Objective To evaluate the association between progression of curvature of scoliosis, and correction for functional component in patients with juvenile idiopathic scoliosis (JIS).
Methods We retrospectively reviewed medical data of patients prescribed custom molded foot orthosis (FO) to correct inequality of RCSPA (resting calcaneal stance position angle), and chose 52 patients (26 females, 26 males) with Cobb angle ≥10° in radiology and uneven pelvic level at iliac crest by different RCSPA (≥3°) as a factor of functional scoliosis. They had different hump angle ≥5° in forward bending test, for idiopathic scoliosis component. Their mean age and mean period of wearing FO were 79.5±10.6 months and 18.6±0.70 months.
Results Cobb angle was reduced from 22.03°±4.39° initially to 18.86°±7.53° after wearing FO. Pelvis height difference and RCSPA difference, were reduced from 1.07±0.25 cm initially to 0.60±0.36, and from 4.25°±0.71° initially to 1.71°±0.75° (p<0.01). Cobb angle improved most in 9 months. However, there was no significant improvement for those with more than 25° of Cobb angle initially. Mean Cobb angle improved in all age groups, but patients less than 6 years had clinically significant improvement of more than 5°.
Conclusion JIS can have functional components, which should be identified and managed. Foot orthosis is useful in correcting functional factors, in the case of pelvic inequality caused by different RCSPA, for patients with juvenile idiopathic scoliosis.
Citations
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IS SCOLIOSIS A COMMON DEFORMITY IN CHILDREN WITH JUVENILE IDIOPATHIC ARTHRITIS? Eylül Pınar Kısa, Ela Tarakcı, Gökçe Leblebici, Mehmet Akif Çaçan, Özgür Kasapçopur Türk Fizyoterapi ve Rehabilitasyon Dergisi.2024; 35(1): 37. CrossRef
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We presented a case which showed clinical improvements after fabricating new ortho-prosthesis to a patient with severe leg length inequality. He was 51 years old and had developed the leg length inequality on the right due to osteomyelitis that he experienced when he was seven. He had been using the orthosis fabricated by a private orthotic shop for more than twenty years from his twenties. We prescribed a new ortho-prosthesis composed of patellar tendon bearing ankle foot orthosis combined with endoskeletal shank and dynamic SACH foot. With this new ortho-prosthesis, there were significant improvements in initial abnormal gait patterns of excessive knee flexion at mid-stance and decreased maximal knee flexion peak at swing phase in the kinematic parameters on transverse plane. And step width, step length and step time were also improved. He got pain relief and improvement of gait endurance. (J Korean Acad Rehab Med 2007; 31: 366-370)
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