By Jordana Bieze Foster
What appears to be idiopathic scoliosis may actually be functional scoliosis that can be effectively treated with foot orthoses in children who are hyperpronators, according to research from Chungnam National University in Daejeon, South Korea.
In 38 patients, investigators found that use of rigid foot orthoses combined with stretching and strengthening exercises significantly reduced pelvic height asymmetry from 8.7 mm at baseline to 5.8 mm at 12 months and 5.1 mm at 18 months.
“This may be misdiagnosed as idiopathic if not recognized while children are young,” said Bong-Ok Kim, MD, a researcher in the department of rehabilitation medicine at the university, who presented her group’s findings at the ISPO World Congress in Hyderabad. “Initially you might think this is just functional and you don’t have to treat it because it will just go straight when the kids get older. But that’s not necessarily true.”
All children had an initial Cobb angle greater than 10°, a pelvic height differential of 5 mm or greater, and a resting calcaneal stance position of at least 2° of eversion. Children with pure leg length discrepancies were excluded.
Children were encouraged to wear the orthoses with shoes during all outdoor activities, at school, and at home when not in bed—which can be a challenge in Korea, where shoes are not typically worn at home, Kim said.
“We encouraged parents to wear shoes in the house when their kids needed to be wearing the shoes,” she said. “We need to change the culture to improve compliance.”
Kim B, Chang I, Park I, Sim E. Effect of custom molded rigid foot orthosis on the functional lumbar scoliosis in children. Presented at International Society of Prosthetics and Orthotics 2013 World Congress, Hyderabad, India, February 2013.