Leg length discrepancy: the importance of a complete history and examination

Coffey, Duncan; Hudson-Phillips, Sarah; Radha, Sarkhell; Ball, Simon

doi:10.1136/bcr-2017-220985

Cited by 3 publications

(3 citation statements)

References 5 publications

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“…Several studies found that LLD is correlated with pelvic tilt in the coronal plane, also called pelvic obliquity 1,2,13,14,[16][17][18] . Some have studied the immediate effects of artificially induced LLDs, using different measuring techniques and showed that LLD affected the pelvic disposition creating pelvic obliquity.…”

Section: Resultsmentioning

confidence: 99%

Indications of sole lift and foot orthoses in the management of mild idiopathic scoliosis—a review

Rothschild¹,

Ng²,

Ng³

2020

J Phys Ther Sci

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Leg length discrepancy is common among patients with scoliosis. Some studies reported reduced functional scoliosis curves with correction of leg length discrepancy. Others, however, have shown that induced leg length discrepancy has little effects on spinal deformities. Also, small number of studies assessed the use of foot orthoses in patients with faulty foot biomechanics and their impact on idiopathic scoliosis. In this context, a review of the literature is needed to determine the current evidence for the appropriate use of sole lift and foot orthoses in a context of scoliosis. [Methods] A literature review was performed. [Results] It appeared that sole lifts are indicated for functional lumbar scoliosis when the level of the sacrum is parallel to that of the hips. Sole lifts may not be indicated for patients with structural scoliosis, seemingly inducing a compensatory curve. Custom foot orthoses were found to reduce spinal curves in juvenile patients with mild idiopathic scoliosis and concomitant abnormal foot biomechanics. [Conclusion] Sole lift appeared to be indicated in the presence of certain types of functional scoliosis. Custom foot orthoses can be considered in the management of mild idiopathic scoliosis in juvenile patients. Evidence, however, is low and quality studies are needed to validate these findings.

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Section: Resultsmentioning

confidence: 99%

Indications of sole lift and foot orthoses in the management of mild idiopathic scoliosis—a review

Rothschild¹,

Ng²,

Ng³

2020

J Phys Ther Sci

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“…An LLI, by altering the support of the acetabulum on the femoral head, alters the balance of the pelvis. Several scholars have reported that LLIs are related to pelvic tilt in the coronal plane, which is also called pelvic obliquity [11,42,57,66,71,[95][96][97]. In a sample of 524 patients with degenerative scoliosis and an average age of 60.7 years, Radcliff et al [80] reported that the prevalence of pelvic obliquity in patients with a single degenerative scoliotic curve was 91%.…”

Section: Relationship Between Lli and Pelvic Inclination In Scoliosis...mentioning

confidence: 99%

Scoliosis and Lower Limb Inequality: To Lift or Not to Lift, That Is the Question

Colonna,

Casacci,

Borghi

2024

Cureus

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In subjects with scoliotic alterations of the spine, asymmetrical lengths of the lower limbs are frequently observed, a condition commonly referred to as leg length inequality (LLI) or discrepancy (LLD). This asymmetry can induce pelvic misalignments, manifested by an asymmetric height of the iliac crests, and consequently an alteration of the spine's axis. Although correcting this discrepancy might appear to be a straightforward solution, further investigation may reveal other indications. The purpose of this article is to aid clinicians confronted with the decision of whether to compensate for an LLI in individuals with scoliosis, encompassing both adolescents and adults. It presents a literature review on the incidence of LLIs in the general population, distinguishing between structural LLI (sLLI) and functional LLI (fLLI) types of LLIs, and quantifying their magnitude with clinical and instrumental evaluation. Additionally, it links these two types of LLIs to the type of scoliosis (structural or functional). From a clinical perspective, it also examines the compensatory mechanisms employed by the pelvis in the presence of structural or functional LLIs in order to draw useful indications for therapeutic decisions. Moreover, it proposes an additional evaluation parameter in the coronal plane, namely the central sacral vertical line (CSVL), to aid in the decision-making process regarding LLI compensation. Although this parameter has been documented in the literature, it has been little associated with LLIs. The findings indicate that scoliotic discrepancies should be compensated (conservatively or surgically) only when the imbalance of the femoral heads is on the same side as the imbalance of the sacrum and the iliac crests; this corrective action should result in a reduction of the overhang in the coronal plane.

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“…The therapist selects sequence a group manual tests for classification lower limbs discrepancy. The techniques will also be classified according to the type of manoeuvres described in the literature and will be explained in detail [9]. The present paper defines a simple assessment plan for therapists, which is design for LLD in the context of SD assessment.…”

Section: Introductionmentioning

confidence: 99%

The Question of Short Lower Limb and Long Lower in Manual Therapy: An Overview

Collebrusco¹,

Censi²,

Casoli³

2020

OJTR

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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.

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Leg length discrepancy: the importance of a complete history and examination

Cited by 3 publications

References 5 publications

Indications of sole lift and foot orthoses in the management of mild idiopathic scoliosis—a review

Indications of sole lift and foot orthoses in the management of mild idiopathic scoliosis—a review

Scoliosis and Lower Limb Inequality: To Lift or Not to Lift, That Is the Question

The Question of Short Lower Limb and Long Lower in Manual Therapy: An Overview

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