020 to October 2020 in China, with 32 healthy peers in the control group and 64 patients in the AIS group. Foot posture and morphology, plantar pressure distribution, and gait characteristics were analyzed. One-way analysis of variance with Bonferroni correction and a post hoc comparison of the mean differences between the different groups was performed. Multiple analyses of covariance adjusted for age, sex, body mass index, foot posture index (FPI), arch index (AI), and walking speed were performed.

Results
Of the 64 adolescents with scoliosis, 18 had mild AIS, 32 had moderate AIS, and 14 had severe AIS. The AI and FPI were much higher in the moderate and severe AIS groups (p = 0.018) and the severe AIS group (p<0.001), respectively, than in the control group. The severe AIS group had advanced and longer midstance (p = 0.014) and delayed propulsion phase (p = 0.013) than the control group. Patients with moderate and severe AIS had asymmetrical gait periods in the left and right limbs (p<0.05). Significant differences in the center-of-pressure excursion index (CPEI) were found between the moderate and severe AIS and control groups (p = 0.003).

Conclusion
Moderate and severe AIS significantly influenced walking performance; however, no significant differences were observed between adolescents with mild AIS and healthy controls. Thus, early intervention could target the prevention of specific functional deficits and prevent it from progressing to a severe state.
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