Leg Length Discrepancy and Nonspecific Low Back Pain: 3-D Stereophotogrammetric Quantitative Posture Evaluation Confirms Positive Effects of Customized Heel-Lift Orthotics.

Autor:	D'Amico M; SMART (Skeleton Movement Analysis and Advanced Rehabilitation Technologies) LAB, Bioengineering and Biomedicine Company Srl, Chieti (CH), Italy.; Department of Neuroscience, Imaging and Clinical Sciences University G. D'Annunzio, Chieti, Italy., Kinel E; Chair of Rehabilitation and Physiotherapy, Department of Rehabilitation, University of Medical Sciences, Poznań, Poland., Roncoletta P; SMART (Skeleton Movement Analysis and Advanced Rehabilitation Technologies) LAB, Bioengineering and Biomedicine Company Srl, Chieti (CH), Italy.
Jazyk:	angličtina
Zdroj:	Frontiers in bioengineering and biotechnology [Front Bioeng Biotechnol] 2022 Feb 10; Vol. 9, pp. 743132. Date of Electronic Publication: 2022 Feb 10 (Print Publication: 2021).
DOI:	10.3389/fbioe.2021.743132
Abstrakt:	Background: The literature reports evidence of leg length discrepancy (LLD) associated with musculoskeletal disorders, alterations in spinopelvic alignment, and body posture, leading to low back pain and lumbar scoliosis. The most common conservative treatment for LLD is the use of internal or external shoe lifts although no treatment guidelines have been established. Aim: The study aimed to contribute to low back pain-LLD relationship comprehension, highlighting the benefits of LLD correction in the nonspecific low back pain (NSLBP) population. Methods: A cross-sectional observational study recruited a cohort of 80 NSLBP patients (48 females, 32 males) with LLD, age ( μ = 35 ± 17.2). Entire body posture, including 3-D spine shape reconstruction, was measured using a nonionizing 3-D optoelectronic stereophotogrammetric approach. After the first 3-D posture evaluation, patients were provided with customized orthotics, including 100% LLD heel lift correction. No other therapeutic interventions were considered. Pain level was assessed using the numerical pain rating scale (NPRS). The gender, age-related, and time-dependent effects of LLD equalization treatment in NSLBP patients was investigated during 2 years of follow-up. The statistical analysis was performed at the global level using multivariate methods by Hotelling T 2 tests and intrasubject-level using t -test. Results and Discussion: An initial average NPRS = 7.8 was determined. In the medium-term follow-up group (4 months), the NPRS dramatically decreased (NPRS = 1.1). The pain disappeared in the long-term (2 years) follow-up group (NPRS = 0). The study results highlight that LLD equalization treatment led to clear statistically significant improvements in all the postural parameters of the frontal plane, including the underfoot load asymmetry. No worsening has been detected. An adaptation period long enough is needed to obtain progressive pain relief improvements and structural posture changes. Younger NSLBP patients showed slightly better improvements than older ones. Minimal differences between healthy young adults' and NSLBP patients' postures were found either in natural erect standing posture or when LLD equalization is applied. Conclusion: Heel-lift customized orthotics with 100% LLD correction are an effective short- and long-term treatment in patients with nonspecific LBP, inducing pain symptom recession and stimulating the improvement of postural parameters without contraindications. Competing Interests: MD and PR own shares of the Bioengineering and Biomedicine Company Srl. This does not alter our adherence to Frontiers in Bioengineering and Biotechnology policies on sharing data and materials. The Bioengineering and Biomedicine Company Srl did not play any direct role in the study design, data collection and analysis, decision to publish, or manuscript preparation. The remaining author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2022 D’Amico, Kinel and Roncoletta.)
Databáze:	MEDLINE
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