Correlation between Gait Asymmetry and Leg Length Discrepancy—What Is the Role of Clinical Abnormalities? (original) (raw)
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BMJ case reports, 2017
Leg length discrepancy (LLD) is associated with many musculoskeletal disorders. Its clinical significance is unclear mainly due to limited functional measurement capacity. An integrated approach measuring true LLD, gait deviations and functional leg length during the gait cycle, based on location of joint centre and anatomical landmarks using a three-dimensional motion analysis system was performed on two patients. In one case, strong agreement was found between all measurements thus, leading to the same treatment intervention. However, in another case, true LLD was not correlated with functional LLD or gait deviations, which led to contradictory results. Functional LLD was found to be correlated with gait deviations in both cases. Our results indicate the effectiveness of integrating into the diagnostic regimen, a dynamic method of measuring LLD, together with the functional outcome of gait deviations as a basis for decision-making regarding the presence and clinical significance o...
British Medical Journal, Case Reports, 2017
Leg length discrepancy (LLD) is associated with many musculoskeletal disorders. Its clinical significance is unclear mainly due to limited functional measurement capacity. An integrated approach measuring true LLD, gait deviations and functional leg length during the gait cycle, based on location of joint centre and anatomical landmarks using a three-dimensional motion analysis system was performed on two patients. In one case, strong agreement was found between all measurements thus, leading to the same treatment intervention. However, in another case, true LLD was not correlated with functional LLD or gait deviations, which led to contradictory results. Functional LLD was found to be correlated with gait deviations in both cases. Our results indicate the effectiveness of integrating into the diagnostic regimen, a dynamic method of measuring LLD, together with the functional outcome of gait deviations as a basis for decision-making regarding the presence and clinical significance of LLD in musculoskeletal disorders.
Gait & posture, 2017
Depending on the extent of a structural leg length discrepancy (LLD), several compensatory mechanisms take place in order to maintain function and to optimize energy consumption during gait. However, studies describing the influence of a structural LLD on upper limb motion are lacking. The current study therefore aimed at the evaluation of upper limb motion during gait in LLD patients compared to healthy controls. Motion capture data from 14 patients with structural LLD and 15 healthy controls that were collected during barefoot walking at a self-selected speed were retrospectively analyzed. Specifically, kinematic parameters of the shoulder and elbow joints as well as the trunk segment were investigated and considered in relation to a minimal clinically important difference of 5°. The shoulders in LLD patients were kept constantly in a more extended and at initial contact in a more adducted position as compared to healthy controls. In addition, the patients' elbow joints showed...
Detecting Anatomical Leg Length Discrepancy Using the Plug-in-Gait Model
Applied Sciences
Leg length discrepancy (LLD) is a significant factor influencing several pathological conditions. Gait analysis is based on biomechanical gait models calculating joint kinematics; however, no previous study has validated its ability to detect anatomical LLD. The aim of the present study was to compare the validity of the Vicon ® Plug-in-Gait-model (PGM) in measuring femur and tibia segmental length discrepancy with measurements attained by X-ray. Fifteen participants with suspected leg length discrepancies underwent a lower limb X-ray and a standing calibration trial using a motion analysis system (Vicon ® , Oxford Metrics, UK). Femur and tibia segment lengths were deducted from both measurements. No differences were found when measuring the discrepancies between sides for the femur (p = 0.3) and tibia (p = 0.45) segmental length. A high correlation was found between methods (r = 0.808-0.962, p < 0.001), however, a significant difference was observed when measuring the femur and tibia length (p < 0.0001). PGM was found to be a valid model in detecting segmental length discrepancy when based on the location of the joint centers compared to X-ray. A variance was noted in the femur and tibial segmental length. The impact of this inconsistency in segmental length on kinematics and kinetics should be further evaluated.
The relation between mild leg-length inequality and able-bodied gait asymmetry
Journal of sports science & medicine, 2010
The causes of able-bodied gait asymmetries are unclear. Mild (< 3 cm) leg-length inequality (LLI) may be one cause of these asymmetries; however, this idea has not been thoroughly investigated. The purpose of this study was to investigate the nature of the relationship between LLI and able-bodied gait asymmetries. We hypothesized that subjects (n = 26) with relatively large LLI, quantified radiographically, would display less symmetrical gait than subjects with relatively small LLI. Gait asymmetries for joint kinematics and joint kinetics were determined using standard gait analysis procedures. Symmetry coefficients were used to quantify bilateral gait symmetry for sagittal-plane hip, knee, and ankle joint angles, moments, and powers. A Pearson product-moment correlation coefficient (r) was used to evaluate the relationship between LLI and the aforementioned symmetry coefficients. Also, these symmetry coefficients were compared between subjects with relatively small LLI (LLI <...
