title: LBP and lower limb discrepancy: 3D evaluation of postural rebalancing via underfoot wedge correction.
abstract: Leg Length Discrepancy (LLD) is very often associated to Low Back Pain (LBP), but still controversial is the use of underfoot wedge correction (heel rise) to re-balance pelvis and trunk posture. In a review of our last 5 years clinical activity we observed that more than 70% out of 300 LBP patients presented a LLD. In more than 80 % we ascertained, via Baropodography, the presence of underfoot asymmetric load, during standing. More durable therapy recovery effect has been observed when LLD correction had been adopted. These reasons led us to start a study to assess if a Full 3D multifactorial Posture evaluation approach, by means of Opto-electronic device associated to foot pressure maps recording, was able to quantitatively discriminate the clinically observed phenomena. On a 94 LBP (av. age 46.3±16 Y range 15-82 Y) patients sample, 83 (88%) have been found to improve posture when LLD was corrected. The 94 patients showed a mean lower limb discrepancy of μ=8±3.2mm associated to a mean scoliotic lumbar curve μ=10.5°±5.1° Cobb (frontal plane), mean Spinal offset μ=6.6±4.9mm and mean Global offset 10.7±8.8mm. The applied paired t-test comparison (indifferent vs. corrected orthostasis) showed significant (p &lt; 0.05) postural improvements could be obtained in the whole or in a part of the considered parameters, both in rebalancing and in spine deformities reduction after the application of suitable under-foot wedge. The joint 3D opto-electronic and foot pressure map approach proved to be effective to control several clinical parameters with statistical significance.
authors: Skeleton Movement Analysis & Advanced Rehabilitation Technology, Università D'Annunzio, Chieti, Italy.
authors: Moreno
authors: M
authors: D'Amico
authors: Piero
authors: P
authors: Roncoletta
authors: Francesca
authors: F
authors: Di Felice
authors: Daniele
authors: D
authors: Porto
authors: Rosagrazia
authors: R
authors: Bellomo
authors: Raoul
authors: R
authors: Saggini
mesh_terms: D005260:Female; D006801:Humans; D007870:Leg Length Inequality / Q000150:complications / Q000503:physiopathology* / Q000534:rehabilitation*; D017116:Low Back Pain / Q000209:etiology / Q000503:physiopathology* / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D009989:Orthotic Devices; D004856:Postural Balance; D011187:Posture; D012775:Shoes; D016896:Treatment Outcome