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Original Research

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THE IMPACT OF LOWER LIMB-LENGTH EQUALISATION ON POSTURAL STABILITY IN PATIENTS TREATED WITH THE ILIZAROV METHOD

  • Łukasz Pawik1
  • Piotr Morasiewicz2
  • Zdzisława Wrzosek1
  • Felicja Fink-Lwow3
  • Malwina Pawik3

1Department of Physiotherapy in Motor Disorders and Dysfunctions, University School of Physical Education, Wroclaw, Poland

2Department and Clinic of Orthopaedic and Traumatologic Surgery, Wroclaw Medical University, Wroclaw, Poland

3Health Promotion, Faculty of Physiotherapy, University School of Physical Education, Wroclaw, Poland

DOI: 10.22374/jomh.v15i3.149 Vol.15,Issue 3,July 2019 pp.71-79

Published: 02 July 2019

*Corresponding Author(s): Łukasz Pawik E-mail: lukaszpawik@gmail.com

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Abstract

Background and Objective

The aim of this study was to assess postural stability in patients with varying degrees of equalisation of limb shortness in the lower leg after treatment with the Ilizarov method (IM) compared to a control group, which consisted of people with lower extremities of equal lengths.

Material and Methods

The study included 58 men treated with the IM due to lower limb-length (LL) inequality in the lower leg and 61 healthy men who served as the control group. Patients with LL inequality were divided into two groups with varying degrees of limb equalisation. The measurement was made using the Biodex Balance System, which enables examination of the patient’s ability to control balance and to assess the patient’s lower limb support function by determining their ability to control bilateral, dynamic pos-tural stability on an unstable surface.

Results

The study showed that not all patients treated with the IM obtained results matching those in the con-trol group. The largest limb-loading asymmetries were recorded in patients with limb shortness of >1 cm. People with LL asymmetry up to 1 cm obtained better results in terms of all measured parameters compared to patients whose LL discrepancy after treatment was more than 1 cm. The results of the balance parameter on an unstable surface differed between the patients subjected to treatment with the IM and the group of healthy individuals.

Conclusions

People with lower limb-length asymmetry up to 1 cm obtained better results on all measured parameters compared to those with a limb-length discrepancy exceeding 1 cm. The results of the balance control parameter obtained on an unstable surface differed between groups of patients following treatment with the IM and healthy individuals. People with limb-length asymmetry up to 1 cm following the treatment placed their weight in the lower extremities in a similar way as healthy individuals did.

Keywords

leg length inequality, Ilizarov technique, postural balance, asymmetry, dynamic test

Cite and Share

Łukasz Pawik,Piotr Morasiewicz,Zdzisława Wrzosek,Felicja Fink-Lwow,Malwina Pawik. THE IMPACT OF LOWER LIMB-LENGTH EQUALISATION ON POSTURAL STABILITY IN PATIENTS TREATED WITH THE ILIZAROV METHOD. Journal of Men's Health. 2019. 15(3);71-79.

References

1. Morasiewicz P, Morasiewicz L, Stepniewski M, et al. Results and biomechanical consideration of treatment of congenital lower limb shortening and deformity using the Ilizarov method. Acta Bioeng Biomech 2014;16:133–40.

2. Nakase T, Kitano M, Kawai H, et al. Distraction osteogenesis for correction of three-dimensional deformities with shortening of lower limbs by Taylor Spatial Frame. Arch Orthop Trauma Surg 2009;129:1197–201. https://doi.org/10.1007/s00402- 008-0702-y

3. Panjavi B, Mortazavi J. Rotational deformities of the lower limb in children. Iran J Ped 2007; 17:393–7.

4. Piper K, Chia M, Graham E. Correcting rotational deformity following femoral nailing. Injury 2009;40:660–2. https://doi.org/10.1016/j.injury.2008. 10.034

5. Probe R. Correction of lower extremity angular malunion. Oper Tech Orthop 2003;13:120–9. https://doi.org/10.1053/otor.2003.0172

6. Staheli LT. Rotational problems in children. Instr Course Lect 1994;43:199–209.

7. Wrzosek Z, Pawik L. [Psycho-physical aspects of curing unequal length of lower limbs]. Pol Manual Med 2009;8:32–6.

8. Fragomen AT, Borst E, Schachter L, Lyman S, Rozbruch SR. Complex ankle arthrodesis using the Ilizarov method yields high rate of fusion. Clin Orthop Relat Res 2012;470:2864–73. https://doi.org/10.1007/s11999-012-2470-9

9. Tellisi N, Fragomen AT, Ilizarov S, Rozbruch SR. Limb salvage reconstruction of the ankle with fusion and simultaneous tibial lengthening using the Ilizarov/Taylor spatial frame. HSS J 2008;4:32–42. https://doi.org/10.1007/s11420-007-9073-0

