Leg Length Inequality

Publication Title: 
Clinical Orthopaedics and Related Research

BACKGROUND: Orthopaedic oncologists often must address leg-length discrepancy after resection of tumors in growing patients with osteosarcoma. There are various alternatives to address this problem. We describe a three-stage procedure: (1) temporary arthrodesis, (2) lengthening by Ilizarov apparatus, and (3) tumor prosthesis.

Author(s): 
Kong, Chang-Bae
Lee, Soo-Yong
Jeon, Dae-Geun
Publication Title: 
Journal of Manipulative and Physiological Therapeutics

The phenomenon of "short leg" has long been used and debated clinically. A uniquely chiropractic measurement technique was not studied in any of the few studies of reliability of measurement which have been reported. An inter- and intra-examiner reliability study was therefore performed to validate a prone leg length-differential test. Naive students (n = 40) were called, in random order, into three adjacent examining rooms where three experienced chiropractic clinicians measured differential leg lengths.

Author(s): 
DeBoer, K. F.
Harmon, R. O.
Savoie, S.
Tuttle, C. D.
Publication Title: 
Journal of Manipulative and Physiological Therapeutics

Previous research has reported upon the use of a radiographic method to determine the presence of structural short leg using full spine radiography. In the current study, ninety-two (92) freshman students at the National College of Chiropractic in Lombard, Illinois were first measured for the presence of structural short leg and then placed on a modified Janse-Illi four quadrant weight scale. Measurements of weight were taken at fifteen, thirty, forty-five and sixty seconds. Precise placement of the feet were used.

Author(s): 
Lawrence, D.
Publication Title: 
Journal of Manipulative and Physiological Therapeutics

There have been relatively few subject areas within the chiropractic profession which have led to such widespread misunderstanding, confusion and controversy. This paper will attempt to examine the research surrounding the development of our current state of understanding concerning the many factors affecting the short leg. Traditionally, research surrounding the short leg has moved in several discreet directions. The first has been toward determining a reliable radiographic method used for measuring structural short legs.

Author(s): 
Lawrence, D. J.
Publication Title: 
Journal of Manipulative and Physiological Therapeutics

Visual leg length insufficiency detection and correction is compared with established radiographic procedures on 41 consecutive patients presenting to a chiropractic clinic with low back pain. It is commonly accepted that the most accurate procedure of short leg demonstration is the standing X ray.

Author(s): 
Aspegren, D. D.
Cox, J. M.
Trier, K. K.
Publication Title: 
Journal of Manipulative and Physiological Therapeutics

Based on statistical analysis of 97 chronic low back patients, a pelvic list model has been proposed explaining the correlation between leg length discrepancies (LLD) and sciatica. This model suggests that asymmetrical pronation patterns (one pedal arch dropping more than the contralateral pedal arch) initiates a forward downward rotation within the sacroiliac joint. Entrapment of the sciatic nerve between the piriformis muscle and sacrospinous ligament occurs. Clinically, paresis is observed: numbness, weakness and eventually paralysis of the affected limb.

Author(s): 
Rothbart, B. A.
Estabrook, L.
Publication Title: 
Journal of Manipulative and Physiological Therapeutics

The Derifield-Thompson test for leg length inequality (LLI) is commonly used by chiropractors to assess a need for adjustment and to evaluate the results of adjustment. The two previous studies testing the reliability of the technique reported conflicting results. This study had two objectives: to demonstrate inter- and intraobserver reliability in detecting a LLI as little as 3 mm; and to document what effect Pierce-Stillwagon cervical adjusting has on a functional LLI.

Author(s): 
Shambaugh, P.
Sclafani, L.
Fanselow, D.
Publication Title: 
Journal of Manipulative and Physiological Therapeutics

A reliability study was conducted to determine whether prone leg length analysis in association with an isolation test maneuver was reproducible. Seventy-two subjects were evaluated by two examiners on separate occasions for the presence of C1 subluxation. Concordance was assessed by the Kappa statistic, and interexaminer percentage of agreement was compared. Agreement beyond chance for the two groups was K = 0.52, p less than 0.01 and 0.55, p less than 0.001, respectively.

Author(s): 
Youngquist, M. W.
Fuhr, A. W.
Osterbauer, P. J.
Publication Title: 
Journal of Manipulative and Physiological Therapeutics

A series of blinded studies to determine the feasibility of documenting functional leg length inequalities and changes in functional leg length in normal and non-normal patients were performed. A new apparatus designed to minimize or eliminate subjective components of inequality assessment, while attaining high levels of precision, was developed. Subjects were evaluated for presence of cervical spine lesion by five independent examiners and grouped into "lesioned" and "nonlesioned" categories.

Author(s): 
Falltrick, D. R.
Pierson, S. D.
Publication Title: 
Journal of Manipulative and Physiological Therapeutics

OBJECTIVE: a) Establish a precise, standardized method to assess prone leg alignment changes (functional "leg length inequality"), which have, until now, been reported clinically to occur as a result putative chiropractic subluxation isolation tests [neck flexion (C5) and extension (C1)]; and b) describe differences in leg alignment changes in a group of healthy subjects and patients with chronic spinal complaints. DESIGN: Two group, two isolation tests, descriptive, repeated measure analysis of variance. SETTING: Exercise and Sport Research Institute, Arizona State University.

Author(s): 
De Witt, J. K.
Osterbauer, P. J.
Stelmach, G. E.
Fuhr, A. W.

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