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Zhi-Wei W, Cheng-Zhen L, Jun-Nan C, Fang-Cai L, Qi-Xin C, Wei-Shan C, Gang C, Ning Z, Jun L, Hao L. The Role of Sole Lift in Treating Pediatric Idiopathic Scoliosis with Mild Thoracolumbar/Lumbar Curve. Orthop Surg 2024. [PMID: 39187981 DOI: 10.1111/os.14168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 06/18/2024] [Accepted: 06/24/2024] [Indexed: 08/28/2024] Open
Abstract
OBJECTIVE Lower limb discrepancy (LLD) was frequently observed in patients with idiopathic scoliosis (IS), potentially associated with etiopathogenesis. Although sole lifts had been proposed as a conservative treatment for IS, evidence supporting their efficacy was limited. This study aimed to assess the effects of sole lift intervention on pediatric patients with mild IS, specifically focusing on thoracolumbar/lumbar (TL/L) curvature. METHODS Twenty patients, with an average age of 12.3 ± 3.1 years and presenting mild TL/L curve (15.6° ± 6.2°), were selected from a pool of 267 pediatric IS patients in the outpatient of our spine center from February 2023 to August 2023. Inclusion criteria comprised a main TL/L curve ranging between 10° and 40°, the lower limb positioned at the convexity of the main curve, and LLD of less than 2 cm; individuals requiring bracing or surgical intervention were excluded. Custom sole lifts were used to address the shorter lower limb with the objective of leveling the pelvis. Radiographic evaluations were conducted both before and after intervention using standing full spine posteroanterior radiographs and full leg length radiographs. Statistical analysis was undertaken to evaluate curve correction and its associations with other influencing factors. RESULTS The mean structural and functional LLD were 7.1 ± 4.5 mm and 7.1 ± 4.1 mm, respectively. Among the 20 patients, four exhibited structural LLD greater than 10 mm. The average follow-up duration was 6.4 ± 1.9 months (range: 3-8 months). Following sole lift intervention (7.0 ± 3.0 mm), a significant reduction was observed in the TL/L curve compared to the pre-sole lifting measurements (15.6° ± 6.2° vs. 12.1° ± 7.2°, p < 0.001), as well as a notable decrease in the thoracic curve (12.2° ± 4.0° vs. 8.6° ± 6.3°, p = 0.064). Nine patients experienced a significant curve reduction of ≥5°, while eight showed a reduction between 0° and 5°; however, two patients exhibited no change in curve magnitude. Furthermore, the correction rate of the TL/L curve correlated significantly with functional LLD (r = -0.484, p = 0.030) and pelvic obliquity (r = -0.556, p = 0.011), highlighting the active pelvic compensation in maintaining balance between the spine and lower limbs. Conversely, no significant correlation was observed between curve correction and structural LLD (p > 0.05). Additionally, even after adjusting for other influencing factors, the TL/L Cobb angle remained significantly different between pre- and post-sole lifting (p = 0.037). CONCLUSION This study confirmed the effectiveness of sole lift intervention in correcting TL/L and thoracic curves among the mild IS children with a main TL/L curve, providing a supplementary conservative treatment option for patients with the lower limb at the convexity of the main curve. Moreover, our findings underscored the active compensation of the lower limbs and the pelvis in the etiopathogenesis of IS, highlighting the importance of considering their influence in treatment strategies.
