GAIT ASYMMETRY IN PATIENTS WITH LIMB-LENGTH INEQUALITY

One of the problems facing the clinician is the differentiation betwee n functional and structural limb-length inequality. This study investi gated 20 subjects (mean age, 9.0 +/- 3.9 years) with documented limb-l ength inequalities to determine the magnitude of discrepancies that re sult in gait abnormalities. The subjects were asked to walk on an 8-m walkway at a self-selected free pace. The contact time, first and seco nd force peaks, and loading and unloading rates of the vertical ground -reaction force were measured for both limbs. These parameters were pr edictive for quantification of gait asymmetry. The asymmetry of these parameters increased as the limb-length inequality increased. In gener al, a limb-length inequality >2.0 cm (3.7%) resulted in gait asymmetry that was greater than that observed in the normal population. However , the amount of asymmetry varied for each individual. A static examina tion can document an anatomic deformity, but this deformity may be com pensated for by functional adaptations. An analysis of the patient's g ait should be performed to identify asymmetries during ambulation. Dyn amic gait findings, such as demonstrated in this study, are needed to support static measurements.