Comparison of Lifts Versus Tape Measure in Determining Leg Length Discrepancy

2014 ◽  
Vol 41 (8) ◽  
pp. 1689-1694 ◽  
Author(s):  
Maziar Badii ◽  
A. Nicole Wade ◽  
David R. Collins ◽  
Savvakis Nicolaou ◽  
B. Jacek Kobza ◽  
...  
Keyword(s):  
Interobserver Reliability ◽  
Pearson Correlation ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Leg Length Discrepancy ◽  
Leg Length ◽  
Length Discrepancy ◽  
Tape Measure ◽  
Pelvic Radiograph ◽  
Clinical Methods

Objective.To evaluate the validity (accuracy) and reliability of 2 commonly used clinical methods, 1 indirect (lifts) and 1 direct (tape measure), for assessment of leg length discrepancy (LLD) in comparison to radiograph.Methods.Twenty subjects suspected of having LLD participated in this study. Two clinical methods, 1 direct using a tape measure and 1 indirect using lifts, were standardized and carried out by 4 examiners. Difference in height of the femoral heads on standing pelvic radiograph was measured and served as the gold standard.Results.The intraclass correlation coefficient assessing interobserver reliability was 0.737 for lifts and 0.477 for tape measure. The remainder of the analysis is based on the average of the measurements by the 4 examiners. Pearson correlation coefficients were 0.93 for the lifts and 0.75 for the tape measure method. Paired sample t tests showed difference in means of 2 mm (p = 0.051) for lifts and −5 mm (p = 0.007) for tape measure compared with radiograph. Sensitivity and specificity were 55% and 89% for lifts and 45% and 56% for tape measure, respectively, using > 5 mm as the definition for LLD. The wrong leg was identified as being shorter in 1 out of 20 subjects using lifts versus 7 out of 20 using tape measure.Conclusion.The indirect standing method of LLD measurement using lifts had superior validity, interobserver reliability, and specificity in comparison with radiograph over the direct supine method using tape measure. Both clinical methods underestimated LLD compared with radiograph.

Distance Between the Malleoli and the Ground

2017 ◽  
Vol 107 (2) ◽  
pp. 112-118 ◽  
Author(s):  
Estela Gomez Aguilar ◽  
Águeda Gómez Domínguez ◽  
Carolina Peña-Algaba ◽  
José M. Castillo-López
Keyword(s):  
Drop Test ◽  
Leg Length Discrepancy ◽  
Leg Length ◽  
San Jose ◽  
Leg Length Inequality ◽  
Length Discrepancy ◽  
Navicular Drop ◽  
Tape Measure ◽  
Foot Posture ◽  
The Difference

Background: The aim of this work is to introduce a useful method for the clinical diagnosis of leg-length inequality: distance between the malleoli and the ground (DMG). Methods: A transversal observational study was performed on 17 patients with leg-length discrepancy. Leg-length inequality was determined with different clinical methods: with a tape measure in a supine position from the anterior superior iliac spine (ASIS) to the internal and external malleoli, as the difference between the iliac crests when standing (pelvimeter), and as asymmetry between ASISs (PALpation Meter [PALM]; A&D Medical Products Healthcare, San Jose, California). The Foot Posture Index (FPI) and the navicular drop test were also used. The DMG with Perthes rule (perpendicular to the foot when standing), the distance between the internal malleolus and the ground (DIMG), and the distance between the external malleolus and the ground were designed by the authors. Results: The DIMG is directly related to the traditional ASIS–external malleolus measurement (P = .003), the FPI (P = .010), and the navicular drop test (P < .001). There are statistically significant differences between measurement of leg-length inequality with a tape measure, in supine decubitus, from the ASIS to the internal malleolus, and from the ASIS to the external malleolus. Conclusions: This new method (the DMG) is useful for diagnosing leg-length discrepancy and is related to the ASIS–external malleolus measurement. The DIMG is significantly inversely proportional to the degree of pronation according to the FPI. Conversely, determination of leg-length discrepancy with a tape measure from the ASIS to the malleoli cannot be performed interchangeably at the level of the internal or external malleolus.

scholarly journals The Validity of In Vivo Tooth Volume Determinations From Cone-Beam Computed Tomography

