Does structural leg-length discrepancy affect postural control? Preliminary study

Małgorzata Eliks, Wioleta Ostiak-Tomaszewska, Przemysław Lisiński, Paweł Koczewski, Małgorzata Eliks, Wioleta Ostiak-Tomaszewska, Przemysław Lisiński, Paweł Koczewski

Abstract

Background: Leg-length inequality results in an altered position of the spine and pelvis. Previous studies on the influence of leg asymmetry on postural control have been inconclusive. The purpose of this paper was to investigate the effect of structural leg-length discrepancy (LLD) on the control of posture.

Methods: We studied 38 individuals (19 patients with structural LLD, 19 healthy subjects). The examination included measurement of the length of the lower limbs and weight distribution as well as a static posturography. All statistical analyses were performed with Statistica software version 10.0. Non-parametrical Kruskal-Wallis with Dunn's post test and Spearman test were used. Differences between the groups and correlation between mean COP sway velocity and the value of LLD as well as the value of LLD and weight distribution were assumed as statistically significant at p < 0.05.

Results: There was a significant difference in the asymmetry of weight distribution between the group of patients and the healthy subjects (p = 0.0005). Differences in a posturographic examination between the groups were not statistically significant (p > 0.05). Meaningful differences in mean COP velocity in mediolateral direction between tandem stance with eyes open and closed were detected in both groups (in controls p = 0.000134, in patients both with the shorter leg in a front and rear position, p = 0.029, p = 0.026 respectively). There was a positive moderate correlation between the value of LLD and the value of mean COP velocity in normal standing in mediolateral direction with eyes open (r = 0.47) and closed (r = 0.54) and in anterioposterior plane with eyes closed (r = 0.05).

Conclusions: The fact that there were no significant differences in posturography between the groups might indicate compensations to the altered posture and neuromuscular adaptations in patients with structural leg-length inequality. LLD causes an increased asymmetry of weight distribution. This study confirmed a fundamental role of the sight in postural control, especially in unstable conditions. The analysis of mean COP sway velocity may suggest a proportional deterioration of postural control with the increase of the value of leg-length asymmetry.

Trial registration number: Trial registry: ClinicalTrials.gov NCT03048656 , 8 February 2017 (retrospectively registered).

Keywords: Leg-length inequality; Postural balance; Postural control; Weight bearing; Weight distribution.

Conflict of interest statement

Ethics approval and consent to participate

All subjects expressed written consent to the participation in the study. All minors had consent provided by their parents and/or guardians.

The study was conducted in the agreement with the Declaration of Helsinki and with the approval of the Bioethics Committee of Poznan University of Medical Sciences (the reference number 418/14). Data were anonymised before analysis.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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Source: PubMed

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