Adams Test for Scoliosis
[Spinal xRays]


Right Thoracic Curve: Inclinometer is used to Measure the Angle of Thoracic Prominence


  Reversing a Right Thoracic curve using Proprioceptive Insoles

Postural Paradigm - Unleveling of the Pelvis, Unlevels and the Spine

  Thoracic curves in Young Females

Clinical Study - Thoracic Curves linked to Abnormal Foot Motion
Homepage - Adolescent Idiopathic Scoliosis
 
Study Completed:        07Mar2006
Page Created OnLine: 12Mar2006


     In a preliminary study of 25 patients with asymmetrical abnormal pronation patterns and a positive Adams Test, a positive statistical correlation was found between the pronation pattern and: (1) the pelvic distortion pattern, (2) the pattern of frontal plane deviation within the thoracic spine. [raw data]
     If the pattern of pronation was right > left (See above model), the pelvis was rotated counterclockwise and tilted downwards towards the right side (See model above).  The left shoulder was rotated forward and downward with a protruding right scapula wing (See Adams Test, right).  The thoracic scoliotic curve was on the right side.
     If the pattern of pronation was left > right, the pelvis was rotated clockwise and tilted downwards towards the left side. The right shoulder was rotated forward and downward with a protruding left scapula wing.  The thoracic scoliotic curve was on the left side.
     Other researchers have linked biomechanics to scoliosis (Giakas, 1996; Raso, 2003).

The purpose of this study was to determine if a correlation exists between abnormal foot motion (in this case abnormal foot pronation) and the development of scoliotic curves.  In this study I only included those subjects that (1) abnormally pronated and (2) were positive for the Adams test.  I ran a t-test on the clinical data to determine if a positive correlation existed between the prominence of the scapula wing, the direction of the thoracic curve and the abnormal pronation pattern.  A positive correlation was identified in this study.

From clinical experience, we know that many abnormal pronators do not develop significant scoliotic curves (Cobb angle greater than 20 degrees).  I believe the development of scoliotic curves is a multifactorial issue.  There are other factors that still need to be identified if we wish to understand why only a few patients end up with significant scoliosis.  But this study suggests that asymmetrical pronation patterns may be a critical factor in the development of scoliotic curves.  Interesting enough, in the screening process, I found no patients with significant scoliotic curves that did not abnormally pronate.

The 25 patients in this study had a sundry of chronic musculoskeletal complaints.  Many of these symptoms were contributed more to the abnormal pronation than directly to the scoliosis.  In this preliminary study I made no attempt to separate the cases into functional or structural scoliosis.  I believe that a rotated and unleveled pelvis is one of the biomechanical determinants that make an individual more prone to develop scoliosis.  In young children, possibly by stabilizing the foot lesion responsible for the asymmetrical abnormal pronation pattern, we can prevent the development of some of these spinal lesions.

(Note: The motion depicted in the animated model (above) was intentionally augmented to help clarify the complex combination of rotations occurring in the pelvis and spine.)

  1. Giakas G, et al. 1996. Comparison of gait patterns between healthy and scoliotic patients using time and frequency domain analysis of ground reaction forces. Spine, 21:2235-2242.
  2. Raso VJ 2003. Review Of Biomechanics In The Etiology Of Idiopathic Scoliosis  http://www.ndos.ox.ac.uk/pzs/Group_2/Raso.html