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http://dx.doi.org/10.12674/ptk.2018.25.4.009

The Effects of Simulated Mild Leg Length Discrepancy on Gait Parameters and Trunk Acceleration  

Jung, Soo-jung (Dept. of Physical Therapy, The Graduate School, Inje University)
An, Duk-hyun (Dept. of Physical Therapy, College of Healthcare Medical Science and Engineering, Inje University)
Shin, Sun-shil (Dept. of Physical Therapy, College of Healthcare Medical Science and Engineering, Inje University)
Publication Information
Physical Therapy Korea / v.25, no.4, 2018 , pp. 9-18 More about this Journal
Abstract
Background: Leg length discrepancy (LLD) leads to many musculoskeletal disorders and affects daily activities such as walking. In the majority of the population, mild LLD is a common condition. Nevertheless, it is still controversy among researchers and clinicians on the effects of mild LLD during gait, and available studies have largely overlooked this issue. Objects: The purpose of the present study is to investigate the effects of mild LLD on the gait parameters and trunk acceleration. Methods: A total of 15 female and male participants with no evidence of LLD of >.5 ㎝ participated in the present study. All participants walked under the following two conditions: (1) The non-LLD condition, where the participants walked in shoes of the same heel height; (2) A mild LLD condition induced by wearing a 1.5 ㎝ higher heel on the right shoe. The GAITRite system and tri-axial accelerometer were used to measure gait parameters and trunk acceleration. To compare the variation of each variable, a paired t-test was performed. Results: Compared to the non-LLD condition, step time and swing phase were significantly increased in the mild LLD condition, while stance phase, single support phase, and double support phase significantly decreased in the short limb (p<.05). In the long limb of the mild LLD condition, single support phase significantly increased, while swing phase significantly decreased (p<.05). Furthermore, significant decrease in the gait velocity and cadence in the mild LLD condition were observed (p<.05). In the comparison between both limbs in the mild LLD condition, the step time and swing phase of the short limb significantly increased compared with the long limb, while step length, stance phase, and single support phase of the long limb significantly increased compared with the short limb (p<.05). Additionally, trunk acceleration of all directions (anterior-posterior, medial-lateral, vertical) significantly increased in the mild LLD condition (p<.05). Conclusion: The results of the present study demonstrate that mild LLD causes altered and asymmetrical gait patterns and affects the trunk, resulting in inefficient gait. Therefore, mild LLD should not be overlooked and requires adequate treatment.
Keywords
Asymmetry; Gait analysis; Mild leg length discrepancy;
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1 Kakushima M, Miyamoto K, Shimizu K. The effect of leg length discrepancy on spinal motion during gait: three-dimensional analysis in healthy volunteers. Spine. 2003;28(21):2472-2476. https://doi.org/10.1097/01.BRS.0000090829.82231.4A   DOI
2 Khamis S, Carmeli E. Relationship and significance of gait deviations associated with limb length discrepancy: A systematic review. Gait Posture. 2017;57:115-123. https://doi.org/10.1016/j.gaitpost.2017.05.028   DOI
3 Knutson GA. Anatomic and functional leg-length inequality: A review and recommendation for clinical decision-making. Part I, anatomic leg-length inequality: prevalence, magnitude, effects and clinical significance. Chiropr osteopat. 2005;13:11. https://doi.org/10.1186/1746-1340-13-11   DOI
4 Ku PX, Abu Osman NA, Wan Abas WAB. Balance control in lower extremity amputees during quiet standing: a systematic review. Gait Posture. 2014;39(2):672-682. https://doi.org/10.1016/j.gaitpost.2013.07.006   DOI
5 Latt MD, Menz HB, Fung VS, et al. Acceleration patterns of the head and pelvis during gait in older people with Parkinson's disease: a comparison of fallers and nonfallers. J Gerontol. 2009;64(6):700-706. https://doi.org/10.1093/gerona/glp009