2010 ◽  
Vol 80 (1) ◽  
pp. 160-166 ◽  
Author(s):  
Yi Liu ◽  
Raphael Olszewski ◽  
Emanuel Stefan Alexandroni ◽  
Reyes Enciso ◽  
Tianmin Xu ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Interobserver Reliability ◽  
Pearson Correlation ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Volumetric Analysis ◽  
Cone Beam ◽  
Water Displacement

Abstract Objective: To determine the accuracy of volumetric analysis of teeth in vivo using cone-beam computed tomography (CBCT). Materials and Methods: The physical volume (Vw) of 24 bicuspids extracted for orthodontic purposes (16 were imaged with the I-CAT and 8 with the CB MercuRay) were determined using the water displacement technique. Corresponding pretreatment CBCT image data were uploaded into Amira 4.0 for segmentation and radiographic volume (Va). All measurements were performed twice by two observers. The statistical difference between Vw and Va was assessed using a paired t-test. The intraobserver and interobserver reliability were determined by calculating Pearson correlation coefficients and intraclass correlation coefficients. Results: The overall mean Vw of teeth specimens was 0.553 ± 0.082 cm3, while the overall mean Va was 0.548 ± 0.079 cm3 (0.529 ± 0.078 cm3 for observer 1 and 0.567 ± 0.085 cm3 for observer 2). There were statistically significant differences between Va and Vw (P < .05). Between observer 1 and observer 2, Va measurements were statistically significantly different (P < .05). The interobserver and intraobserver correlation coefficient for Vw was high. Lastly, surface smoothing reduced the volume by 3% to 12%. Conclusions: In vivo determination of tooth volumes from CBCT data is feasible. The measurements slightly deviate from the physical volumes within −4% to 7%. Smoothing operations reduce volume measurements. Currently, no requirements for accuracy of volumetric determinations of tooth volume have been established.

scholarly journals LEG LENGTH DISCREPANCY;

2013 ◽  
Vol 20 (06) ◽  
pp. 995-998
Author(s):  
HAFIZ MUHAMMAD ASIM, ◽  
AHMAD QAYYUM, ◽  
JAWAD ALI HASHIM,
Keyword(s):  
Standard Deviation ◽  
Treatment Strategies ◽  
Leg Length Discrepancy ◽  
P Value ◽  
Leg Length ◽  
Perfect Agreement ◽  
Length Discrepancy ◽  
Standard Scale ◽  
Tape Measure ◽  
Primary Investigator

Objective: Leg length discrepancy (LLD) has been deemed one of the causative factors for back, sacroiliac conditions andhip pathologies in patients. Increased LLD can exacerbate musculoskeletal impairments in patients that would require the clinician toreflect on the appropriate treatment strategies. The objective of the study was to measure the reliability of “Tape Measure Method” in Leglength discrepancy. Methodology: This is a hospital based study. The procedures for obtaining leg length measures in the study weresimilar to those described by Magee DJ (Orthopedic physical assessment. 5thed).The primary investigator briefly reviewed theprocedures for measuring the leg length with the subjects. Only the subject’s right side was measured for the study. The subject’s weightand height were measured using a standard scale and recorded. The first rater palpated the prominent aspect of the ASIS. The rater thenguided the string to the prominent aspect of the MM. The rater repeated this procedure three times for each subject. After the first raterobtained three strings that correspond to the leg length, the second rater repeated the three measurements using the same procedure.After all cuts of strings were obtained each rater measured the lengths of his three strings with a standard tape measure and was recordedon a separate data sheet. Each rater was blinded to the other measures. Results: Means and standard deviation for each subject’s age,height, weight and BMI were measured. Mean standard deviation and 95% Confidence interval (95% CI) for leg length measurements forboth raters are provided in Table 2. According to the results derived from data there were no significant differences in leg length measuresbetween Rater 1 and Rater 2 (t-value = - 0.000; df = 58; p-value = .9981). The ICC (3, 3) for Rater 1 was .999, (95% CI = .998 to .999).This value indicates almost perfect agreement between the measures for Rater 1. The ICC (3, 3) for Rater 2 was .979 (95% CI = .962 to.990). These findings are indicative of almost perfect agreement between the measures. The ICC (2, 2) between Rater 1 and Rater 2 was.987 (95% CI = .972 to .994). A Bland-Altman plot identifies any bias between the two raters. The bias line is almost on zero, indicating nobias between the two raters. It can be concluded that any observed bias was not clinically important. Conclusions and Discussion: It wasconcluded measuring leg length using the tape measure was simple and highly reliable. There were several limitations that may haveinfluence overall results of the study.

