Biomechanical changes in adolescent idiopathic scoliosis during walking: A protocol for systematic review and meta-analysis

Background: To clarify the differences in biomechanical characteristics present in adolescent idiopathic scoliosis (AIS) patients during walking.Methods: Cross-sectional studies related to the biomechanical characteristics of AIS were included by searching 7 major databases and analyzed using RevMan 5.4 software.Results: There were a total of 15 trials involving 377 AIS patients. The results showed that during walking, AIS had increased pelvic coronal tilt (effect size [ES] = -1.34, 95% confidence intervals [CI] = -2.41 to -0.27, P = .01), knee and ankle sagittal mobility were reduced (ES = -5.22, 95% CI = -7.51 to -2.94, P < .001; ES = -3.58, 95% CI = -5.93 to -1.22, P = .003). The duration of electromyogram activity was prolonged in the gluteus medius (ES = 7.65, 95% CI = 5.33-9.96, P < .001), lumbar square (ES = 10.73, 95% CI = 6.97-14.49, P < .001), and erector spinae (ES = 14.35, 95% CI = 6.94-21.76, P < .001) muscles. The results of subgroup analysis showed that the step length of the concave side of the spine was reduced (ES = -0.36, 95% CI = -0.71 to -0.01, P = .04).Conclusion: AIS has characteristic biomechanical changes in spatiotemporal, phase kinematics, motor mechanics, and electromyographic signatures. Further comprehensive studies are required in the future to analyze the biomechanical and electromyographic differences among different degrees and types of scoliosis, as well as the differences between the concave and convex sides of scoliosis during walking.