| Background and purposeAdolescent idiopathic scoliosis(AIS)is a structural three-dimensional spinal deformity disease with unknown etiology during puberty.The prevalence of AIS is about 2%.Some patients deteriorate rapidly during the growth spurt of adolescence,which severely affect physical and mental health.Therefore,the key to prevention and control depends on early detection,early diagnosis,and early treatment.To investigate the posture and behaviour of AIS patients,especially from the perspective of the biomechanical such as balance,gait,and plantar pressure,is an important basic or clinical research.However,most studies did not consider curve classification of AIS,and this results in seemingly inconsistent results.In addition,previous studies have disputed about foot posture of AIS patients,and its relationship with plantar pressure is still unclear.Therefore,the purpose of this study is to analyze the major abnormalities in foot posture,balance,gait,and plantar pressure.Another critical purpose is to explore whether a correlation exists between foot posture and plantar pressure in AIS patients.This study is expected to provide a more sufficient theoretical and experimental basis for the conservative treatment of AIS.Research subjects and methodsA cross-sectional case-control study was conducted with 34 AIS patients(aged 10-18 years)with type Rigo A and an equal number of healthy age and sex-matched teenagers(control group)were recruited.The IFoot s 3D Full Foot Laser Scanner was used to investigate the foot posture parameter(arch index)and the Zebris FDM 3 Plantar Pressure Plate was used to collect the following parameters:(1)static plantar pressure: the 90% confidence ellipse area,COP path length,the mean mediolateral COP position(COPx),the mean anteroposterior COP position(COPy),left/right foot force,fore/backfoot force;(2)dynamic plantar pressure: lateral symmetry,ant-post position,fore/backfoot max load,pressure curves,gait line;(3)kinematic parameters: step width,foot rotation,stride length,stance phase,swing phase,double stance phase,step time,stride time,cadence,velocity.Independent-samples t-tests were performed to assess the between-group differences in the above parameters.For comparison of left and right foot posture and kinematic parameters,the paired-samples t-test was used.All values are presented as mean ± standard deviations(SD).Additionally,multiple linear regression analyses were performed to identify any correlation between the foot posture and ipsilateral plantar pressure.Finally,the Graph Pad Prism 9.9.1 was used to draw the pressure curves and gait line.Research results(1)Foot posture: An increased arch index on the right side compared to that of the left side was found in AIS patients(p<0.05),but there was no visible difference in control group(p>0.05).In terms of right arch index,AIS patients was higher than the control group(p<0.05),while in left arch index,there was no statistical difference between two groups(p>0.05).(2)Static plantar pressure: It was observed that a higher 90% confidence ellipse area,COP path length and COPx in the AIS group(p<0.05).A reduced left foot force and an increased right foot force were found in AIS patients(p<0.01).The left forefoot force of AIS group was less than control group,whereas the right backfoot force was greater(p<0.01).There were no statistically significant differences in the COPy,left backfoot force and right forefoot force(p>0.05).(3)Dynamic plantar pressure: Lateral symmetry in AIS group was significantly higher and the right backfoot max load was substantially lower than that in the control group(p<0.05).There was no statistically significant difference in the ant-post position,left forefoot max load,left backfoot max load and right forefoot max load(p>0.05).The first pressure peak of the left foot was higher in the AIS group than those in the control group,and the second was just the opposite,while that of the right foot was smaller only around the second peak.Compared to the control group,the gait line of the left foot in the AIS group was initially on the medial side,but transitioned to the lateral side at the toes,and terminated at the lateral side of the control group.The gait line of the right foot was the same as the left foot,except it turned laterally in the midfoot.(4)Kinematic parameters: The step time of the right foot and stride time was significantly increased in AIS patients compared with the control group(p<0.05),and the cadence was correspondingly reduced(p<0.05).Other kinematic parameters between the two groups were not significantly different(p>0.05).No significant differences were observed for any bilateral kinematic parameters between the two sides in each group.(5)Correlation between foot posture and plantar pressure: In the multiple linear regression analyses of foot posture and plantar pressure in left foot,no variable was remaining(p>0.05).The same goes for the right foot(p>0.05).Research conclusionsThe static balance of AIS patients with Rigo A is impaired.We were able to record important differences in dynamic plantar pressure,pressure curve,gait line,and kinematic parameters between AIS patients and healthy subjects.There is a downward trend in the arch index of the right foot in the AIS group,but no correlation with plantar pressure is found. |
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