Leg Length Discrepancy Assessment: Accuracy and Precision in Five Clinical Methods of Evaluation

Effect of simulating leg length inequality on pelvic torsion and trunk mobility

“…The findings in the present study are of interest in that the method used herein has previously been put forward as a 'clinically' useful approach for assessing functional leg length inequality [16]. Lateral pelvic tilt, determined from the heights of the iliac crests (Fig.…”

“…Woerman and Binder-Macleod [16] compared several inexpensive and readily implemented methods to estimate leg length inequality and advocated using the heights of iliac crests with the subject standing as a relatively precise method. Subsequent investigations have confirmed that difference between iliac crest heights cannot match the roentgenographic method in precision and accuracy [17,18].…”

Clinimetric properties of observer‐assessed impairment tests used to evaluate hip and groin impairments: A systematic review

“…Tape measures have routinely been used to assess LLD in clinical practice (44 -47). Contrary to the findings of this review, the validity of this technique has been demonstrated in other populations, including in people with lower back pain and in healthy people (48,49). It is possible that the use of a single tape measurement of LLD in the study included in this review may have influenced the validity of this test, since it previously has been recommended that a mean score from 2 trials be used for measuring LLD (48).…”

Heuristic exploration of how leg checking procedures may lead to inappropriate sacroiliac clinical interventions

“…Woerman and Binder-Macleod, 33 in one of the oldest and more rigorous of studies that compared a variety of TMMs to a radiological reference standard, preferred measuring from the ASIS to the medial malleolus. However, careful reading of this original report, in which 20 examiners measured only 5 patients, does not seem to bear out this conclusion.…”

“…Tape measure methods 12,[20][21][22][23][24][25][26][27][28][29][30][31][32][33] A variety of TMMs (also called direct methods) has been described, with one end of the measure applied to either the anterior superior iliac spine (ASIS), umbilicus, or ziphoid process and the other brought to either the medial or lateral malleolus. Woerman and Binder-Macleod, 33 in one of the oldest and more rigorous of studies that compared a variety of TMMs to a radiological reference standard, preferred measuring from the ASIS to the medial malleolus.…”