Predictor index for anatomic leg length discrepancy as a screening tool for referral to tertiary care center of India
Article Sidebar
Main Article Content
Abstract
OBJECTIVES: To assess the anatomical leg length discrepancy (LLD), correlation of discrepancy with body mass index (BMI), height, and weight; and to determine the predictor index in healthy Indians.
METHODS: This descriptive cross-sectional study was conducted at the Department of Anatomy, Teerthanker Mahaveer Medical College and Research Centre, Teerthanker Mahaveer University, from November 2020 to November 2021. Three hundred and forty-seven (187 males and 187 females) healthy adult Indians without any evidence of LLD were recruited. Lengths of lower extremity, height, weight of the participants were measured. LLD, basal metabolic index and predictor index were calculated. Data was analyzed through SPSS v25 software and P-value <0.05 was considered statistically significant.
RESULTS: Out of 374 subjects, 168 (44.9%) had mild LLD and 10 (2.67%) had moderate LLD in both genders. In moderate discrepancy cases, predictor index was observed to be ≥1.75. There was no statistically significant correlation between LLD and height, weight, or BMI. Measurements of leg length for the right leg were 89.13±4.90 cm in males and 86.13±4.28 cm in females (p>0.05), and for the left leg was 89.07±4.94 cm in males and 86.20±4.29 cm in females (p<0.05), respectively.
CONCLUSION: This study on 347 healthy adult Indians revealed 44.9% with mild LLD and 2.67% with moderate LLD. Moderate LLD cases had a predictor index of ≥1.75. No significant correlation was found between LLD and height, weight, or BMI. Gender-based variations existed in left leg length. Further research and early interventions are imperative for addressing moderate leg length discrepancy cases effectively.
Article Details
Work published in KMUJ is licensed under a
Creative Commons Attribution 4.0 License
Authors are permitted and encouraged to post their work online
(e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
References
Cieza A, Causey K, Kamenov K, Hanson SW, Chatterji S, Vos T. Global estimates of the need for rehabilitation based on the Global Burden of Disease study 2019: A systematic analysis for the Global Burden of Disease Study. Lancet 2021;396(10267):2006-17. https://doi.org/10.1016/S0140-6736(20)32340-0
Briggs AM, Woolf AD, Dreinhöfer K, Homb N, Hoy DG, Kopansky-Giles D, et al. Reducing the global burden of musculoskeletal conditions. Bull World Health Organ 2018;96(5):366-68. https://doi.org/10.2471/BLT.17.204891
Johnson VL, Hunter DJ. The epidemiology of osteoarthritis. Best Pract Res Clin Rheumatol 2014;28(1):5-15. https://doi.org/10.1016/j.berh.2014.01.004
Murray KJ, Azari MF. Leg length discrepancy and osteoarthritis in the knee, hip and lumbar spine. J Can Chiropr Assoc 2015;59(3):226-37.