6 Perttunen JR, Anttila E, Sodergard J, et al. Gait asymmetry in patients with limb length discrepancy. Scand J Med Sci Sports. 2004;14(1):49-56. https://doi.org/10.1111/j.1600-0838.2003.00307.x   DOI
7 Resende RA, Kirkwood RN, Deluzio KJ, et al. Biomechanical strategies implemented to compensate for mild leg length discrepancy during gait. Gait Posture. 2016a;46:147-153. https://doi.org/10.1016/j.gaitpost.2016.03.012   DOI
8 Resende RA, Kirkwood RN, Deluzio KJ, et al. Mild leg length discrepancy affects lower limbs, pelvis and trunk biomechanics of individuals with knee osteoarthritis during gait. Clin Biomech. 2016b;38:1-7. https://doi.org/10.1016/j.clinbiomech.2016.08.001   DOI
9 Asai T, Doi T, Hirata S, et al. Dual tasking affects lateral trunk control in healthy younger and older adults. Gait Posture. 2013;38(4):830-836. https://doi.org/10.1016/j.gaitpost.2013.04.005   DOI
10 Bhave A, Paley D, Herzenverg JE, et al. Improvement in gait parameters after lengthening for the treatment of limb-length discrepancy. J Bone Joint Surg. 1999;81(4):529-534.   DOI
11 Bloz S, Davies GJ. Leg length differences and correlation with total leg strength. J Orthop Sports Phys Ther. 1984;6(2):123-129. https://doi.org/10.2519/jospt.1984.6.2.123   DOI
12 Gurney B, Mermier C, Robergs R, et al. Effects of limb-length discrepancy on gait economy and lower-extremity muscle activity in older adults. J Bone Joint Surg. 2001;83(6):907-915.   DOI
13 Defrin R, Ben Benyamin S, Aldubi RD, et al. Conservative correction of leg length discrepancies of 10 mm or less for the relief of chronic low back pain. Arch Phys Med Rehabil. 2005;86(11):2075-2080. https://doi.org/10.1016/j.apmr.2005.06.012   DOI
14 Friberg O. To the Editor. Spine. 1992;17(4):458-460.   DOI
15 Gurney B. Leg length discrepancy. Gait Posture. 2002;15(2):195-206. https://doi.org/10.1016/S0966-6362(01)00148-5   DOI
16 Harvey WF, Yang M, Cooke TD, et al. Association of leg-length inequality with knee osteoarthritis: A cohort study. Ann Intern Med. 2010;152(5):287-295. https://doi.org/10.7326/0003-4819-152-5-201003020-00006   DOI
17 Helbostad JL, Moe-Nilssen R. The effect of gait speed on lateral balance control during walking in healthy elderly. Gait Posture. 2003;18(2):27-36. https://doi.org/10.1016/S0966-6362(02)00197-2   DOI
18 Hsue BJ, Miller F, Su FC. The dynamic balance of the children with cerebral palsy and typical developing during gait. Part I: Spatial relationship between COM and COP trajectories. Gait Posture. 2009;29(3):465-470. https://doi.org/10.1016/j.gaitpost.2008.11.007   DOI
19 Carabello RJ, Reid KF, Clark DJ, et al. Lower extremity strength and power asymmetry assessment in healthy and mobility-limited populations: Reliability and association with physical functioning. Aging Clin Exp Res. 2010;22(4):324-329. https://doi.org/10.3275/6676   DOI
20 Brady RJ, Dean JB, Skinner TM, et al. Limb length inequality: clinical implications for assessment and intervention. J Orthop Sports Phys Ter. 2003;33(5):221-234. https://doi.org/10.2519/jospt.2003.33.5.221   DOI
21 Tucker MG, Kavanagh JJ, Barrett RS, et al. Age-related differences in postural reaction time and coordination during voluntary sway movements. Hum Mov Sci. 2008;27(5):728-737. https://doi.org/10.1016/j.humov.2008.03.002   DOI
22 Saunders JB, Inman VT, Eberhart HD. The major determinants in normal and pathological gait. J Bone Joint Surg. 1953;35(3):543-557.   DOI
23 Shin SS, Yoo WG, An DH, et al. Difference in trunk stability during semicircular turns with and without a bag in elderly women. J Back Musculoskelet Rehabil. 2017;30(5):1069-1074. https://doi.org/10.3233/BMR-169680   DOI
24 Subotnick SI. Limb length discrepancies of the lower extremity (the short leg syndrome). J Orthop Sports Phys Ther. 1981;3(1):11-16. https://doi.org/10.2519/jospt.1981.3.1.11   DOI
25 Yack HJ, Berger RC. Dynamic stability in the elderly: identifying a possible measure. J Gerontol. 1993;48(5):225-230. https://doi.org/10.1093/geronj/48.5.M225