Changes in Dynamic Plantar Pressure and Asymmetry in AIS Following PSSE

Area of Science:

• Orthopedics
• Biomechanical Engineering
• Physical Therapy

Background:

• Adolescent idiopathic scoliosis (AIS) can cause gait instability and abnormal plantar pressure.
• Limited objective evidence exists on the efficacy of physiotherapy scoliosis specific exercises (PSSE) for improving plantar pressure in AIS.
• This study investigates the impact of PSSE, with and without bracing, on plantar pressure parameters and gait symmetry in AIS patients.

Purpose of the Study:

• To compare plantar pressure parameters and their symmetry indexes during gait before and after PSSE treatment in AIS patients.
• To assess the differences in gait parameters between braced and non-braced AIS patient groups after PSSE treatment.
• To evaluate the short-term effects of PSSE on plantar pressure redistribution and balance in AIS.

Main Methods:

• Surface topography analysis and plantar pressure data were collected from AIS patients before and after 6-16 weeks of PSSE.
• Plantar pressure data was analyzed overall and stratified by bracing status.
• The Robinson symmetry index (RSI) was calculated to assess foot pressure symmetry.

Main Results:

• Regardless of bracing, PSSE increased bilateral step length, peak hallux pressure, medial hindfoot pressure, and convex lateral hindfoot pressure.
• The braced group showed decreased concave center of pressure (CoP) oscillation and increased CoP anterior-posterior (AP) trajectory, suggesting improved balance.
• Bracing also led to increased concave peak pressure at the 5th metatarsal head, indicating altered weight distribution.

Conclusions:

• Short-term PSSE effectively redistributes abnormal plantar pressure and improves walking capability in AIS patients.
• Concomitant bracing with PSSE further enhances balance and ambulatory efficiency, particularly on the concave side.
• These findings support the use of PSSE, with or without bracing, for managing gait abnormalities in AIS.