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Objective:To study whether conservative correction in a leg-length discrepancy (LLD) of 10mm or less in patients with chronic low back pain (CLBP) can relieve pain.
Design: Randomized, controlled intervention study, with a mean follow-up duration of 10 weeks.
Setting: Physical therapy clinic of the national health services.
Participants: Thirty-three patients with CLBP were screened for an LLD of 10mm or less, which was measured with ultrasound. Patients were randomly divided into intervention and control groups.
Intervention: In 22 patients, LLD was corrected by applying individually fitted shoe inserts. In 11 patients, LLD was not corrected.
Main Outcome Measures: Chronic pain intensity (visual analog scale) and disability score (Roland-Morris Disability Questionnaire).
Results: Shoe inserts significantly reduced both pain intensity (P<.001) and disability (P<.05). A moderate positive correlation was found between LLD and the degree of pain relief after wearing shoe inserts (r=.47).
Conclusions: Shoe inserts appear to reduce CLBP and functional disability in patients with LLDs of 10mm or less. Shoe inserts are simple, noninvasive, and inexpensive therapeutic means that can be added to the treatment of CLBP.
Dear All
How do you measure leg lenght using an ultrasound?
The only way known so far s to use a CT leg length, nothing else.
Also the follow up period was only 10 weeks. I would like to see the confidence interval etc. at 6 months and 12 and 18 months. This may give a realistic outcome.
The size of the group may be too small to have power.
What sort of 'inserts' were they using? Heel lifts or full length lifts? How much of the LLD were they posting - the whole amount, half or something else? And how do you measure LLD with ultrasound?