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Published on: December 2, 2025
Plantar Pressure-Paraspinal Surface Electromyography Associations and Within-Participant Surface Electromyography
Peng Dou1, Min Xiao1, Huitong Lin2
1Department of Rehabilitation Medicine, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen.
Objectives:
To examine associations between plantar pressure and paraspinal surface electromyography amplitude in idiopathic scoliosis and to describe within-participant changes in paraspinal surface electromyography symmetry under ordinary (nonorthotic) versus orthotic insole conditions.
Design:
A cross-sectional observational correlation study and a single-arm, within-participant repeated-measures comparison.
Setting:
Hospital.
Participants:
Twenty-four patients (N=24) with idiopathic scoliosis and without organic lower-limb or ankle disease.
Interventions:
After baseline testing, participants wore customized biomechanical orthotic insoles in their usual footwear during daily activities for 1 week (familiarization period).
Main Outcome Measures:
Regional plantar load distribution across predefined foot regions, expressed as a percentage of body weight, and paraspinal surface electromyography amplitude (root mean square) were measured; the symmetry index was calculated from bilateral root mean square values.
Results:
The root mean square of the convex-side apical vertebra showed a moderate negative correlation with concave-side forefoot load (Spearman ρ=-0.55; P=.006) and a moderate positive correlation with convex-side rearfoot load (ρ=0.55; P=.005). During walking, symmetry index was significantly lower under the orthotic insole condition than under the ordinary condition (orthotic vs ordinary: 35.57% vs 46.35%; P=.004). No significant difference in standing symmetry index was observed between conditions (P=.408).
Conclusions:
Plantar pressure distribution was associated with paraspinal muscle activation in idiopathic scoliosis, consistent with a potential foot-spine neuromuscular coupling relationship. Orthotic insoles were associated with greater paraspinal activation symmetry during walking; these findings may provide preliminary guidance for further exploration of integrated foot-spine rehabilitation strategies.
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