Acute postural adaptations induced by a shoe lift in idiopathic scoliosis patients

Abstract

The objective of this study was to identify acute spinal and three-dimensional postural adaptations induced by a shoe lift in a population of idiopathic scoliosis (IS) patients. Forty-six IS patients (mean age: 12 +/- 2 years) were evaluated radiologically and with a stereovideographic system for pelvic obliquity. Based on the initial postural and radiological evaluation, a pertinent shoe lift height was chosen for each with the result that 12 patients were tested with 5-mm (S5) lifts, 20 patients were tested with 10-mm (S10) lifts, and 14 patients with 15-mm (S15) lifts. The posture for all 46 patients was then re-evaluated and a spinal radiograph obtained for 14 patients. The implementation of a shoe lift independent of the type of curve and amplitude significantly decreased the Cobb angle. As expected there was a change in the vertical height of the left tibial plateau and greater trochanter that induced a change in pelvic tilt. There was also a significant increase in the vertical height of S1 and T1. There was a significant change in the left and right iliac bone version, as well as a decrease in the difference in version between these two bones. The implementation of the shoe lifts also changed the lateral shift of the pelvis. A relative change between the shoulders and pelvis for tilt and anteroposterior shift was also found to be significant. In conclusion, using a shoe lift resulted in acute postural adaptations which specifically affected the spine and the three-dimensional position and orientation of the pelvis and shoulder girdle.

Influence of side-shift therapy associated or not with a shoe lift on idiopathic scoliosis

“…In the static position, with a high or low shoe lift, the same results were not observed, especially regarding the thoracolumbar and lumbar postural angles that showed that the lower shoe lifts produced a greater effect when compared to the higher shoe lifts. This demonstrates that a static intervention with a shoe lift does not have a linear relationship with its height, as found by Zabjek et al (14). However, in a dynamic situation the shoe lift height should be taken into account, as shown in these study results, since the side-shift movement, as stated above, acts by inhibiting the shoe lift effect, whereby greater stimulation needs to be given in order to achieve the effectiveness of a static intervention.…”

“…According to Hawes and O'Brien (3) the secondary or compensatory curves are more flexible and could present more alterations when subjected to shoe lift or movement interventions. However, Zabjek et al (14) indicate that the use of insoles, regardless of the curve type and amplitude, significantly decrease the Cobb angle. On the other hand, when the shoe lift was used on the right side, the greatest changes were obtained in the minimum angles α2 and α3 for both heights of shoe lift.…”

“…Thus, the primary goal of the shoe lift is to decrease the compensations that occur in idiopathic scoliosis due to information reorganization, to maintain the postural stability compensation brings, thereby aligning the feet, knees, pelvis, scapula and shoulders (11)(12)(13)(14).…”

The relationship between pelvic torsion and anatomical leg length inequality: a review of the literature

“…The data were not analyzed using regression, but a provided scatter plot confirms that a dose relationship was indeed present. Lifts did not reduce torsion in subjects with appreciable preexisting pelvic tilt, unlike the positive outcome in Zabjek et al 24 In 2001, Zabjek et al 24 studied the impact of 5-, 10-, or 15-mm heel lifts in a population of 46 young scoliotic females, mean age of 12 years, all with left convex lumbar or lumbopelvic curvature of the spine. The lift was always inserted under the left foot.…”

Emerging Technology and Analytical Techniques for the Clinical Assessment of Scoliosis

“…The terms and measures that have been adopted to describe the position and orientation of the pelvis are quite extensive, and specific to the sacrum, iliac bones and pelvis [34,36,38,[42][43][44][45]. The anatomical landmarks that provide the point of reference to describe the pelvis include: Anterior-Superior Iliac Spines (ASIS), Posterior-Superior Iliac Spines (PSIS), Superior Lateral Border of the Iliac Crests, and the Sacral Plateau [34,36,38,[42][43][44][45].…”