Healthcare, 2021
Background: The effect of Leg-Length Discrepancy (LLD) on dynamic gait parameters has been extensively discussed. Podobarography is the study of foot-to-ground pressure distribution. It has been used to test plantar footprint deviations that could reveal pathology. Purpose: The aim of this study is to determine the effects of simulated LLD on dynamic gait parameters measured with a pressure platform in healthy subjects. Methods: Thirty-seven healthy subjects participated in observational cross-sectional research. A procedure was performed to capture the dynamic parameters of each participant under five different simulated LLD conditions. Support time, mean pressure, and peak pressure measures were registered on three trials for each foot and LLD level per session. An analysis of variance (ANOVA) test for repeated measures was performed to check for differences between the different simulated LLD levels. Results: The stance time of the short leg had no significant changes. The stance...
Improvement in gait parameters after lengthening for the treatment of limb-length discrepancy
The Journal of bone and joint surgery. American volume, 1999
Patients who have limb-length discrepancy demonstrate an altered gait pattern or a limp. The purpose of this prospective study was to compare the objective gait parameters for the shorter lower limb with those for the longer lower limb before and after lengthening and to compare these data with those for a group of twenty subjects who had no limb-length discrepancy. Eighteen patients had equalization of limb length to within one centimeter. We analyzed the stance time, the second peak of the vertical ground-reaction-force vector, and the rate of loading with use of two force-plates arranged in a series. The difference in the mean stance times between the shorter and longer limbs before lengthening was 12 percent, whereas that after lengthening was 2.4 percent; the difference between the values before and after lengthening was significant (p<0.001). The difference in the stance times between the limbs of the patients who did not have limb-length discrepancy was 2 percent. Preopera...
Effect of Tibial Length Discrepancy on the Pelvic List During Human Gait
International Journal of Current Research and Review, 2021
Introduction: Tibial length discrepancy (TLD) is an anatomical leg length discrepancy in which tibia length differs in the same individual. Current literature has not documented the TLD as the source of discrepancy for studying the biomechanics of walking. Instead of TLD studies have considered the total leg length discrepancy for studying the biomechanics of walking. Objective: The objective of the study was to investigate the motion of the pelvis in the frontal plane during walking with various degrees of TLD. Settings and Design: Musculoskeletal modelling Material and Methods: The study used the Stanford-based software (Opensim) in which several levels of TLD were manipulated to a generic musculoskeletal model of gait and subsequently the simulations were carried out using the inverse kinematics tool. A data set of the pelvic lists during a complete gait cycle was generated which was exported to the database for statistical operations. Statistical Analysis Used: Mann Whitney’s U ...
Review Paper: A Review of Selected Factors Affecting Gait Symmetry
Purpose: Because walking is the main activity of humans for movement, many research studies have been conducted to understand its details. One of the main issues in this regard is gait symmetry and the effect of various factors on it. Accordingly, the present study aimed to review the selected factors affecting gait symmetry. Methods: A literature review was performed on articles published from 2000 to 2016 using Science Direct, Google scholar, PubMed, Ovid Medline, Scopus and Medline databases. The search keywords were " gait asymmetry " , " bilateral coordination " , " bilateral asymmetry " , " limb dominance " , " laterality " , " limb preference " and " performance asymmetry. " Results: A total of 60 scientific articles were selected according to the research criteria by searching the relevant articles published from 2000 to 2016 in reliable scientific databases. Conclusion: A review of the previous studies shows that walking in normal people is asymmetric in terms of the lower limb function. Also, limb disorder due to the illness and or disorder creates gait asymmetry. Therefore, regaining perfect symmetry or decreasing gait asymmetry by exercise and intervention in such individuals is considered a method to examine the success of rehabilitation process. However, as factors like movement speed and age can affect gait asymmetry, they should be controlled during the examination of gait asymmetry. Moreover, this information could be useful for gait assessment, clinical prescriptions for patients with abnormalities, designing orthosis and prosthesis, as well as improving the performance of athletes.
Kinematic Quantification of Gait Asymmetry Based on Characteristics of Angle-Angle Diagrams
Acta Polytechnica Hungarica, 2014
Our work focuses on studying gait symmetry with the use of bilateral angle-angle diagrams. The geometric characteristics of angle-angle diagrams can be used to characterize gait, as well as, identify and quantify the associated gait asymmetry. The angle-angle diagrams were created for ten patients with leg length inequality (LLI), to quantify gait symmetry before and after an application of the heel lift. In order to quantify the symmetry of human walking, we have invented and used the characteristics of an angleangle diagram, which represent the evolution of the two joint angles, i.e. left and right knee angles or left and right hip angles. The novel methods are based on the area of the convex hull of the hip-hip diagram or knee-knee diagram, and can be used as an additional method for the determination of gait symmetry of the bipedal walking of human subjects or robots. Our method is not limited to gait studies, it can also be used to study arm swing symmetry.