Correlation between foot pressure distribution and curve pattern in adolescent idiopathic scoliosis

Authors

  • Mahmoud Mahmoud German International University (GIU), Cairo, Egypt and ARC for Scoliosis Physiotherapy and Bracing, Cairo, Egypt
  • Elsaieed Attia Alhayah University, Cairo, Egypt
  • Manal Fayed ARC for Scoliosis Physiotherapy and Bracing, Cairo, Egypt
  • Manal Helmy Koura Department of Physical Therapy for pediatrics and its surgery, faculty of Physical Therapy, Benha University, Benha, Egypt
  • Alshimaa Mokhtar Darwesh Lecturer of physical therapy for Cardiovascular Respiratory Disorders and Geriatrics , faculty of physical therapy ,Egyptian Chinese University, Cairo, Egypt.
  • Marwa Yehia Abdelhamid Abdelkhalek Lecturer of physical therapy Department of basic sciences ,faculty of physical Therapy Egyptian Chinese university, Cairo, Egypt and Physical Therapy 2-department. National Heart Institute, Giza, Egypt
  • Sahar Mahmoud Hassan Department of physical therapy, Cairo university hospitals, Cairo, Egypt. Department of physical therapy, College of Applied Medical Sciences, Qassim University, Buraydah, Saudi Arabia
  • Mohamed Samir Abdellah Mohamed Lecturer of Neurology Physical Therapy, Department of Neurology Disorders and Its Surgery, Faculty of Physical Therapy, Merit University, Egypt https://orcid.org/0009-0009-3356-026X

DOI:

https://doi.org/10.47197/retos.v79.119077

Keywords:

Adolescent idiopathic scoliosis, plantar pressure, baropodometry, postural balance, biomechanics

Abstract

Introduction. Adolescent Idiopathic Scoliosis (AIS) is a three-dimensional spinal deformity that impacts postural control and plantar pressure distribution, yet the relationship between specific curve patterns and foot loading remains poorly understood. 

Objectives: To evaluate how thoracic and lumbar curve patterns influence plantar pressure distribution in the coronal and sagittal planes. 

Methodology: Eighty-six adolescents with moderate AIS (Cobb angle ≈38°) were prospectively recruited and categorized into two groups: Thoracic group (n=43; Lenke type 1) and Lumbar group (n=43; Lenke type 5). Static plantar pressure was measured using the FreeMed® computerized pressure platform (Sensor Medica, Rome, Italy). Primary outcomes included percentage of body weight on the concave versus convex side (coronal plane) and forefoot versus rearfoot (sagittal plane). 

Main Results: A very strong positive correlation was found between curve pattern and coronal pressure distribution (R = 0.853; p < 0.001; 95% CI: 0.781–0.905), with weight consistently shifting toward the concave side. Thoracic curves demonstrated significantly greater concavity loading (54.9% ± 2.4%) compared to lumbar curves (52.5% ± 2.1%; mean difference = 2.4%; p < 0.001). A moderate correlation was observed between Cobb angle and asymmetry (R = 0.412; p = 0.023). No significant correlation was found in the sagittal plane (R = 0.064; p = 0.547). 

Conclusions: Curve location in AIS significantly dictates coronal plantar loading, with thoracic curves producing greater asymmetry than lumbar curves. Sagittal plane distribution remains unaffected by curve pattern. These findings support the integration of baropodometry into clinical assessment and the development of curve-specific rehabilitation protocols.

References

Betsch, M., Rapp, W., Przibylla, A., Jungbluth, P., Hakimi, M., Schneppendahl, J., Thelen, S., & Wild, M. (2013). Determination of the amount of leg length inequality that alters spinal posture in healthy subjects using rasterstereography. European Spine Journal, *22*(6), 1354–1361. https://doi.org/10.1007/s00586-013-2720-x

Czernicki, K., Nowak, Z., & Kowalski, M. (2023). Correlation between the CSVL and pelvic shift in scolio-sis. European Spine Journal, *32*(5), 1580–1589. https://doi.org/10.1007/s00586-023-07654-w

Dalleau, G., Damavandi, M., Leroyer, P., Verkindt, C., Rivard, C. H., & Allard, P. (2011). Horizontal body and trunk center of mass offset and standing balance in scoliotic girls. European Spine Jour-nal, *20*(1), 123–128. https://doi.org/10.1007/s00586-010-1554-z

de Oliveira, R. G., Oliveira, L. C., & Nápolis, L. M. (2020). Baropodometric analysis of static plantar pres-sure in adolescents with idiopathic scoliosis. Coluna/Columna, *19*(3), 188–192. https://doi.org/10.1590/s1808-185120201903225164

Grivas, T. B., Vasiliadis, E. S., & Rodopoulos, G. (2021). The role of foot deformity in the development of AIS. Scoliosis and Spinal Disorders, *16*(1), 12. https://doi.org/10.1186/s13013-021-00286-x

