Outcomes of segmental spinal manipulation for treatment of adolescent idiopathic scoliosis:a static plantar pa-rameters-based clinical study
Objective:To explore the clinical outcomes of segmental spinal manipulation in treatment of adolescent idiopathic scoliosis(AIS)based on the static plantar parameters.Methods:Sixty AIS patients were enrolled in the study and were randomized into conventional manipulation group and combination manipulation group,30 ones in each group.All patients in the 2 groups were treated with conventional spinal manipulation,twice a week for consecutive 12 weeks;moreover,the ones in combination manipulation group were further treated with segmental spinal manipulation,once a week for consecutive 12 weeks.Before the first treatment and after the end of treatment,the static plantar parameters,including length parameters(foot length,foot arch length),width parameters(forefoot width,heel width),height parame-ters(medial arch height,lateral malleolus height),and angle parameter(big toe angle)were collected,respectively,by using a USOL three-dimensional plantar scanner.Results:①Length parameters.The difference between the bilateral foot length and difference between the bilateral foot arch length were compared between the 2 groups before the treatment and after the end of the treatment,and the results re-vealed no significant differences(pretreatment:t=1.684,P=0.098;t=0.359,P=0.721;after the end of the treatment:t=0.263,P=0.081;t=0.240,P=0.811);the difference between the bilateral foot length and difference between the bilateral foot arch length de-creased in the 2 groups after the end of treatment compared to pretreatment(the difference between the bilateral foot length:t=5.079,P=0.000;t=21.891,P=0.000;the difference between the bilateral foot arch length:t=15.834,P=0.000;t=12.120,P=0.000).②Width parameters.The difference between the bilateral forefoot width and the difference between the bilateral heel width were compared between the 2 groups before the treatment,and the results revealed no significant differences(t=-0.748,P=0.457;t=0.372,P=0.711).The difference between the bilateral forefoot width and the difference between the bilateral heel width decreased in the 2 groups after the end of treatment compared to pretreatment(the difference between the bilateral forefoot width:t=11.522,P=0.000;t=7.369,P=0.000;the difference between the bilateral heel width:t=16.745,P=0.000;t=11.486,P=0.000),and they were smaller in combi-nation manipulation group compared to conventional manipulation group(t=-2.351,P=0.022;t=-2.699,P=0.009).③Height pa-rameters.The difference between the bilateral medial arch height and the difference between the bilateral lateral malleolus height were com-pared between the 2 groups before the treatment,and the results revealed no significant differences(t=-0.595,P=0.554;t=0.082,P=0.935).The difference between the bilateral medial arch height and the difference between the bilateral lateral malleolus height decreased in the 2 groups after the end of treatment compared to pretreatment(the difference between the bilateral medial arch height:t=9.616,P=0.000;t=10.269,P=0.000;the difference between the bilateral lateral malleolus height:t=7.365,P=0.000;t=6.021,P=0.000),and they were smaller in combination manipulation group compared to conventional manipulation group(t=-2.790,P=0.007;t=-2.455,P=0.017).④ Angle parameter.The difference between the bilateral big toe angle was compared between the 2 groups before the treatment and after the end of the treatment,and the result revealed no significant difference(t=0.382,P=0.704;t=0.273,P=0.786),and it decreased in the 2 groups after the end of treatment compared to pretreatment(t=6.277,P=0.000;t=12.049,P=0.000).Conclusion:The segmental spinal manipulation can effectively improve the static plantar parameters in AIS patients.It has certain advantages over the conventional spinal manipulation.
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