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Effects of Artificial Leg Length Discrepancies on the Dynamic Joint Angles of the Hip, Knee, and Ankle During Gait
J Korean Soc Phys Med 2019;14(1):53-61
Published online February 28, 2019;  https://doi.org/10.13066/kspm.2019.14.1.53
© 2019 Korean Society of Physical Medicine.

Yong-Wook Kim, PT, Ph.D⋅Seung-Yeon Jo⋅Yeoung-In Byeon⋅Ji-Ho Kwon⋅Seok-Hee Im⋅ Su-Hyeon Cheon⋅Eun-Joo Kim, OT, Ph.D1†

Department of Physical Therapy, College of Medical Sciences, Jeonju University
1Department of Occupational Therapy, College of Medical Sciences, Jeonju University
Received December 4, 2018; Revised December 11, 2018; Accepted January 3, 2019.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
PURPOSE: This study examined the dynamic range of motion (ROM) of the hip, knee, and ankle joint when wearing different shoe sole lifts, as well as the limb asymmetry of the range according to the leg length discrepancy (LLD) during normal speed walking.
METHODS: The participants were 40 healthy adults. A motion analysis system was used to collect kinematic ROM data. The participants had 40 markers attached to their lower extremities and were asked to walk on a 6 m walkway, under three different shoe lift conditions (without an insole, 1 cm insole, and 2 cm insole). Visual3D professional software was used to coordinate kinematic ROM data.
RESULTS: Most of the ROM variables of the short limbs were similar under each insole lift condition (p>.05). In contrast, when wearing a shoe with a 2 cm insole lift, the long limbs showed significant increases in flexion and extension of the knee joint as well as; plantarflexion, dorsiflexion, pronation, eversion, and inversion of the ankle joint (p<.05). Of the shoes with the insole lifts, significant differences in all ROM variables were observed between the left and right knees, except for the knee internal rotation (p<.05).
CONCLUSION: As the insole lift was increased, more ROM differences were observed between the left and right limbs, and the asymmetry of the bilateral lower limbs increased. Therefore, appropriate interventions for LLD are needed because an artificial mild LLD of less than 2.0 cm could lead to a range of musculoskeletal problems of the lower extremities, such as knee and ankle osteoarthritis.
Keywords : Gait, Joint range of motion, Leg length discrepancy


February 2019, 14 (1)
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