Konieczny, M. R., Senyurt, H., & Krauspe, R. (2013). Epidemiology of adolescent idiopathic scolio-sis. Journal of Children's Orthopaedics, *7*(1), 3–9. https://doi.org/10.1007/s11832-012-0457-4

Kuru, T., Yeldan, I., & Dereli, E. E. (2021). Efficiency of Schroth exercises in AIS: A randomized con-trolled trial. Clinical Rehabilitation, *35*(8), 1120–1130. https://doi.org/10.1177/0269215521994338

Lafferty, R., Smith, A., & Johnson, B. (2020). Asymmetric plantar pressure distribution in spinal deform-ities: A systematic review. Gait & Posture, *78*, 114–122. https://doi.org/10.1016/j.gaitpost.2020.03.015

Legaye, J., Duval-Beaupère, G., Hecquet, J., & Marty, C. (1998). Pelvic incidence: A fundamental pelvic parameter for three-dimensional regulation of spinal sagittal curves. European Spine Jour-nal, *7*(2), 99–103. https://doi.org/10.1007/s005860050038

Lenke, L. G., Betz, R. R., Harms, J., Bridwell, K. H., Clements, D. H., Lowe, T. G., & Blanke, K. (2001). Ado-lescent idiopathic scoliosis: A new classification to determine extent of spinal ar-throdesis. Journal of Bone and Joint Surgery, *83*(8), 1169–1181. https://doi.org/10.2106/00004623-200108000-00006

Lin, Y. C., Chen, C. S., & Wang, Y. T. (2022). Effect of spinal bracing on plantar pressure and balance con-trol in AIS. Prosthetics and Orthotics International, *46*(4), 310–317. https://doi.org/10.1097/PXR.0000000000000124

Nault, M. L., Allard, P., Hinse, S., Le Blanc, R., Caron, O., Labelle, H., & Sadeghi, H. (2002). Relations be-tween standing stability and body posture parameters in adolescent idiopathic scolio-sis. Spine, *27*(17), 1911–1917. https://doi.org/10.1097/00007632-200209010-00018

Negrini, S., Donzelli, S., Aulisa, A. G., Czaprowski, D., Schreiber, S., de Mauroy, J. C., Diers, H., Grivas, T. B., Knott, P., Kotwicki, T., Lebel, A., Marti, C., Maruyama, T., O'Brien, J., Price, N., Parent, E., Rigo, M., Romano, M., Stikeleather, L., ... Zaina, F. (2018). 2016 SOSORT guidelines: Orthopaedic and re-habilitation treatment of idiopathic scoliosis during growth. Scoliosis and Spinal Disor-ders, *13*, 3. https://doi.org/10.1186/s13013-017-0145-8

O'Brien, M. F., Kuklo, T. R., Blanke, K. M., & Lenke, L. G. (2008). Radiographic measurement manual. Medtronic Sofamor Danek.

Park, H. J., & Kim, S. S. (2021). Correlation between Cobb angle and foot pressure in AIS. Journal of Phys-ical Therapy Science, *33*(1), 56–60. https://doi.org/10.1589/jpts.33.56

Pauk, J., Ihnatouski, M., & Daunoraviciene, K. (2020). Plantar pressure distribution in young patients with idiopathic scoliosis. Acta of Bioengineering and Biomechanics, *22*(4), 85–91. https://doi.org/10.37190/ABB-01608-2020-03

Schreiber, S., Parent, E. C., Moez, E. K., Hedden, D. M., Hill, D., Moreau, M. J., Lou, E., Watkins, E. M., & Southon, S. C. (2019). Schroth physiotherapeutic scoliosis-specific exercises for adolescent idi-opathic scoliosis: How many patients require treatment to prevent one deterioration? Scoliosis and Spinal Disorders, *14*, 25. https://doi.org/10.1186/s13013-019-0198-y

Wang, J., Li, X., & Zhang, Y. (2023). Biomechanical characteristics of plantar pressure in AIS during walking. Scientific Reports, *13*, 7654. https://doi.org/10.1038/s41598-023-34824-3

Weinstein, S. L., Dolan, L. A., Cheng, J. C., Danielsson, A., & Morcuende, J. A. (2008). Adolescent idiopathic scoliosis. The Lancet, *371*(9623), 1527–1537. https://doi.org/10.1016/S0140-6736(08)60658-3

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Published

01-06-2026

Issue

Vol. 79 (2026)

Section

Original Research Article

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Copyright (c) 2026 Mahmoud Mahmoud, Elsaieed Attia, Manal Fayed, Manal Helmy Koura, Alshimaa Mokhtar Darwesh, Marwa Yehia Abdelhamid Abdelkhalek, Sahar Mahmoud Hassan, Mohamed Samir Abdellah Mohamed

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How to Cite

Mahmoud, M., Attia, E., Fayed, M., Koura, M. H., Darwesh, A. M., Abdelkhalek, M. Y. A., Hassan, S. M., & Mohamed, M. S. A. (2026). Correlation between foot pressure distribution and curve pattern in adolescent idiopathic scoliosis. Retos, 79, 634-641. https://doi.org/10.47197/retos.v79.119077