The purpose of this paper is to review relevant literature concerning
limb length inequalities in adults and to make recommendations for assessment
and intervention based on the literature and our own clinical experience. The
research was carried out on PUB MED, Non-English articles and duplicates in the databases
were not included. Limb length inequality and common classification criteria
are defined and etiological factors are present. Common methods of detecting
limb length inequality include model manual technics. This work has the purpose of describing a well standardized therapeutic
in the form of practical guidance. The approach we describe provides
standardized model evaluation for leg lower limb in order to be used in rehabilitation clinic.
References
[1]
Iversen, M.D., et al. (2011) Influence of Self-Reported Limb Length Discrepancy on Function and Satisfaction 6 Years after Total Hip Replacement. Journal of Geriatric Physical Therapy, 34, 148-152. https://doi.org/10.1519/JPT.0b013e31820e16dc
[2]
Vitale, M.A., Choe, J.C. and Sesko, A.M. (2006) The Effect of Limb Length Discrepancy on Health-Related Quality of Life: Is the “2 cm Rule” Appropriate? Journal of Pediatric Orthopaedics, 15, 1-5.
[3]
Brady, R.J., Dean, J.B., Skinner, M.T. and Gross, M.T. (2003) Limb Length Inequality: Clinical Implications for Assessment and Intervention. Journal of Orthopaedic & Sports Physical Therapy, 33, 221-234. https://doi.org/10.2519/jospt.2003.33.5.221
[4]
Danbert, R.J., et al. (2008) Clinical Assessment and Treatment of Leg Length Inequalities. Journal of Manipulative and Physiological Therapeutics, 11, 290-295.
[5]
Collebrusco, L., Lombardini, R. and Censi, G. (2016) Regional Interdependence: A Model That Needs to Be Integrated in the Functional Evaluation and Physiotherapy Treatment—Part 1. Open Journal of Therapy and Rehabilitation, 4, 117-124.
https://doi.org/10.4236/ojtr.2016.43010
[6]
Khamis, S. and Carmeli, E. (2017) A New Concept for Measuring Leg Length Discrepancy. Journal of Orthopaedics, 14, 276-280.
https://doi.org/10.1016/j.jor.2017.03.008
[7]
Friberg, O., Nurminen, M., Korhonen, K., Soininen, E. and Manttari, T. (1988) Accuracy and Precision of Clinical Estimation of Leg Lenght Inequality and Lumbar Scoliosis: Comparision of Clinical and Radiological Measurements. International Disability Studies, 10, 49-53. https://doi.org/10.3109/09638288809164098
[8]
Collebrusco, L., Lombardini, R. and Censi, G. (2017) Regional Interdependence: A Practical Guidance in Rehabilitation Clinic—Part 2. Open Journal of Therapy and Rehabilitation, 5, 11-28. https://doi.org/10.4236/ojtr.2017.51002
[9]
Coffey, D., et al., (2017) Leg Length Discrepancy: The Importance of a Complete History and Examination. BMJ Case Reports, 2017, Article ID: 220985.
https://doi.org/10.1136/bcr-2017-220985
[10]
Bhave, A., et al., (1999) Improvement in Gait Parameters after Lengthening for the Treatment of Limb-Length Discrepancy. The Journal of Bone and Joint Surgery, 81, 529-534. https://doi.org/10.2106/00004623-199904000-00010
[11]
Aguilar, E.G., et al., (2017) Distance between the Malleoli and the Ground. Journal of the American Podiatric Medical Association, 107, 112-118.
https://doi.org/10.7547/15-013
[12]
Woerman, A.L., et al. (1984) Leg Length Discrepancy Assessment: Accuracy and Precision in Five Clinical Method Evaluation. Journal of Orthopaedic & Sports Physical Therapy, 5, 230-239. https://doi.org/10.2519/jospt.1984.5.5.230
[13]
Petrone, M.R., et al. (2003) The Accuracy of the Palpation Meter (PALM) for Measuring Pelvic Crest Height Difference and Leg Length Discrepancy. Journal of Orthopaedic & Sports Physical Therapy, 33, 319-325.
https://doi.org/10.2519/jospt.2003.33.6.319
[14]
Selye, H. (1956) The Stress of Life. Mcgraw-Hill, New York.
[15]
Mueller, M.J. and Maluf, K.S. (2002) Tissue Adaptation to Physical Stress: A Proposed “Physical Stress Theory” to Guide Physical Therapist Practice, Education, and Research. Physical Therapy, 82, 383-403. https://doi.org/10.1093/ptj/82.4.383
[16]
Sueki, D.G., Cleland, J.A. and Wainner, R.S. (2013) A Regional Interdependence Model of Musculoskeletal Dysfunction: Research, Mechanisms, and Clinical Implications. Journal of Manual & Manipulative Therapy, 21, 90-102.
https://doi.org/10.1179/2042618612Y.0000000027
[17]
Hoppenfeld, S. (2019) Physical Examination of the Spine and Extremities. Pearson College, Victoria, 288 Pages.
