Document Type : Full Research Paper
Authors
1 M.Sc., Department of Biomechanics, Department of Biomedical Engineering, Sahand University of Technology, Tabriz, Iran
2 Assistant Professor, Department of Biomechanics, Department of Biomedical Engineering, Sahand University of Technology, Tabriz, Iran
3 Assistant Professor, Department of Rehabilitation, University of Medical Sciences, Isfahan, Iran
Abstract
People who suffer from leg length discrepancy (LLD) due to the shortening of one side of the lower extremities change their movement pattern because of using compensatory mechanisms. Methods such as manipulating a compensating insole are used to correct the movement pattern to normal. Therefore, the knowledge of movement pattern changes in with and without using of insoles can help to develop rehabilitation methods. The aim of this study was to investigate the kinematics of the lower extremities of people with leg length discrepancy during stair climbing with and without using insoles. Twenty participants including 10 normal and 10 LLD people took part in this study. Their movement on stair was recorded using a 7 camera 3-D motion analysis system. Changes in the angles of the hip, the knee and the ankle joints were calculated by the 7-member Euler model and compared by independent and paired sample t-test at 95% confidence level. The results showed that there was a significant difference between healthy people and people with LLD without using insoles. These people had higher extension of the knee, pelvis and ankle at the initial contact and toe off in sagittal plane and more knee and pelvis range of movement, less adduction of the knee and pelvis at the initial contact in frontal plane, higher internal and external rotation of pelvis at the initial contact and ankle in toe off in horizontal plane (p<0.05). The results also showed that maximum abduction of the pelvis and maximum adduction of the ankle, maximum internal rotation and the value of the angle of the knee and ankle had no significant different between normal and LLD people (p>0.05) when using insoles. Therefore, the use of insoles can correct some parameters of the movement pattern of the lower joints.
Keywords
Main Subjects
- Gurney, B., Leg length discrepancy. Gait & posture, 2002. 15(2): p. 195-206.
- Blake, R. and H. Ferguson, Limb length discrepancies. Journal of the American Podiatric Medical Association, 1992. 82(1): p. 33.
- Resende, R.A., et al., Biomechanical strategies implemented to compensate for mild leg length discrepancy during gait. Gait & posture, 2016. 46: p. 147-153.
- Song, K.M., S.E. Halliday, and D.G. Little, The effect of limb-length discrepancy on gait. JBJS, 1997. 79(11): p. 1690-8.
- Ashour, R., et al., Effect of footwear modification on postural symmetry and body balance in leg length Discrepancy: A randomized controlled study. International Journal of Osteopathic Medicine, 2019. 32: p. 13-20.
- Muratagic, H., T. Ramakrishnan, and K.B. Reed, Combined effects of leg length discrepancy and the addition of distal mass on gait asymmetry. Gait & posture, 2017. 58: p. 487-492.
- Murrell, P., M.W. Cornwall, and S.K. Doucet, Leg-length discrepancy: effect on the amplitude of postural sway. Archives of physical medicine and rehabilitation, 1991. 72(9): p. 646-648.
- Murray, K.J. and M.F. Azari, Leg length discrepancy and osteoarthritis in the knee, hip and lumbar spine. The Journal of the Canadian Chiropractic Association, 2015. 59(3): p. 226.
- Dixon, P.C. and D.J. Pearsall, Gait dynamics on a cross-slope walking surface. Journal of applied biomechanics, 2010. 26(1): p. 17-25.
- Kendall, J.C., A.R. Bird, and M.F. Azari, Foot posture, leg length discrepancy and low back pain–Their relationship and clinical management using foot orthoses–An overview. The foot, 2014. 24(2): p. 75-80.
- Stel, V.S., et al., Consequences of falling in older men and women and risk factors for health service use and functional decline. Age and ageing, 2004. 33(1): p. 58-65.
- Startzell, J.K., et al., Stair negotiation in older people: a review. Journal of the American Geriatrics Society, 2000. 48(5): p. 567-580.
- Meyer, P., et al., Stairs instead of elevators at workplace: cardioprotective effects of a pragmatic intervention. European Journal of Cardiovascular Prevention & Rehabilitation, 2010. 17(5): p. 569-575.
- Teh, K.C. and A.R. Aziz, Heart rate, oxygen uptake, and energy cost of ascending and descending the stairs. Medicine and science in sports and exercise, 2002. 34(4): p. 695-699.
- Riahi, H., A.H. Oskouei, and A.E. Oskouei, Activity of Quadriceps muscle among people with knee osteoarthritis during stair ascending and descending with different heights. Medical Journal of Tabriz University of Medical Sciences and Health Services, 2017. 39(6): p. 29-34.
- Palmanovich, E., et al., The effect of eliminating leg length difference on plantar foot pressure distribution in patients wearing forefoot offloading shoe. The Foot, 2017. 33: p. 39-43.
- Wang, K., et al., Research and development of 3D printing orthotic insoles and preliminary treatment of leg length discrepancy patients. Technology and Health Care, 2020(Preprint): p. 1-10.
- Menez, C., et al., Effects of Orthotic Insoles on Gait Kinematics and Low Back Pain in Subjects with Mild Leg Length Discrepancy. Journal of the American Podiatric Medical Association, 2020.
- Moseley, C., Leg length discrepancy and angular deformity of the lower limbs. Lovell and Winter’s pediatric orthopedics. 4th ed. Philadelphia: Lippincott-Raven, 1996: p. 849-901.
- Nagi, O., M. Dhillon, and V. Goni, Does the piriformis compress the sciatic nerve during limb length equalization? Singapore medical journal, 1999. 40(12): p. 749-751.
- Price, C.T. and A.C. Carantzas, Severe growth retardation following limb lengthening: a case report. The Iowa Orthopaedic Journal, 1996. 16: p. 139.
- Zietz, D., L. Johannsen, and M. Hollands, Stepping characteristics and Centre of Mass control during stair descent: Effects of age, fall risk and visual factors. Gait & posture, 2011. 34(2): p. 279-284.
- Subotnick, S.I., Limb length discrepancies of the lower extremity (the short leg syndrome). Journal of Orthopaedic & Sports Physical Therapy, 1981. 3(1): p. 11-16.
- Basford, J. and M.A. Smith, Shoe insoles in the workplace. Orthopedics, 1988. 11(2): p. 285-288.
- Defrin, R., et al., Conservative correction of leg-length discrepancies of 10mm or less for the relief of chronic low back pain. Archives of physical medicine and rehabilitation, 2005. 86(11): p. 2075-2080.
- Frederic, H.M., Fundamentals of anatomy & physiology. 2015: Pearson.
- Mokhtarian, A., A. Fattah, and S. Agrawal, Design of a novel passive pelvic orthosis for gait rehabilitation using 3D dynamic model. Modares Mechanical Engineering, 2013. 13(9): p. 111-125.
- Vaughan, C.L.K., The biomechanics of human locomotion. 2009, University of Cape Town.
- Park, S.-E., et al., Measurement and Analysis of Gait Pattern during Stair Walk for Improvement of Robotic Locomotion Rehabilitation System. Applied bionics and biomechanics, 2019. 2019.
- Brand, R.A. and H.J. Yack, Effects of leg length discrepancies on the forces at the hip joint. Clinical orthopaedics and related research, 1996(333): p. 172-180.
- Lewis, C.E. and D.T. Felson, Association of Leg-Length Inequality with Knee Osteoarthritis. Ann Intern Med, 2010. 152: p. 287-295.
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