McCaw ST, Bates BT. Biomechanical implications of mild leg length inequality. Br J Sports Med 1991;25(1):10-3. https://doi.org/10.1136/bjsm.25.1.10
Gurney B. Leg length discrepancy. Gait Posture 2002;15(2):195-206. https://doi.org/10.1016/s0966-6362(01)00148-5
Alfuth M, Fichter P, Knicker A. Leg length discrepancy: A systematic review on the validity and reliability of clinical assessments and imaging diagnostics used in clinical practice. PLoS One 2021;16(12):e0261457. https://doi.org/10.1371/journal.pone.0261457
Wylde V, Whitehouse SL, Taylor AH, Pattison GT, Bannister GC, Blom AW. Prevalence and functional impact of patient-perceived leg length discrepancy after hip replacement. Int Orthop 2009;33(4):905-9. https://doi.org/10.1007/s00264-008-0563-6
Carlson M, Wilkerson J. Are differences in leg length predictive of lateral patello-femoral pain? Physiother Res Int 2007;12(1):29-38. https://doi.org/10.1002/pri.351
Singh VA, Ramalingam S, Haseeb A, Yasin NFB. Predictor index of functional limb length discrepancy. J Orthop Surg 2020;28(2). https://doi.org/10.1177/2309499020941659
Ahdhi GS, Subramanian R, Saya GK, Yamuna TV. Prevalence of low back pain and its relation quality of life and disability among women in rural area of Puducherry, India. Indian J Pain 2016;30(2):111-5. http://dx.doi.org/10.4103/0970-5333.186467
Sabharwal S, Kumar A. Methods for assessing leg length discrepancy. Clin Orthop Relat Res 2008;466(12):2910-22. https://doi.org/10.1007/s11999-008-0524-9
Neelly K, Wallmann HW, Backus CJ. Validity of measuring leg length with a tape measure compared to a computed tomography scan. Physiother Theory Pract 2013;29(6):487-92. https://doi.org/10.3109/09593985.2012.755589
Carter JEL. The Heath-Carter Anthropometric Somatotype Instruction Manual. San Diego, CA, USA. 2002:92182-7251
Keys A, Fidanza F, Karvonen MJ, Kimura N, Taylor HL. Indices of relative weight and obesity. Int J Epidemiol 2014;43(3):655-65. https://doi.org/10.1093/ije/dyu058
Gogia PP, Braatz JH. Validity and reliability of leg length measurements. J Orthop Sports Phys Ther 1986;8(4):185-8. https://doi.org/10.2519/jospt.1986.8.4.185
Haryono IR, Kawilarang M, Prastowo NA. Leg length discrepancy in college students and its association with low back pain: a preliminary study. J Anthropol Sport Physical Edu 2019;3(2):15-8. https://doi.org/10.26773/jaspe.190403
Soukka A, Alaranta H, Tallroth K, Heliövaara M. Leg-length inequality in people of working age. The association between mild inequality and low-back pain is questionable. Spine 1991;16(4):429-31. https://doi.org/10.1097/00007632-199104000-00007
Golightly YM, Allen KD, Renner JB, Helmick CG, Salazar A, Jordan JM. Relationship of limb length inequality with radiographic knee and hip osteoarthritis. Osteoarthritis Cartilage 2007;15(7):824-9. https://doi.org/10.1016/j.joca.2007.01.009
Sheha ED, Steinhaus ME, Kim HJ, Cunningham ME, Fragomen AT, Rozbruch SR. Leg-Length Discrepancy, Functional Scoliosis, and Low Back Pain. J Bone Joint Surg Rev 2018;6(8)e6. https://doi.org/10.2106/JBJS.RVW.17.00148
Brady RJ, Dean JB, Skinner TM, Gross MT. Limb length inequality: clinical implications for assessment and intervention. J Orthop Sports Phys Ther 2003;33(5):221-34. https://doi.org/10.25s19/jospt.2003.33.5.221
Resende RA, Kirkwood RN, Deluzio KJ, Morton AM, Fonseca ST. Mild leg length discrepancy affects lower limbs, pelvis and trunk biomechanics of individuals with knee osteoarthritis during gait. Clin Biomech 2016;38:1-7. https://doi.org/10.1016/j.clin biomech.2016.08.001
Rannisto S, Okuloff A, Uitti J, Paananen M, Rannisto PH, Malmivaara A, et al. Correction of leg-length discrepancy among meat cutters with low back pain: a randomized controlled trial. BMC Musculoskelet Disord 2019;20(1):105. https://doi.org/10.1186/s12891-019-2478-3
The Weather Channel India (edit team). National Institute of Nutrition Changes Average Weight, Height Measurements for Indian Men and Women. Accessed on: August 15, 2023. Available from URL: https://weather.com/en-IN/india/health/news/2020-09-29-national-institute-of-nutrition-changes-ideal-weight-height-for