[18]
Robert Cooperstein, M.A. and Lucente, M. (2017) Comparison of Supine and Prone Methods of Leg Length Inequality Assessment. Journal of Chiropractic Medicine, 16, 103-110. https://doi.org/10.1016/j.jcm.2017.01.001
[19]
Redmond, A.C., Crosbie, J. and Ouvrier, R.A. (2006) Development and Validation of a Novel Rating System for Scoring Standing Foot Posture: The Foot Posture Index. Clinical Biomechanics, 21, 89-98.
https://doi.org/10.1016/j.clinbiomech.2005.08.002
[20]
Gross, M.T., Burns, C.B., Chapman, S.W., et al. (1998) Reliability and Validity of Rigid Lift and Pelvic Leveling Device Method in Assessing Functional Leg Length Inequality. Journal of Orthopaedic & Sports Physical Therapyapy, 27, 285-294.
https://doi.org/10.2519/jospt.1998.27.4.285
[21]
Hinson, R. and Brown, S. (1998) Supine Leg Length Differential Estimation: An Inter- and Intra-Examiner Reliability Study. Chiropractic Research Journal, 5, 17-22.
[22]
Havran, M., et al. (2016) Deconstructing Chronic Low Back Pain in the Older Adult, Step-By-Step Evidence and Expert-Based Recommendations for Evaluation and Treatment: Part XII: Leg Length Discrepancy. Pain Medicine, 17, 2230-2237.
https://doi.org/10.1093/pm/pnw270
[23]
Ali, A., et al. (2014) The Importance of Submalleolar Deformity in Determining Leg Length Discrepancy. The Surgeon, 12, 201-205.
https://doi.org/10.1016/j.surge.2013.12.003
[24]
Rothbart, B.A., et al. (2006) Relationship of Functional Leg-Length Discrepancy to Abnormal Pronation. Journal of the American Podiatric Medical Association, 96, 507-507. https://doi.org/10.7547/0960507
[25]
Sheha, E.D., et al. (2018) Leg-Length Discrepancy, Functional Scoliosis, and Low Back Pain. JBJS Reviews, 6, e6. https://doi.org/10.2106/JBJS.RVW.17.00148
[26]
Rannisto, S., et al. (2015) Leg-Length Discrepancy Is Associated With Low Back Pain among Those Who Must Stand While Working. BMC Musculoskeletal Disorders, 16, Article No. 110. https://doi.org/10.1186/s12891-015-0571-9
[27]
Raczkowski, J.W., et al. (2010) Functional Scoliosis Caused by Leg Length Discrepancy. Archives of Medical Science, 6, 393-398.
https://doi.org/10.5114/aoms.2010.14262
[28]
Gross, R.H., et al. (1983) Leg Length Discrepancy in Marathon Runners. The American Journal of Sports Medicine, 11, 121-124.
https://doi.org/10.1177/036354658301100303
[29]
Cleveland, R.H., et al. (1998) Determination of Leg Length Discrepance. A Comparison of Weight-Bearing and Supine Imaging. Investigative Radiology, 23, 301-304. https://doi.org/10.1097/00004424-198804000-00010
[30]
Hoikka V. et al., (1989) Leg-Length Inequality Has Poor Correlation With Lumbar Scoliosis. Archives of Orthopaedic and Trauma Surgery, 108, 173-175.
https://doi.org/10.1007/BF00934262
[31]
Rhodes, D.W., et al. (1995) The Validity of the Prone Leg Check as An Estimate of Standing Leg Length Inequality Measured by X-Ray. Journal of Manipulative and Physiological Therapeutics, 18, 343-346.
[32]
Soukka, A., et al. (1991) Leg-Length Inequality in People of Working Age. The Association between Mild Inequality and Low-Back Pain Is Questionable. Spine, 16, 429-431. https://doi.org/10.1097/00007632-199104000-00007
[33]
Mincer, A.E., Cummings, G.S, Andrew, P.D. and Rau, J.L. (1997) Effect of Leg Length Discrepancy on Trunk Muscle Fatigue and Unintended Trunk Movement. Journal of Physical Therapy Science, 9, 1-6. https://doi.org/10.1589/jpts.9.1
[34]
Sabharwal, S., et al. (2008) Methods for Assessing Leg Length Discrepancy, Clinical Orthopaedics and Related Research, 466, 2910-2922.
https://doi.org/10.1007/s11999-008-0524-9
[35]
Gross, M.T., et al. (2015) Lower Quarter Screening for Skeletal Malalignment-Suggestions for Orthotics and Shoewear. Journal of Orthopaedic & Sports Physical Therapy, 21, 389-405. https://doi.org/10.2519/jospt.1995.21.6.389