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Affiliation(s)
- Wang Zhi-Wei
- Department of Orthopedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou City, China
- Zhejiang University School of Medicine Second Affiliated Hospital Songyang Branch, Lishui City, China
- Orthopedics Research Institute of Zhejiang University, Hangzhou City, China
- Key Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province, Hangzhou City, China
- Clinical Research Center of Motor System Disease of Zhejiang Province, Hangzhou City, China
| | - Liang Cheng-Zhen
- Department of Orthopedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou City, China
- Orthopedics Research Institute of Zhejiang University, Hangzhou City, China
- Key Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province, Hangzhou City, China
- Clinical Research Center of Motor System Disease of Zhejiang Province, Hangzhou City, China
| | - Chen Jun-Nan
- Zhejiang University School of Medicine Second Affiliated Hospital Songyang Branch, Lishui City, China
| | - Li Fang-Cai
- Department of Orthopedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou City, China
- Orthopedics Research Institute of Zhejiang University, Hangzhou City, China
- Key Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province, Hangzhou City, China
- Clinical Research Center of Motor System Disease of Zhejiang Province, Hangzhou City, China
| | - Chen Qi-Xin
- Department of Orthopedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou City, China
- Orthopedics Research Institute of Zhejiang University, Hangzhou City, China
- Key Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province, Hangzhou City, China
- Clinical Research Center of Motor System Disease of Zhejiang Province, Hangzhou City, China
| | - Chen Wei-Shan
- Department of Orthopedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou City, China
- Orthopedics Research Institute of Zhejiang University, Hangzhou City, China
- Key Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province, Hangzhou City, China
- Clinical Research Center of Motor System Disease of Zhejiang Province, Hangzhou City, China
| | - Chen Gang
- Department of Orthopedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou City, China
- Orthopedics Research Institute of Zhejiang University, Hangzhou City, China
- Key Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province, Hangzhou City, China
- Clinical Research Center of Motor System Disease of Zhejiang Province, Hangzhou City, China
| | - Zhang Ning
- Department of Orthopedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou City, China
- Orthopedics Research Institute of Zhejiang University, Hangzhou City, China
- Key Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province, Hangzhou City, China
- Clinical Research Center of Motor System Disease of Zhejiang Province, Hangzhou City, China
| | - Li Jun
- Department of Orthopedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou City, China
- Orthopedics Research Institute of Zhejiang University, Hangzhou City, China
- Key Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province, Hangzhou City, China
- Clinical Research Center of Motor System Disease of Zhejiang Province, Hangzhou City, China
| | - Li Hao
- Department of Orthopedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou City, China
- Orthopedics Research Institute of Zhejiang University, Hangzhou City, China
- Key Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province, Hangzhou City, China
- Clinical Research Center of Motor System Disease of Zhejiang Province, Hangzhou City, China
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Arslan M, Görgü SÖ. Effect of short-term spinal orthosis and insoles application on cobb angle, plantar pressure and balance in individuals with adolescent idiopathic scoliosis. Clin Biomech (Bristol, Avon) 2023; 110:106121. [PMID: 37864921 DOI: 10.1016/j.clinbiomech.2023.106121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 09/21/2023] [Accepted: 10/09/2023] [Indexed: 10/23/2023]
Abstract
BACKGROUND Spinal orthosis applications are preferred for conservative treatment of adolescent idiopathic scoliosis, and holistic biomechanical approaches are recommended. METHODS This was single-blind, prospective, randomized, controlled study. It included 42 patients (29 females/13 males) aged 10-18 years with adolescent idiopathic scoliosis, Cobb angle of 20°-45°, who were deemed suitable for spinal orthosis use. Patients were randomly divided into two groups: control, spinal orthosis group (n = 21), and insoles and spinal orthosis group (n = 21). All participants used spinal orthoses for 3 months. This study evaluated the functional capacities, quality of life, balance, and plantar pressures of the participants. The evaluations were repeated after 1 week, and 3 months following spinal orthosis application. FINDINGS Statistically significant difference and positive effect were observed in Cobb angle (p = 0.008; p = 0.878, respectively), right total (p = 0.037; p = 0.193, respectively), left total (p = 0.037; p = 0.193, respectively), left rearfoot (p = 0.002; p = 0.708, respectively), and right forefoot plantar pressure (p = 0.001; p = 0.739, respectively) in participants in insoles and spinal orthosis group compared with those in the control group. Statistically significant differences and positive effects were observed in swing length (p = 0.001; p = 0.053, respectively) and functional capacity (p = 0.005; p = 0.220, respectively), which are parameters related to postural balance. No change was found in quality of life of either group (p > 0.05). INTERPRETATION Insoles may have positive impact on functional capacity, balance, and plantar pressure during long-term follow-up in individuals with scoliosis. Therefore, the evaluation of foot plantar pressure in individuals with scoliosis is recommended, and personalized insoles may be a beneficial option.
