Determination of the amount of leg length inequality that alters spinal posture

NewsBot · Mar 13, 2013

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Determination of the amount of leg length inequality that alters spinal posture in healthy subjects using rasterstereography.
Betsch M, Rapp W, Przibylla A, Jungbluth P, Hakimi M, Schneppendahl J, Thelen S, Wild M.
Eur Spine J. 2013 Mar 13.

PURPOSE:
Leg length inequalities (LLIs) can result in an increased energy consumption, abnormal gait or osteoarthritis of the hip. In a previous study we simulated different LLIs of up to 15 mm and evaluated their effects on the pelvic position and spinal posture. We found a correlation between LLIs and resulting changes of the pelvic position. Despite suggestions in the literature we were not able to detect significant changes of the spinal posture. Therefore, the purpose of this study was to determine the amount of LLI that would in fact alter the spinal posture.

METHODS:
The subjects were placed on a simulation platform, whose height could be precisely controlled by the measuring device, to simulate different LLIs of up to 20 mm. For LLIs >20 mm, additional precision-cut wooden blocks were used under one foot. After an adaptation period the resulting changes of the pelvis and spine were measured with a rasterstereographic device.

RESULTS:
We found a significant correlation between platform height changes and changes of the pelvic position. The frontal spinal parameters surface rotation and lateral deviation changed significantly when simulating differences greater than 20 mm. No changes of the sagittal spinal curvature were measured, however, a trend to decreasing kyphotic angles was noted.

CONCLUSIONS:
Our study has shown for the first time that LLIs >20 mm will lead to significant changes in the spinal posture of healthy test subjects. However, these changes were only found in frontal (surface rotation and lateral flexion) spinal parameters, but not in sagittal parameters. Here for the kyphotic angle only a tendency to decreasing angles was noted. We have also found a significant correlation between different leg lengths and changes of the pelvic position. Further, females and males seem to react in the same way to LLIs.
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Admin2 · Mar 13, 2013

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drsha · Mar 17, 2013

NewsBot said: ↑

Determination of the amount of leg length inequality that alters spinal posture in healthy subjects using rasterstereography.
Betsch M, Rapp W, Przibylla A, Jungbluth P, Hakimi M, Schneppendahl J, Thelen S, Wild M.
Eur Spine J. 2013 Mar 13.
Click to expand...

IMHO, this paper is moot because it is not longitudinal.

Wolffs and Davis's Laws must be allowed to have impact over time on the entire posture including the spine.

The fact that there is no immediate change with lifts < 20mm's shows a lack of understanding of the dynamics of bioarchitecture.

In bioarchitecture, first there is a positional change (the lifts) which impacts posture. Then there is the functional adaptation of bone and soft tissue to produce an actual postural change.

Put the lifts onto a foot bed and bring the patients back in 6-9 months and I predict there will be postural changes in the feet up to the spine, different for N=1, to accompany the positional changes for lifts much smaller than 20mm's.

I would enjoy hearing a reaction form the members but mostly I would hope one or more of the authors will comment.
Dennis

Robertisaacs · Mar 17, 2013

If anyone has access, I'd much like to read this in its entirety.

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