Khamis Sam, Leisman Gerry, Carmeli Eli
Department of Physical Therapy, University of Haifa, Haifa, Israel.
The National Institute for Brain and Rehabilitation Sciences, Nazareth, Israel.
BMJ Case Rep. 2017 Aug 7;2017:bcr-2017-219645. doi: 10.1136/bcr-2017-219645.
Leg length discrepancy (LLD) is associated with many musculoskeletal disorders. Its clinical significance is unclear mainly due to limited functional measurement capacity. An integrated approach measuring true LLD, gait deviations and functional leg length during the gait cycle, based on location of joint centre and anatomical landmarks using a three-dimensional motion analysis system was performed on two patients. In one case, strong agreement was found between all measurements thus, leading to the same treatment intervention. However, in another case, true LLD was not correlated with functional LLD or gait deviations, which led to contradictory results. Functional LLD was found to be correlated with gait deviations in both cases. Our results indicate the effectiveness of integrating into the diagnostic regimen, a dynamic method of measuring LLD, together with the functional outcome of gait deviations as a basis for decision-making regarding the presence and clinical significance of LLD in musculoskeletal disorders.
腿长差异(LLD)与许多肌肉骨骼疾病相关。其临床意义尚不清楚,主要是由于功能测量能力有限。基于关节中心位置和解剖标志点,使用三维运动分析系统,对两名患者进行了一种综合方法,测量步态周期中的真实LLD、步态偏差和功能腿长。在一个病例中,所有测量结果之间发现了高度一致性,因此导致了相同的治疗干预。然而,在另一个病例中,真实LLD与功能LLD或步态偏差不相关,这导致了相互矛盾的结果。在两个病例中均发现功能LLD与步态偏差相关。我们的结果表明,将测量LLD的动态方法与步态偏差的功能结果相结合纳入诊断方案,对于判断肌肉骨骼疾病中LLD的存在及其临床意义具有有效性,可作为决策的依据。