ABNORMALITIES OF DISTRIBUTION OF THE PODALIC LOAD IN SCOLIOTIC PATIENTS

Introduction. Idiopathic scoliosis is a spine deformity characterized by deviation in the frontal (lateral tilt) and horizontal plane (rotation and torsion). The incidence is about 2% and the 0.7% of cases requires surgical intervention. The aim of our case- control study is to detect an association between idiopathic scoliosis and abnormalities of the distribution of the podalic load by postural examination. Materials and methods. From January to May 2012, we assessed 37 subjects: 20 affected by idiopathic scoliosis and 17 controls. All patients and controls underwent clinical and postural examination (baropodometric and stabilometric exam, podoscanalyzer). Results. Of the 20 patients with idiopathic scoliosis, 16 were females; the mean age was 13.4 (range 11- 17); the mean BMI was 20.99 kg/m2 (SD±3.1). Cobb angle range was 20°-40° (average value 32.25°) in scoliotic patients. Six patients presented a right dorsal curve, other six a double curve (right dorsal - left lumbar), seven a right dorsal-lumbar double curve and one subject a left lumbar curve. Sixteen patients presented heterometry (average value 6.83mm). Of the 17 patients of the control group 10 were females, the mean age was 12.4 (range 10- 16), BMI average 20.52 kg/m2 (SD± 2.74). The parameters assessed by baropodometric exam (in static), showed that the average percentage of support in the region of midfoot resulted 10.39 ± 9.38% (SD) in scoliotic patients and 23.20 ± 15.11% (SD) in the control group. The ratio between the hindfoot and forefoot was altered in 17/20 (85%) scoliotic patients (both for left and right foot), while in the control group this ratio was altered in 13/17 (76.5%) subjects at the right foot and in 10/17 (58.8%) at the left foot. Conclusions. The results show an association between scoliotic disease and presence of load variations, especially in the area of midfoot. In scoliotic patients, in fact, there is an alteration of load distribution with an almost complete exclusion of the midfoot and a greater load in hindfoot and forefoot regions. This is in line with the hypotheses of postural changes in relation to the difference of loads in scoliotic subjects. Bibliography 1. Grivas TB, Stavlas P, Koukos K, Samelis P, Polyzois B. Scoliosis and cavus foot. Is there a relationship? Study in referrals, with and without scoliosis, from school screening. Stud Health Technol Inform. 2002;88:10-4. 2. Carpintero P, Entrenas R, Gonzalez I, Garcia E, Mesa M. The relationship between pes cavus and idiopathic scoliosis. Spine (Phila Pa 1976). 1994 Jun 1;19(11):1260-3. 3. Wiernicka M, Lochyński D, Kotwicki T, Michałowski L, Kamińska E, Lewandowski J, Hurnik E. Static and dynamic postural control in girls with idiopathic scoliosis. Stud Health Technol Inform. 2012;176:460.