Effect of leg length difference on plantar pressures

NewsBot · Jul 17, 2014

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THE EFFECT OF LEG LENGTH DESCREPENCY UPON LOAD DISTRIBUTION IN THE STATIC PHASE (STANDING)
V. Swaminathan, M. Cartwright-Terry, J.D. Moorehead, A. Bowey, S.J. Scott
Gait & Posture; Articles in Press

Leg length discrepancy (LLD) is commonly recognized as a complication of total hip arthroplasty. Some patients with only minor LLD complain of major difficulties. The effect of LLD has been described in the dynamic phase, but not static phase. The aim of this project was to investigate the effect of leg length discrepancy on static limb loading (ie. Standing). A pedobarograph was used to measure the limb loading of 20 normal volunteers whilst changing the height of the other foot thus simulating a LLD. With both feet at the same level, the left limb took 54% of the load. When the right foot was lower, (simulating a long left leg), the left leg took 39% of the load. When the right foot was higher, (simulating a long right leg), the left leg took 65% of the load. A paired t-test comparison of the simulation with the level load showed a significant difference with P = 0.002. Our results show that weight distribution increased in the shorter limb when LLD was simulated. This uneven distribution is likely to lead to premature fatigue when standing and may explain why some patients with LLD post hip arthroplasty have poorer outcomes.
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NewsBot · Jul 17, 2014

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Craig Payne · Jul 17, 2014

NewsBot said: ↑

THE EFFECT OF LEG LENGTH DESCREPENCY UPON LOAD DISTRIBUTION IN THE STATIC PHASE (STANDING)
V. Swaminathan, M. Cartwright-Terry, J.D. Moorehead, A. Bowey, S.J. Scott
Gait & Posture; Articles in Press
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Static measures
Artificially induced LLD
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NewsBot · Dec 29, 2017

The effect of simulated leg length discrepancy on lower limb biomechanics during gait
Sam Khamis et al
Gait and Posture Article in Press

Highlights
•LLD, as small as 5 mm, causes biomechanical changes in the lower limbs during gait.
•LLD is reflected in both kinematic deviations and DLL during the gait cycle.
•Frontal and rotational plane deviations, not only sagittal, compensate for LLD.
•DLL measurements can quantify the change in leg length needed to compensate LLD.
•LLD is compensated by increasing the shorter limb DLL and reducing the longer limb.
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Understanding the effects of leg length discrepancy (LLD) on the biomechanics of gait and determining as to what extent of LLD alters gait is essential. A total of 91 biomechanical data were assessed from 14 lower limbs of healthy individuals walking under random conditions: shod only and with a 5, 10, 15, 20, 30 and 40 mm sole lift. Lower limb kinematics and dynamic leg length (DLL) were measured by a motion capture system. Hotelling's T-Square test was used to evaluate the differences in DLLs throughout the gait cycle in conjunction with differences between the sides based on the maximal stance phase and minimal swing phase DLLs. Kinematics were compared using the one-way blocked analysis of variance and Post-hoc analysis by the paired t test. Significant dynamic shortening of the longer limb, mainly during the swing phase, and significant change in maximal stance and minimal swing phase DLL relationship started at a 10 mm lift condition (p < 0.05). Thirteen kinematic variables produced a significant angular main effect (p < 0.05), with a more flexed position of the longer limb and extended shorter limb beginning at a 5 mm lift. An increase in hip abduction and external foot rotation during the swing phase was also found. This study demonstrates that simulated LLD, as low as 5 mm, causes biomechanical changes in the lower limbs during gait revealed in both kinematics and dynamic leg length, suggesting that LLD, as small as 5–10 mm, should not be ignored.
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