Low-back pain in transfemoral amputees: is there a correlation with static or dynamic leg-length discrepancy?
OBJECTIVE
Low-back pain (LBP) is an important cause of secondary disability in transfemoral amputees (TFA). The correction of leg-length discrepancy (LLD) is a common clinical approach to the treatment of LBP in this population. The aim of our study is to assess the relationship of static and dynamic LLD and LBP in a sample TFA population.


METHODS
Nine TFA with LBP and eight TFA without LBP were studied. Static leg length was measured with subjects standing in a self-selected comfortable position. Dynamic leg length was measured during the single-limb support and double-limb support phases of the gait cycle.


RESULTS
There were no statistically significant differences between the pain and no pain groups in terms of static LLD (P = 1.0; 95% confidence interval, -6.8 to 6.6 mm); dynamic LLD during single-limb support (P = 0.3; 95% confidence interval, -27.3 to 7.3 mm); dynamic LLD during double-limb support with either the prosthetic limb leading (P = 0.3; 95% confidence interval, -4.0 to 12.2 mm) or the intact foot leading (P = 0.8, 95% confidence interval, -6.4 to 7.8 mm).


CONCLUSIONS
This study calls into question whether LLD plays a significant role in persistence of LBP in TFA. Further study of the effects of LLD and its possible relationship to causation of LBP in amputees is needed.
Morgenroth
David C
DC
From the Rehabilitation Research and Development Center of Excellence in Limb Loss Prevention and Prosthetic Engineering, VA Puget Sound Health Care System, Seattle, Washington 98108, USA.
Shakir
Ali
A
Orendurff
Michael S
MS
Czerniecki
Joseph M
JM
D000368:Aged; D000674:Amputees / Q000534:rehabilitation; D001186:Artificial Limbs; D001696:Biomechanical Phenomena; D005260:Female; D005684:Gait; D006801:Humans; D007870:Leg Length Inequality / Q000209:etiology* / Q000503:physiopathology; D017116:Low Back Pain / Q000209:etiology*; D008297:Male; D008875:Middle Aged