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Affiliation(s)
- Merve Arslan
- Department of Orthotics and Prosthesis, Graduate School of Health Sciences, Istanbul Medipol Universty, Istanbul, Türkiye; Department of Orthosis and Prosthetics, School of Health Sciences, Istanbul Medipol University, Istanbul, Türkiye.
| | - Sena Özdemir Görgü
- Department of Orthosis and Prosthetics, School of Health Sciences, Istanbul Medipol University, Istanbul, Türkiye.
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Ameer MA, Abdel-Aziem AA, Abd-Eltawab AE. The impact of anthropometric measures on plantar pressure distribution in male handball players and non-athletes: A cross-sectional study. J Bodyw Mov Ther 2023; 36:55-61. [PMID: 37949600 DOI: 10.1016/j.jbmt.2023.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/05/2023] [Accepted: 06/05/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Increasing body anthropometry brings substantial spinal stress, which influences the spinal curvatures; this in turn may affect the foot plantar pressure distribution. OBJECTIVES This study investigated the impact of body anthropometry on static plantar pressure distribution and their relationship among handball players and non-athletes subjects. METHODS Thirty handball players aged from 21 to 26 years, and thirty age-matched non-athletes subjects aged from 21 to 28 years participated in this study. The spinal lordosis and kyphosis angles, trunk length, pelvic tilting, and pelvic rotation were evaluated using Formetric 4-dimensions and the Pedoscan device was used to assess the plantar pressure distribution. RESULTS The handball players were significantly taller, heavier, and have a long trunk length than non-athletes group (p < 0.05), and a significantly increased thoracic kyphosis, forefeet pressure distribution compared to non-athletes group (p < 0.05). The handball players had a significantly increased forefeet pressure distribution compared to the rearfeet pressure distribution (p < 0.05), a high positive correlation between body height, and both trunk length and kyphosis angle (r = 0.932, 0.665 respectively), and the body height showed a high positive correlation with the forefeet pressure distribution (r = 0.665). There was a high positive correlation between the handball players' thoracic kyphosis and forefeet pressure distribution (r = 0.751). CONCLUSION Increasing the handball players' body height was related to increased thoracic kyphosis and forefeet pressure distribution compared to non-athletes subjects. Additionally, the kyphotic posture of handball players is associated with increasing the total forefeet pressure distribution compared to the total rearfeet pressure distribution.
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Affiliation(s)
- Mariam A Ameer
- Department of Biomechanics, Faculty of Physical Therapy, Cairo University, Giza, Egypt; Physical Therapy and Health Rehabilitation Department, Faculty of Applied Medical Sciences, Jouf University, Al-Jouf, Saudi Arabia
| | - Amr A Abdel-Aziem
- Department of Biomechanics, Faculty of Physical Therapy, Cairo University, Giza, Egypt.
| | - Amany E Abd-Eltawab
- Department of Biomechanics, Faculty of Physical Therapy, Cairo University, Giza, Egypt; Physical Therapy and Health Rehabilitation Department, Faculty of Applied Medical Sciences, Jouf University, Al-Jouf, Saudi Arabia
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Rothschild D, Ng SY, Ng YLE. Indications of sole lift and foot orthoses in the management of mild idiopathic scoliosis—a review. J Phys Ther Sci 2020; 32:251-256. [PMID: 32184542 PMCID: PMC7064353 DOI: 10.1589/jpts.32.251] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 12/24/2019] [Indexed: 01/19/2023] Open
Abstract
[Purpose] Leg length discrepancy is common among patients with scoliosis. Some studies
reported reduced functional scoliosis curves with correction of leg length discrepancy.
Others, however, have shown that induced leg length discrepancy has little effects on
spinal deformities. Also, small number of studies assessed the use of foot orthoses in
patients with faulty foot biomechanics and their impact on idiopathic scoliosis. In this
context, a review of the literature is needed to determine the current evidence for the
appropriate use of sole lift and foot orthoses in a context of scoliosis. [Methods] A
literature review was performed. [Results] It appeared that sole lifts are indicated for
functional lumbar scoliosis when the level of the sacrum is parallel to that of the hips.
