Dynamic and Static Balance Evaluation of Scoliosis Based on Force Platforms

Scoliosis is a 3-D deformity of the spine that severely affects the healthy growth of adolescents. This disease leads to impaired balance, severely affecting the quality of life. Although X-ray examinations can only assess the Cobb angle or other radiologic parameters and cannot perform integrated dynamic and static evaluations, they remain the most commonly used method in clinical practice. Force platforms can capture force signals, calculate spatial, mechanical, and gait cycle parameters and assess the changes in both dynamic and static balance in scoliosis patients. In this study, we collected force platform data from patients with scoliosis and healthy participants under four dynamic and static postures. We extracted spatial, mechanical, and gait features, applied a random forest algorithm to determine the feature importance and classification changes. Even in mild scoliosis (a Cobb angle range of 10°–25°), balance ability in all postures is altered. In static postures, balance declined in scoliosis patients is primarily concentrated on mechanical parameters, whereas in dynamic postures, the changes are more evident in spatial and gait parameters. This decline in balance ability (such as work, stance-to-swing ratio, center of plantar pressure trajectory length, etc.) is correlated with the Cobb angle measured on full-spine X-rays in the standing position ( ${R}^{{2}} =0.5063$ –0.6989). The clinical application of plantar force examination can provide valuable information for the combined dynamic and static evaluation of balance in scoliosis.