Therapeutic Effect of Schroth Method on Plantar Pressure and Related Muscle Imbalance in Children and Adolescent With Idiopathic Scoliosis

Abstract

Objective

To investigate the effects of Schroth method with a 6-month intervention on gait-specific dynamic plantar pressure distribution and functional muscular balance in children/adolescents with idiopathic scoliosis (IS).

Design

This is an observation before-after control study.

Setting

Conducted in the rehabilitation department of a tertiary hospital.

Participants

A total of 21 children/adolescents (N=21) with IS.

Interventions

All participants performed Schroth exercises ≥5 times/wk, each session ≥30 minutes. The training was completed independently at home under the supervision of guardians.

Main Outcome Measures

Plantar pressure parameters and surface electromyogram data of key postural muscles were collected before and after training. Outcome measures: (1) Cobb angle; (2) plantar pressure gait analysis: gait line length, single support line, left-right symmetry, heel-to-forefoot temporal difference, maximum force, maximum pressure, maximum temporal force in foot tripod regions; (3) surface electromyogram parameters: root mean square and mean power frequency, analyzed to assess activation and fatigue of the quadratus lumborum, erector spinae, gluteus medius, and semitendinosus.

Results

After 6-month Schroth intervention, patients with IS showed reduced Cobb angle (P<.05) and decreased convex-concave gait line length difference (P<.05), and improved left-right symmetry (P<.05). Significant decreases were also observed in heel-to-forefoot temporal difference (absolute and relative to total gait time: P<.05) and lumbar extensor/erector spinae root mean square values (P<.05).

Conclusions

The Schroth method not only improves Cobb angle in patients with IS, but also reduces gait line length asymmetry and paraspinal muscles activation imbalance. In addition, it enhances gait left-right symmetry and optimizes dynamic foot pressure distribution.