School-based screening for scoliosis and foot biomechanical abnormalities: a study of prevalence, plantar pressure, and gait among adolescents in Haidian District, Beijing

Zelong Miao; Yuanyuan Xue; Chengxin Li; Chaohui Xing; Hao Jiang; Tianxiang Wang; Dongyuan Zhang; Qian Li; Yi Liu; Chenxi Wang; Yuansong Zhao; Zhong Zhang; Dechen Song; Bin Jia

doi:10.3389/fped.2026.1749070

School-based screening for scoliosis and foot biomechanical abnormalities: a study of prevalence, plantar pressure, and gait among adolescents in Haidian District, Beijing

Front Pediatr. 2026 Apr 1:14:1749070. doi: 10.3389/fped.2026.1749070. eCollection 2026.

Authors

Zelong Miao^#^{1

2}, Yuanyuan Xue^#³, Chengxin Li², Chaohui Xing², Hao Jiang³, Tianxiang Wang^{3

4}, Dongyuan Zhang⁵, Qian Li², Yi Liu², Chenxi Wang², Yuansong Zhao², Zhong Zhang², Dechen Song², Bin Jia²

Affiliations

¹ Biology, School of Teacher's Education, Hainan Normal University, Haikou, China.
² Beijing DCN Orthopaedic Hospital, Beijing, China.
³ MOE Key Laboratory of Bioinformatics, Center for Synthetic and Systematic Biology, School of Life Sciences, Tsinghua University, Beijing, China.
⁴ Tsinghua-Peking Center for Life Sciences, Beijing, China.
⁵ Department of Nutrition and Health, China Agricultural University, Beijing, China.

^# Contributed equally.

Abstract

Background: Adolescent idiopathic scoliosis (AIS) and foot biomechanical disorders are significant public health concerns, impacting physical function and quality of life. Despite national screening mandates, regional data remain sparse.

Methods: We conducted a school-based screening study to investigate the prevalence of scoliosis and foot-related biomechanical abnormalities among adolescents in Haidian District, Beijing, China. A total of 1,419 participants (739 males and 680 female) from primary and middle schools underwent spinal and plantar health assessments using standardized protocols, including the Adams forward bend test with a scoliometer, Foot Posture Index-6 (FPI-6), and static/dynamic plantar pressure analysis.

Results: This cross-sectional study of 1,419 Beijing adolescents revealed a 2.04% prevalence of scoliosis (29 cases), showing significant female predominance (3.53% vs. 0.68%; χ ² = 14.397, p < 0.001, φ = -0.101, Cramer's V = 0.101). Scoliosis prevalence showed distinct developmental patterns, with a significant increasing trend across grades (p = 0.011). Clear peaks were observed in 6th (4.22%) and 9th (4.35%) grades, where cases significantly exceeded expected counts, though the reliability of estimates for upper grades (11th-12th) may be limited by smaller sample sizes (48 and 18 participants, respectively). In contrast, the detection rate of foot abnormalities was slightly higher among males (47.8% vs. 43.4%), this difference did not reach statistical significance (p = 0.098), and the effect size was negligible (Phi = 0.044). This indicates that foot abnormalities represent a common health concern affecting both sexes. Significant variation in foot abnormality prevalence was observed across grades [χ ²(11) = 36.98, p < 0.001], peaking sharply at school entry (62.7% in 1st grade) and then declining rapidly through elementary school. Prevalence stabilized during middle adolescence, with a non-significant apparent rebound in the small 12th-grade sample requiring cautious interpretation.

Conclusions: Key findings highlight the need for early and targeted interventions within school health programs. A gender-stratified approach is recommended: implementing gender-sensitive screening for scoliosis, while adopting universal promotion measures for foot health. Specific priorities include increasing flatfoot screening frequency among 1st-2nd grade boys and enhancing posture-related health education for adolescent girls during key transitional growth phases. These strategies aim to mitigate long-term musculoskeletal complications.

Keywords: adolescents; biomechanics; gait analysis; plantar pressure; scoliosis.