Leg Length Alignment Asymmetry In A Non-clinical Population And Its Correlation To A Decrease In General Health As Measured By The SF-12: A Pilot Study

Purpose:

To determine if there is an association between a test commonly used by chiropractors as a sign of subluxation/joint dysfunction – supine leg length alignment (LLA) asymmetry - and health-related quality of life as measured by the SF-12 questionnaire, in a non-clinical population.

Design:

Volunteers answered the SF-12 and background questionnaires and were then examined for supine LLA by a chiropractor blinded to their answers.

Setting:

Gatherings of people in the general population.

Participants:

Fifty-five unscreened volunteers.

Examiner:

Chiropractor with approximately 20 years of clinical experience.

Main Outcome Measures:

The association of supine LLA asymmetry with general health based on the two summary scores - physical (PCS) and mental (MCS) - of the SF-12.

Results:

There were 27 volunteers with LLA asymmetry, they had a mean PCS of 49.6 and a mean MCS of 47.9. In the no - LLA asymmetry group (n=23) the mean PCS was 50.8, and mean MCS of 54.0. A multiple regression analysis found that of the variables gender, age, back pain (current/former) and LLA asymmetry, the only factor to approach significance with the SF-12 MCS/PCS was the presence of LLA asymmetry. A t-test found there was a significant difference (p=0.017) in the MCS between the supine LLA asymmetry and no-LLA asymmetry groups.

Conclusion:

This pilot study suggests that in this group of volunteers (n=50) from the non-clinical general population, those who demonstrated a commonly used sign of subluxation/joint dysfunction - supine leg length alignment asymmetry - had a significantly (P=0.017) lower measure of general health as determined by the SF-12 survey than those volunteers without such asymmetry. Further investigation to clarify this relationship and to establish whether there is a connection between the putative entity of chiropractic subluxation and unloaded leg length alignment asymmetry is recommended.

Leg Length Inequality (Short/Long Leg)

The supine leg check as a determinant of physiological/postural leg length inequality: a case study and analysis leg length inequality (LLI) Knutson, Gary A., Chiropractic Research Journal, Vol. VII, No. 1, Spring 2000.

This paper presents a case study of imposed leg length inequality following total hip replacement surgery and compares and contrasts methods used to determine anatomic and physiologic or postural LLI.

It is proposed that, within certain parameters, nonweight-bearing postural leg checks are evidence of physiological or postural, and not anatomic, LLI.

Thermal asymmetry of the upper extremity in scalenus anticus syndrome, leg-length inequality and response to chiropractic adjustment. Knutson GA. Journal of Manipulative and Physiological Therapeutics 1997; 20(7):476-481.