Correction of leg-length discrepancy among meat cutters with low back pain: a randomized controlled trial

Abstract

BackgroundThe etiology of non-specific low back pain (LBP) is complex and not well understood. LBP is common and causes a remarkable health burden worldwide. Leg-length discrepancy (LLD) is potentially a risk factor for development of LBP, although this relationship has been questioned. Yet only one randomized controlled study (RCT) has been performed. The objective of our study was to evaluate the effect of insoles with leg-length discrepancy (LLD) correction compared to insoles without LLD correction among meat cutters in a RCT-design.MethodsThe study population consisted 387 meat cutters who were over 35 years old and had been working 10 years or more. The LLD measurement was done by a laser ultrasound technique. All workers with an LLD of at least 5 mm and an LBP intensity of at least 2 on a 10-cm Visual Analog Scale were eligible. The LLD of all the participants in the intervention group was corrected 70%, which means that if the LLD was for example 10 mm the correction was 7 mm. The insoles were used at work for eight hours per day. The control group had insoles without LLD correction. The primary outcome was between-group difference in LBP intensity. Secondary outcomes included sciatic pain intensity, disability (Roland Morris), RAND-36, the Oswestry Disability Index, physician visits and days on sick leave over the first year. We used a repeated measures regression analysis with adjustments for age, gender and BMI. The hurdle model was used for days on sick leave.ResultsIn all, 169 workers were invited and 114 (67%) responded. Of them, 42 were eligible and were randomized to the intervention (n = 20) or control group (n = 22). The workers in the intervention group had a higher improvement in LBP intensity (− 2.6; 95% confidence intervals − 3.7 – − 1.4), intensity of sciatic pain (− 2.3; − 3.4 – − 1.07) and RAND-36 physical functioning (9.6; 1.6–17.6) and a lesser likelihood of sick leaves (OR -3.7; − 7.2 - -0.2).ConclusionsCorrection of LLD with insoles was an effective intervention among workers with LBP and a standing job.Trial registrationISRCTN11898558. Registration date 11. Feb 2011. BioMed Central Ltd.

Immediate Effects of Myofascial Release on the Thoracolumbar Fascia and Osteopathic Treatment for Acute Low Back Pain on Spine Shape Parameters: A Randomized, Placebo-Controlled Trial

“…Numerous studies document significant biomechanical changes through MFR and OMT on the myofascial system [15][16][17][18]. The relationships between postural parameters, muscle activations, changes in TLF and LBP are poorly understood [10,19]. Therefore, this study provides an assessment of the immediate effects of MFR on the TLF and OMT.…”

“…Functional leg length discrepancy (fLLD), on the other hand, is thought to be involved in the process of LBP development [8][9][10][11]. LBP patients also show a greater tendency for asymmetry of motor control in the form of pathological muscle activation than healthy individuals [12].…”

“…The TLF as a central biomechanical part of the pelvic corset system influences pelvic statics. It can be concluded that other components, including postural parameters such as fLLD or altered kyphotic and lordotic angles, are involved in these mechanisms and may influence each other over myofascial chains [10,13,14]. The fascia represents, in a manner of tensegrity structure, the link between skin, musculature and bone [1].…”

Immediate Effects of Myofascial Release on the Thoracolumbar Fascia and Osteopathic Treatment for Acute Low Back Pain on Spine Shape Parameters: A Randomized, Placebo-Controlled Trial

“…Functional leg length discrepancies (fLLD) are suspected to be involved in the development of LBP [ 8 , 9 , 10 , 11 ]. LBP patients show a greater tendency for asymmetry in motor control in the form of pathological muscle activation than healthy individuals [ 12 ].…”

Comparison of the Effect of Insole Correction on Three-Dimensional Knee Joint Moments during Gait in Standing Workers with Leg Length Discrepancy

“…9,17 Previous studies verifying the effects of insole correction in standing workers with LLD used pain intensity measured on a visual analog scale or a paper-based questionnaire to measure outcomes. 18,19 Few studies, however, have explored the effect of the insole correction of LLD on the kinetic characteristics of the knee joints using a three-dimensional (3D) motion analysis system during gait among those who must stand. Thus, the purpose of this study was to investigate the effect of a shoe insole for LLD on the kinetics of the knee joints and contributions to knee stability in standing workers with LLD using a motion analysis system and force platforms during gait.…”