Abstract
BACKGROUND: We aimed to systematically review studies assessing gait kinetics in individuals with scoliosis. MAIN BODY: This systematic review and meta-analysis used the Newcastle-Ottawa Scale to assess quality of included studies. GRADE was employed to assess the overall quality of the evidence in the meta-analysis. Subgroup and sensitivity analyses were performed to address potential heterogeneity. We searched four databases including PubMed, Web of Science, Scopus and Embase from their inception through 4th January 2025. studies which assessed gait kinetics in individuals with scoliosis. Twenty seven studies with a total sample size of 1087 were included. The meta-analysis indicated strong evidence of decreased left foot first peak vertical ground reaction force (vGRF) (Z = 2.87, P = 0.004), 16% increase in energy cost (Z = 7.13, P = 0.00001) with high certainty, and non-significant change in right foot anterior and posterior GRF, right foot first and second peak mediolateral GRF with moderate certainty and internal work, left foot vGRF at midstance, left foot anterior and posterior GRF, right foot third peak mediolateral GRF and left foot first, second and third peak mediolateral GRF. Sensitivity analysis revealed a non-significant change in right and left second peak vGRF. CONCLUSION: This systematic review and meta-analysis provide evidence of altered gait kinetics in individuals with scoliosis, highlighting significant differences in GRF and energy cost. These findings support the need for braces with dynamic pressure redistribution to address uneven loading, alongside rehabilitation strategies (e.g., symmetry-focused gait training specially mediolateral GRF) to improve functional outcomes. Future longitudinal studies should evaluate whether correcting these kinetic deviations mitigates secondary complications like joint degeneration.