본문 바로가기
KERD
논문KCI 등재

The Effects of Simulated Mild Leg Length Discrepancy on Gait Parameters and Trunk Acceleration

1

조회

0

다운로드

0

인용

0

참고문헌

키워드

주제분류물리치료학

초록

Background: Leg length discrepancy (LLD) leads to many musculoskeletal disorders and affects daily activities such as walking. In the majority of the population, mild LLD is a common condition. Nevertheless, it is still controversy among researchers and clinicians on the effects of mild LLD during gait, and available studies have largely overlooked this issue. Objects: The purpose of the present study is to investigate the effects of mild LLD on the gait parameters and trunk acceleration. Methods: A total of 15 female and male participants with no evidence of LLD of >.5 ㎝ participated in the present study. All participants walked under the following two conditions: (1) The non-LLD condition, where the participants walked in shoes of the same heel height; (2) A mild LLD condition induced by wearing a 1.5 ㎝ higher heel on the right shoe. The GAITRite system and tri-axial accelerometer were used to measure gait parameters and trunk acceleration. To compare the variation of each variable, a paired t-test was performed. Results: Compared to the non-LLD condition, step time and swing phase were significantly increased in the mild LLD condition, while stance phase, single support phase, and double support phase significantly decreased in the short limb (p<.05). In the long limb of the mild LLD condition, single support phase significantly increased, while swing phase significantly decreased (p<.05). Furthermore, significant decrease in the gait velocity and cadence in the mild LLD condition were observed (p<.05). In the comparison between both limbs in the mild LLD condition, the step time and swing phase of the short limb significantly increased compared with the long limb, while step length, stance phase, and single support phase of the long limb significantly increased compared with the short limb (p<.05). Additionally, trunk acceleration of all directions (anterior-posterior, medial-lateral, vertical) significantly increased in the mild LLD condition (p<.05). Conclusion: The results of the present study demonstrate that mild LLD causes altered and asymmetrical gait patterns and affects the trunk, resulting in inefficient gait. Therefore, mild LLD should not be overlooked and requires adequate treatment.

Abstract

Background: Leg length discrepancy (LLD) leads to many musculoskeletal disorders and affects daily activities such as walking. In the majority of the population, mild LLD is a common condition. Nevertheless, it is still controversy among researchers and clinicians on the effects of mild LLD during gait, and available studies have largely overlooked this issue. Objects: The purpose of the present study is to investigate the effects of mild LLD on the gait parameters and trunk acceleration. Methods: A total of 15 female and male participants with no evidence of LLD of >.5 ㎝ participated in the present study. All participants walked under the following two conditions: (1) The non-LLD condition, where the participants walked in shoes of the same heel height; (2) A mild LLD condition induced by wearing a 1.5 ㎝ higher heel on the right shoe. The GAITRite system and tri-axial accelerometer were used to measure gait parameters and trunk acceleration. To compare the variation of each variable, a paired t-test was performed. Results: Compared to the non-LLD condition, step time and swing phase were significantly increased in the mild LLD condition, while stance phase, single support phase, and double support phase significantly decreased in the short limb (p<.05). In the long limb of the mild LLD condition, single support phase significantly increased, while swing phase significantly decreased (p<.05). Furthermore, significant decrease in the gait velocity and cadence in the mild LLD condition were observed (p<.05). In the comparison between both limbs in the mild LLD condition, the step time and swing phase of the short limb significantly increased compared with the long limb, while step length, stance phase, and single support phase of the long limb significantly increased compared with the short limb (p<.05). Additionally, trunk acceleration of all directions (anterior-posterior, medial-lateral, vertical) significantly increased in the mild LLD condition (p<.05). Conclusion: The results of the present study demonstrate that mild LLD causes altered and asymmetrical gait patterns and affects the trunk, resulting in inefficient gait. Therefore, mild LLD should not be overlooked and requires adequate treatment.

참고문헌 (25)

