Ajustes posturais e de membros inferiores durante a marcha de adolescentes com escoliose idiopática: revisão de literatura

Abstract

Scoliosis is an alteration that affects the curvature of the spine in the three planes, which can cause stiffening of the spine, increased stiffness in the lower limbs (LL), differences in muscle activations, intervertebral stiffness, among other elements. Adolescent idiopathic scoliosis (AIS) affects 2% to 4% of young people between 10 and 16 years old and is classified according to severity, location, and might progress and interfere on life quality and daily activities. Human gait is a locomotion process characterized by a sequence of rapid and complex multiple events and a basic life activity. The locomotion pattern changes according to age, functions, footwear and needs. It is important to understand gait to assess and identify possible injuries, adaptations, movement restrictions, muscle weaknesses, postural adjustments and movement changes resulting from other dysfunctions, such as AIS. The objective of the present study was to identify the postural adjustments of the trunk and lower limbs during the gait of adolescentes with AIS, through a critical review of literature. Searches were made, from March to April of 2022, at the databases indexed in the Portal de Periódicos CAPES, National Library of Medicine (Medline), Scientific Electronic Library Online (SciELO), Cochrane and Physiotherapy Evidence Database (PEDro), using the key words “adolescent idiopathic scoliosis”, “gait”, “kinematic” and “balance”. Studies which adolescents with AIS underwent surgical treatment, studies which gait analysis occurred with the use of an orthosis (e.g. brace) and/or with comparisons with radiological examinations, and studies that only described muscle function were excluded. The bibliographic search resulted in 11 analyzed studies, which made it possible to identify the presence of adaptations/adjustments at the spatiotemporal gait parameters (shorter step length, lower gait speed, etc.) of individuals with AIS, as well as differences in kinematics parameters in the three motion planes and in all LL joints when compared to their peers without AIS. Due to the diversity of alterations and the heterogeneity of the AIS group sample in the different studies in terms of location and severity of scoliosis, age and personal factors, it is not possible to generalize a specific movement pattern of the trunk and LL that is characteristic of this public. Trunk and LL adaptations in patients with AIS are variable and must be analyzed individually to contribute to assertive therapeutic approaches.