How would one measure a LLD of 1mm? I don't think it's possible. Is this
supposed to suggest that if we treat the LLD the radic will go away? I
doubt it.
Patrick Zerr
www.apluspt.com
The easiest way to prepare for the National PT Exam!
www.summitpt.com
Summit Physical Therapy; Tempe, Arizona
----- Original Message -----
From: "Doug Bourne" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Monday, August 12, 2002 10:29 PM
Subject: Re: A Question of Posture
> To put more fuel on the fire:
>
> Spine 1999 Apr 1;24(7):684-6
> Is leg length discrepancy associated with the side of radiating pain
> in patients with a lumbar herniated disc?
>
> ten Brinke A, van der Aa HE, van der Palen J, Oosterveld F.
>
> Department of Physical Therapy, Medisch Spectrum Twente, Enschede,
> The Netherlands.
>
> STUDY DESIGN: The association between leg length discrepancy and the
> side of the radiating pain in lumbar disc herniation was investigated in
> a case series. OBJECTIVES: To investigate whether pain tends to radiate
> into the longer or shorter leg in patients with a lumbar herniated disc.
> SUMMARY OF BACKGROUND DATA: No previous studies have investigated the
> association between leg length discrepancy and side of radiating pain in
> patients with a herniated disc. Results of studies of low back pain with
> radiation and leg length discrepancy are inconsistent concerning this
> association. METHODS: Of 132 consecutive patients admitted to a district
> hospital for surgical management of a lumbar herniated disc, leg length
> discrepancy was assessed using the indirect method as described by
> Calliet. RESULTS: Seventy-three patients (55%) were men, and 59 (45%)
> were women. The mean age was 40 years, and 99% of all herniated discs
> appeared at L4-L5 (n = 60) or L5-S1 (n = 71). In 64 (62%) of the 104
> patients with a leg length discrepancy of 1 mm or more, the pain
> radiated in the shorter leg (P = 0.02). In subgroups of patients with
> larger leg length discrepancies, similar results were found but because
> of smaller sample sizes, these findings did not each statistical
> significance. In 32 of the 57 men (56.1%), the pain radiated to the
> shorter leg (P = 0.43); this was observed in 33 of the 47 women (70.2%;
> P = 0.01). CONCLUSION: The results of this study showed a statistically
> significant association between leg length discrepancy and the side of
> radiating pain in a case series of patients with lumbar herniated discs.
> The relation was more pronounced and statistically significant in women
> only.
>
> John: not all (or most) spinal stability researchers are
> physiotherapists.
>
> Barrett: I agree with most of your points in the first post but as usual
> I take exception with your comments:
>
> >
> > The "core researchers" have *not* been well-received by large portions
of
> > the research and clinical communities. The best resource for this is in
the
> > archives of the "Supertraining" list on Yahoo groups.
>
> "Supertraining" is by no means the authoritative source of spinal
> stability training. Some good points have been made there but they are
> not novel in any way. Spinal stability is gaining more and more
> respect. At this years world congress of biomechanics they set up a
> special session on spinal stability. The panel (Hodges, McGill,
> Panjabi, Solomonow, and Stokes) have a combined four Volvo awards for
> research in low back pain. This is one of the most prestigious awards
> in this area. Please don't tell me that none of these people are well
> respected.
> RCTs are supposed to be the pinnacle of evidenced based practice. I
> have yet to see anyone criticize Hides et al.
>
> Doug
>
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