Risk factors and foot biomechanical characteristics of idiopathic scoliosis: a cross-sectional study

Idiopathic scoliosis (IS) caused by an unknown etiology is prevalent in primary and secondary school students. Early detection and prevention are challenging because of the limited knowledge about controllable risk factors and imbalances in body mechanics. In this study, we examined the potential causative factors of IS and its correlation with foot mechanics among 7-14 year-old students in northern Jiangsu Province, China. Based on a stratified whole cluster sampling, 4387 students were examined, of whom of whom 165 were diagnosed with scoliosis. Through logistic regression analysis, the following risk factors were identified: age group, female gender, thinness, unsuitable desk and chair heights, heavy schoolbags, backpack carried on one shoulder, daily sedentary time ≥ 10 h, daily playing electronic products time ≥ 2 h, daily physical activity time < 1 h, sports programs with unilateral limb power, lumbar and back fatigue, unequal thickness of worn soles on both feet and flat foot. When compared to healthy people, IS patients exhibit foot biomechanics characterized by a diagonal distribution of bilateral weight-bearing and walking instability, as well as poor balance function if they have an abnormal foot type, as in the case of flat foot. Our study revealed that the detection rate of scoliosis in primary and secondary school students in northern Jiangsu Province, China, is relatively is on the high side, so it is necessary to strengthen education and screening, concentrate on female students, and provide guidance on how to develop a healthy lifestyle and learning habits. Assessment of plantar pressure distribution and postural symmetry is an effective means of predicting scoliosis. Plantar pressure analysis can serve as an additional tool for assessing the risk of scoliosis.