 10. Lobst C. Taylor Spatial Frame for deformity cor-rection in children. Oper Tech Orthop 2011;21: 144–55. https://doi.org/10.1053/j.oto.2011.01.002

 11. Morasiewicz P, Filipiak J, Krysztoforski K, Dragan

S. Clinical factors affecting lower limb torsional deformities treatment with the Ilizarov method. Orthop Traumatol Surg Res 2014;100:631–6. https://doi.org/10.1053/j.oto.2011.01.002

 12. Bor N, Rubin G, Rozen N. Ilizarov method for gradual deformity correction. Oper Tech Orthop 2011;21:1004–12. https://doi.org/10.1053/j.oto. 2011.01.006

 13. Morasiewicz M, Koprowski P, Wrzosek Z, Dragan S. Gait analysis in patients after lengthen-ing and correction of tibia with Ilizarov tech-nique. Fizoter 2010;18:9–18. https://doi.org/10. 2478/v10109-010-0045-4

 14. Morasiewicz P, Dragan S. Pedobarographic eval-uation of body weight distribution on the lower limbs and balance after derotation corticotomies using the Ilizarov method. Acta Bioeng Biomech 2013;15:91–6.

 15. Morasiewicz P, Dragan S, Dragan SL, Wrzosek Z, Pawik L. Pedobarographic analysis of body weight distribution on the lower limbs and bal-ance after Ilizarov corticotomies. Clin Biomech (Bristol , Avon ) 2016;31:2–6. https://doi.org/10. 1016/j.clinbiomech.2015.10.009

 16. Jancova J. Measuring the balance control system—Review. Acta Medica (Hradec Kralove) 2008;51: 129–37. https://doi.org/10.14712/18059694.2017.14

 17. Veilleux LN, Robert M, Ballaz L, Lemay M, Rauch F. Gait analysis using a force-measuring gangway: Intrasession repeatability in healthy adults. J Musculoskelet Neuronal Interact 2011;11:27–33.

 18. Czerwinski E, Kumorek A. [Falls, vitamin D, fractures]. Post Nauk Med 2012;3:226–31.

 19. Dolganov D, Makushin K, Kuftyrev L. Restoration of loading in patient’s lower limb during reconstructive-restorative treatment of femoral and tibial defects after Ilizarov. Ortrop Travmatol Protez 1986;88–96.

 20. Bhave A, Paley D, Herzenberg JE. Improvement in gait parameters after lengthening for the treat-ment of limb-length discrepancy. J Bone Joint Surg Am 1999;81:529–34. https://doi.org/10.2106/ 00004623-199904000-00010

 21. Liu XC, Fabry G, Molenaers G, Lammens J, Moens P. Kinematic and kinetic asymmetry in patients with leg-length discrepancy. J Pediatr Orthop 1998;18:187–9. https://doi.org/10.1097/ 01241398-199803000-00010

 22. Song KM, Halliday SE, Little DG. The effect of limb-length discrepancy on gait. J Bone Joint Surg Am 1997;79:1690–8. https://doi.org/10.2106/ 00004623-199711000-00011

 23. Morasiewicz P, Konieczny G, Pawik L, Dragan S. Sport and physical activity in patients after dero-tational corticotomies with the Ilizarov method. Acta Orthop Belg 2015;81:90–9.

 24. Hoffman M, Schrader J, Applegate T, Koceja D. Unilateral postural control of the functionally dom-inant and nondominant extremities of healthy sub-jects. J Athl Train 1998;33:319–22.

 25. Cachupe W, Shifflett B, Kahanov L, Wughalter

E. Reliability of Biodex Balance System mea-sures. Meas Phys Educ Exerc Sci 2009;5:97–108. https://doi.org/10.1207/S15327841MPEE05 02_3

 26. Sohn MK, Lee SS, Song HT. Effects of acute low back pain on postural control. Ann Rehabil Med 2013;37:17–25. https://doi.org/10.5535/arm.2013. 37.1.17

 27. Barker KL, Lamb SE, Simpson HR. Recovery of muscle strength and power after limb-lengthening surgery. Arch Phys Med Rehabil 2010;91:384–8. https://doi.org/10.1016/j.apmr.2009.11.014

 28. Ostiak W, Koczewski P. [Pain intensity in patients treated by the external fixation. Chir Narzadow Ruchu Ortop Pol 2009;74:228–32.

 29. Koczewski P, Urban F, Jozwiak M. [Analysis of some gait parameters at different stages of leg lengthening using the Ilizarov technique]. Chir Narzadow Ruchu Ortop Pol 2004;69:393–7.

 30. Majewski M, Bischoff-Ferrari HA, Gruneberg C, Dick W, Allum JH. Improvements in balance after total hip replacement. J Bone Joint Surg Br 2005;87:1337–43. https://doi.org/10.1302/ 0301-620X.87B10.16605

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