Leg Length Discrepancy: Dynamic Balance Response during Gait

Balance in the human body's movement is generally associated with different synergistic pathologies. The trunk is supported by one's leg most of the time when walking. A person with poor balance may face limitation when performing their physical activities on a daily basis, and they may be more prone to having risk of fall. The ground reaction forces (GRFs), centre of pressure (COP), and centre of mass (COM) in quite standing posture were often measured for the evaluation of balance. Currently, there is still no experimental evidence or study on leg length discrepancy (LLD) during walking. Analysis of the stability parameters is more representative of the functional activity undergone by the person who has a LLD. Therefore, this study hopes to shed new light on the effects of LLD on the dynamic stability associated with VGRF, COP, and COM during walking. Eighteen healthy subjects were selected among the university population with normal BMIs. Each subject was asked to walk with 1.0 to 2.0 ms-1 of walking speed for three to five trials each. Insoles of 0.5 cm thickness were added, and the thickness of the insoles was subsequently raised until 4 cm and placed under the right foot as we simulated LLD. The captured data obtained from a force plate and motion analysis present Peak VGRF (single-leg stance) and WD (double-leg stance) that showed more forces exerted on the short leg rather than long leg. Obviously, changes occurred on the displacement of COM trajectories in the ML and vertical directions as LLD increased at the whole gait cycle. Displacement of COP trajectories demonstrated that more distribution was on the short leg rather than on the long leg. The root mean square (RMS) of COP-COM distance showed, obviously, changes only in ML direction with the value at 3 cm and 3.5 cm. The cutoff value via receiver operating characteristic (ROC) indicates the significant differences starting at the level 2.5 cm up to 4 cm in long and short legs for both AP and ML directions. The present study performed included all the proposed parameters on the effect of dynamic stability on LLD during walking and thus helps to determine and evaluate the balance pattern.