Indications of sole lift and foot orthoses in the management of mild idiopathic scoliosis-a review.
Diego Rothschild, Shu Yan Ng, Yin Ling Elaine Ng
PMID 32184542WHAT IT FOUND
Sole lifts may help functional scoliosis if the sacrum is level with the hips, but custom foot orthoses have little evidence for structural curves.
Most leg length differences in scoliosis are functional, not anatomical, so lifts can worsen the spine.
Key findings
01Sole lifts are suggested for functional lumbar scoliosis only when the sacrum is parallel to the hip level, as lifts on an apparent short leg can induce compensatory curves in structural scoliosis.
02Custom foot orthoses may reduce Cobb angles in juvenile patients with mild scoliosis (<25°) and abnormal foot biomechanics, but evidence is weak and guidelines do not support their routine use.
03Structural leg length discrepancies are rare in adolescent idiopathic scoliosis; most discrepancies are functional and linked to pelvic tilt rather than bone shortening.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The review is narrative, not systematic, so it may miss relevant studies or introduce selection bias. The included studies vary widely in design, population, and intervention specifics, making direct comparisons difficult. The authors state the available evidence is of low quality. The review excludes non-English papers, potentially limiting generalizability. No new data was generated; conclusions rely on existing literature which often lacks rigorous controls.
Declared interests
The authors declare no funding and no conflicts of interest.
The easy way to misread this
Do not assume all leg length discrepancies in scoliosis patients are structural. Most are functional, caused by pelvic tilt. Prescribing a sole lift for a functional discrepancy in structural scoliosis can induce new compensatory curves and worsen the patient's condition.