  1. Tsuyoshi Asai, "Dual tasking affects lateral trunk control in healthy younger and older adults", Gait & Posture, 38(4), pp.830~836 (2013), Elsevier BV[DOI]
  2. Bhave A, "Improvement in gait parameters after lengthening for the treatment of limb-length discrepancy", J Bone Joint Surg, 81(4), pp.529~534 (1999)
  3. Sandy Bolz, "Leg Length Differences and Correlation with Total Leg Strength", Journal of Orthopaedic & Sports Physical Therapy, 6(2), pp.123~129 (1984), Journal of Orthopaedic & Sports Physical Therapy (JOSPT)[DOI]
  4. Rebecca J. Brady, "Limb Length Inequality: Clinical Implications for Assessment and Intervention", Journal of Orthopaedic & Sports Physical Therapy, 33(5), pp.221~234 (2003), Journal of Orthopaedic & Sports Physical Therapy (JOSPT)[DOI]
  5. Carabello RJ, "Lower extremity strength and power asymmetry assessment in healthy and mobility-limited populations:Reliability and association with physical functioning", Aging Clin Exp Res, 22(4), pp.324~329 (2010)[DOI]
  6. Ruth Defrin, "Conservative Correction of Leg-Length Discrepancies of 10mm or Less for the Relief of Chronic Low Back Pain", Archives of Physical Medicine and Rehabilitation, 86(11), pp.2075~2080 (2005), Elsevier BV[DOI]
  7. Friberg O, "To the Editor", Spine, 17(4), pp.458~460 (1992)
  8. Burke Gurney, "Leg length discrepancy", Gait & Posture, 15(2), pp.195~206 (2002), Elsevier BV[DOI]
  9. Gurney B, "Effects of limb-length discrepancy on gait economy and lower-extremity muscle activity in older adults", J Bone Joint Surg, 83(6), pp.907~915 (2001)
  10. William F. Harvey, "Association of Leg-Length Inequality With Knee Osteoarthritis", Annals of Internal Medicine, 152(5), pp.287~295 (2010), American College of Physicians[DOI]
  11. Jorunn L. Helbostad, "The effect of gait speed on lateral balance control during walking in healthy elderly", Gait & Posture, 18(2), pp.27~36 (2003), Elsevier BV[DOI]
  12. Bih-Jen Hsue, "The dynamic balance of the children with cerebral palsy and typical developing during gait. Part I: Spatial relationship between COM and COP trajectories", Gait & Posture, 29(3), pp.465~470 (2009), Elsevier BV[DOI]
  13. Kakushima M, "The effect of leg length discrepancy on spinal motion during gait: three-dimensional analysis in healthy volunteers", Spine, 28(21), pp.2472~2476 (2003)[DOI]
  14. Sam Khamis, "Relationship and significance of gait deviations associated with limb length discrepancy: A systematic review", Gait & Posture, 57, pp.115~123 (2017), Elsevier BV[DOI]
  15. Gary A Knutson, "Anatomic and functional leg-length inequality:A review and recommendation for clinical decision-making. Part I, anatomic leg-length inequality: prevalence, magnitude, effects and clinical significance", Chiropractic & Osteopathy, 13(1), pp.11~ (2005), Springer Nature[DOI]
  16. Pei Xuan Ku, "Balance control in lower extremity amputees during quiet standing: A systematic review", Gait & Posture, 39(2), pp.672~682 (2014), Elsevier BV[DOI]
  17. Latt MD, "Acceleration patterns of the head and pelvis during gait in older people with Parkinson's disease: a comparison of fallers and nonfallers", J Gerontol, 64(6), pp.700~706 (2009)[DOI]
  18. J. R. Perttunen, "Gait asymmetry in patients with limb length discrepancy", Scandinavian Journal of Medicine and Science in Sports, 14(1), pp.49~56 (2004), Wiley[DOI]
  19. Renan A. Resende, "Biomechanical strategies implemented to compensate for mild leg length discrepancy during gait", Gait & Posture, 46, pp.147~153 (2016), Elsevier BV[DOI]
  20. Renan A. Resende, "Mild leg length discrepancy affects lower limbs, pelvis and trunk biomechanics of individuals with knee osteoarthritis during gait", Clinical Biomechanics, 38, pp.1~7 (2016), Elsevier BV[DOI]
  21. Saunders JB, "The major determinants in normal and pathological gait", J Bone Joint Surg, 35(3), pp.543~557 (1953)
  22. Sun-Shil Shin, "Difference in trunk stability during semicircular turns with and without a bag in elderly women", Journal of Back and Musculoskeletal Rehabilitation, 30(5), pp.1069~1074 (2017), IOS Press[DOI]
  23. Steven I. Subotnick, "Limb Length Discrepancies of the Lower Extremity (The Short Leg Syndrome)", Journal of Orthopaedic & Sports Physical Therapy, 3(1), pp.11~16 (1981), Journal of Orthopaedic & Sports Physical Therapy (JOSPT)[DOI]
  24. Murray G. Tucker, "Age-related differences in postural reaction time and coordination during voluntary sway movements", Human Movement Science, 27(5), pp.728~737 (2008), Elsevier BV[DOI]
  25. Yack HJ, "Dynamic stability in the elderly:identifying a possible measure", J Gerontol, 48(5), pp.225~230 (1993)[DOI]

이 간행물의 다른 논문 (5건)