Sole lifts may not be indicated for patients with structural scoliosis, seemingly inducing
a compensatory curve. Custom foot orthoses were found to reduce spinal curves in juvenile
patients with mild idiopathic scoliosis and concomitant abnormal foot biomechanics.
[Conclusion] Sole lift appeared to be indicated in the presence of certain types of
functional scoliosis. Custom foot orthoses can be considered in the management of mild
idiopathic scoliosis in juvenile patients. Evidence, however, is low and quality studies
are needed to validate these findings.
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Affiliation(s)
- Diego Rothschild
- Hong-Kong Chiropractic College Foundation: 11&12/F China Hong Kong Tower, 8-12 Hennessy Road, Wan chai, Hong-Kong SAR
| | - Shu Yan Ng
- Hong-Kong Chiropractic College Foundation: 11&12/F China Hong Kong Tower, 8-12 Hennessy Road, Wan chai, Hong-Kong SAR
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Ohlendorf D, Fisch V, Doerry C, Schamberger S, Oremek G, Ackermann H, Schulze J. Standard reference values of the upper body posture in healthy young female adults in Germany: an observational study. BMJ Open 2018; 8:e022236. [PMID: 30082360 PMCID: PMC6078251 DOI: 10.1136/bmjopen-2018-022236] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVE Classifications of posture deviations are only possible compared with standard values. However, standard values have been published for healthy male adults but not for female adults. DESIGN Observational study. SETTING Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt/Main. PARTICIPANTS 106healthy female volunteers (21-30 years old; 25.1±2.7 years) were included. Their body weight ranged from 46 to 106 kg (60.3±7.9 kg), the heights from 1.53 to 1.82 m (1.69±0.06 m) and the body mass index from 16.9 kg/m² to 37.6 kg/m² (21.1±2.6 kg/m²). OUTCOME MEASURES A three-dimensional back scan was performed to measure the upper back posture in habitual standing. The tolerance ranges and CI were calculated. Group differences were tested by the Wilcoxon Mann-Whitney U test. RESULTS In normal posture, the spinal column was marginally twisted to the left, and the vertebrae were marginally rotated to the right. The kyphosis angle is larger than the lumbar angle. Consequently, a more kyphotic posture is observed in the sagittal plane. The habitual posture is slightly scoliotic with a rotational component (scapular depression right, right scapula marginally more dorsally, high state of pelvic right, iliac right further rotated anteriorly). CONCLUSIONS Healthy young women have an almost ideally balanced posture with minimal ventral body inclination and a marginal scoliotic deviation. Compared with young males, women show only marginal differences in the upper body posture. These values allow a comparison to other studies, both for control and patient data, and may serve as guideline in both clinical practice and scientific studies.
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Affiliation(s)
- Daniela Ohlendorf
- Institute of Occupational, Social and Environmental Medicine, Goethe Universität Frankfurt am Main, Frankfurt, Germany
| | - Vanessa Fisch
- Institute of Occupational, Social and Environmental Medicine, Goethe Universität Frankfurt am Main, Frankfurt, Germany
| | - Charlotte Doerry
- Institute of Occupational, Social and Environmental Medicine, Goethe Universität Frankfurt am Main, Frankfurt, Germany
| | - Sebastian Schamberger
- School of Dentistry, Department of Orthodontics, Goethe-University Frankfurt, Frankfurt, Germany
| | - Gerhard Oremek
- Institute of Occupational, Social and Environmental Medicine, Goethe Universität Frankfurt am Main, Frankfurt, Germany
| | - Hanns Ackermann
- Institute of Biostatistics and Mathematical Modeling, Goethe University Hospital, Frankfurt, Germany
| | - Johannes Schulze
- Institute of Occupational, Social and Environmental Medicine, Goethe Universität Frankfurt am Main, Frankfurt, Germany
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