Evaluation of pelvic asymmetry and lower limb

Evaluation of pelvic asymmetry and lower limb functional shortening in a cohort of children re‐examined after a ten‐year observation
¹∙² M. Kluszczyński, ² A. Kluszczyńska, ²A. Kluszczyński,³ J. Raczkowski, 4 P. Siwik
1. Specialist Hospital in Czestochowa. Poland
2. “Troniny” Children Rehabilitation Center in Czestochowa, Poland 3. Medical Sciences University in Lodz. Poland
4. University of Varmia and Masuria in Olsztyn, Poland
The study is a retrospective and prospective analysis of the results of examinations
of children for the occurrence of pelvis
asymmetry and lower limb shortening.
The children were selected randomly
and the study was carried out ten years
after the first examination by the same doctor and with the same method. EVALUATION PARAMETERS
LLD
LLD
Age and sex of children in the 1st examination ‐ number
of children ‐ 530.
Boys
Girls
Total
Age range
n
%
n
%
n
%
4 ‐7 56
21,71
60
22,06
116
21,89
8 ‐ 11 130
50,39
147
54,04
277
52,26
12 ‐16 72
27,91
65
23,90
137
25,85
Total
258
100
272
100
530
100
n‐ number of participants
Chi.kw=1,170 df=2 p > 0,05
Number of participants classified
for the second examination ‐ 100 people.
Female
Male
Total
Age range
n
%
n
%
n
%
14 ‐17 17
40,5
14
24,1
31
31,00
18 ‐ 21 18
42,9
30
51,7
48
48,00
22 ‐26 7
16,6
14
24,2
21
21,00
Total
42
100
58
100
100
100
n‐ number of participants Chi.kw=3,144 df=2 p > 0,05
The assessment of pelvis symmetry
The functional length assessment
of the lower limb in Derbolowsky test
The incidence of pelvis asymmetry in girls and boys
in the 1st examination.
Boys
Girls
Total
Asymmetry
n
%
n
%
n
%
No
33
76,20
45
77,59
78
78,00
Yes
9
23,80
13
22,41
22
22,00
Total
42
100
58
100
100
100
Chi.kw=0,093 df=1 p > 0,05
The incidence of pelvis asymmetry
in the 1st and 2nd examination.
60
50
40
30%
20
10
0
1‐st examination
2‐nd examination
p < 0,05
The incidence of pelvis asymmetry
in girls and boys in the 2nd examination.
Male
Female
Total
Asymmetry
n
%
n
%
n
%
No
12
28,57
31
53,45
43
43,00
Yes
30
71,43
27
46,55
57
57,00
Total
42
100
58
100
100
100
Chi.kw=6,151 df=1 The incidence of lower limb shortening
in boys and girls in the 1st examination.
30
Boys
1‐st examination
25
Girls
20
%
15
10
5
0
Left shorter
p < 0,05
Right shorter
The incidence of lower limb shortening
in boys and girls in the 2nd examination.
40
Boys
2 nd examination
Girls
35
30
25
%
20
15
10
5
0
Left shorter
Right shorter
The developmental pelvis asymmetry is a physiological
aspect of a human, and
is the result of asymmetrical
construction of Human body.
The disturbance of balance of tensions within sacral‐
bone and spine leads consequently to developmental
structural‐ functional asymmetry of pelvis during the growth
period, and may be demonstrated by the lower limb functional
shortening.
Bandii M Spine, 2003, 28,(12): 1335‐1339.
Rigo M: Stud Health Technol Inform 1997, 37:63‐65.
D’Amico et all: Stud Health Technol Inform 2012, 146‐150.
Manganiello A: scoliosis ( Editors: Burwell R.G., Dangerfield P.H.,
Lowe T.G., Margulies J.Y.), Hanley&Belfus, Livingstone, 2000, 14,2: 423‐429. Discussion
The presented changes of lower limbs shortenings are in
accordance with the phenomenon presented by Castelein. The
author proved the change of minimal spine rotation in younger
children to the left side, which changes to the right side
rotation at a later age ( adolescents and adults).
Derbolowsky test, is a very simple to perform and apply
element of clinical trial, which allows to assess the occurrence
of LLD.
R. Castelein: [W] Research into spinal deformities 8 ( T. Kotwicki. T. Grivas), Stud Health Technol
Inform 2012, 20‐25. Buckup K. Stuttgart: Thieme; 2005. Klinische tests an Knochen, Gelenken und Muskeln, 3rd Auflage; p. 1‐60.
Conclusions
 The second examination revealed a statistically significant increase in occurrence of pelvis asymmetry.  After 10 years a functional shortening of one of the lower
limbs has increased in both sexes.  In the first study, a functional shortening of the left lower
extremity predominated in the girls, while in the second
study it was the right lower extremity and was identified
in the boys. Thank you for your attention