Foot posture and gait in adolescent idiopathic scoliosis patients: three-dimensional morphological analysis and biomechanics evaluation

doi:10.12307/2021.316

Abstract

Abstract: 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.

Key words: spine, adolescents, adolescent idiopathic scoliosis, biomechanics, foot morphology, foot posture, gait, plantar pressure, balance

CLC Number:

Zhu Feilong, Zhang Ming, Wu Yu, Wang Bin, Guo Xiaoqi, Cao Jiangang, Zhu Qian, Chen Wei. Foot posture and gait in adolescent idiopathic scoliosis patients: three-dimensional morphological analysis and biomechanics evaluation[J]. Chinese Journal of Tissue Engineering Research, 2021, 25(33): 5294-5300.

Figures/Tables 9

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