scholarly journals Reliability of a Three-Dimensional Wound Camera and Correlation With Routine Ruler Measurement in Diabetes-Related Foot Ulceration

2020 ◽  
pp. 193229682097465
Author(s):  
Joel Willem Johan Lasschuit ◽  
Jill Featherston ◽  
Katherine Thuy Trang Tonks
Keyword(s):  
Interobserver Reliability ◽  
Pearson Correlation ◽  
Intraclass Correlation ◽  
Three Dimensional ◽  
Correlation Coefficients ◽  
Area Measurement ◽  
Foot Care ◽  
Foot Ulceration ◽  
Intraclass Correlation Coefficients ◽  
Service Setting

Background: In an era of increasing technology and telehealth utilization, three-dimensional (3D) wound cameras promise reliable, rapid, and touch-free ulceration measurements. However, reliability data for commercially available devices in the diabetes foot service setting is lacking. We aimed to evaluate the reliability of diabetes-related foot ulceration measurement using a 3D wound camera in comparison to the routinely used ruler and probe. Method: Participants were prospectively recruited from a tertiary interdisciplinary diabetes foot service. Ulcerations were measured at each visit by two blinded observers, first by ruler and probe, and then using a 3D wound camera twice. Reliability was evaluated using intraclass correlation coefficients (ICC). Measurement methods were compared by Pearson correlation. Results: Sixty-three ulcerations affecting 38 participants were measured over 122 visits. Interobserver reliability of ruler measurement was excellent for estimated area (ICC 0.98, 95% CI 0.97-0.98) and depth (ICC 0.93, 95% CI 0.90-0.95). Intraobserver and interobserver reliability of the 3D wound camera area was excellent (ICC 0.96, 95%CI 0.95-0.97 and 0.97 95% CI 0.96-0.98, respectively). Depth was unrecordable in over half of 3D wound camera measurements, and reliability was inferior to probe measurement. Area correlation between methods was good ( R = 0.88 and 0.94 per observer); however, depth correlation was poor ( R = 0.49 and 0.65). Conclusions: 3D wound cameras offer practical advantages over ruler-based measurement. In diabetes-related foot ulceration, the reliability and comparability of area measurement was excellent across both methods, although depth was more reliably obtained by the probe. These limitations, together with cost, are important considerations if implementing this technology in diabetes foot care.

scholarly journals A comparison of leg length discrepancy between direct anterior and anterolateral approaches in total hip arthroplasty

Arthroplasty ◽  
2020 ◽  
Vol 2 (1) ◽  
Author(s):  
Henry Dunn ◽  
Geoff Rohlfing ◽  
Robert Kollmorgen
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Outcome Measurement ◽  
Pearson Correlation ◽  
Leg Length Discrepancy ◽  
Leg Length ◽  
Total Hip ◽  
Length Discrepancy ◽  
Observer Reliability ◽  
Overlay Technique

Abstract Background Leg length discrepancy (LLD) after total hip arthroplasty (THA) is a known source of complications and a leading cause of litigation (J Bone Joint Surg Br 87:155–157, 2005). There are limited studies investigating surgical approach combined with the use of fluoroscopy intraoperatively and their potential effects on LLD after THA. The purpose of this study was to compare the direct anterior (DA) approach utilizing a fluoroscopic overlay technique and anterolateral (AL) approach and their potential effect on LLD. Methods We retrospectively reviewed 121 patients who had undergone primary THA from September 1, 2016 to November 1, 2018 by either DA or AL approach by two separate surgeons. Leg length discrepancies were measured on pre-operative post-anesthesia care unit (PACU) and on post-operative low anterior/posterior (AP) pelvis plain radiographs by two investigators blinded to each other’s measurements. To confirm inter-observer and intra-observer reliability between LLD measurements amongst investigators, a Pearson correlation test was performed. The primary outcome measurement was leg length discrepancy (LLD). Results We observed LLD > 1.0 cm and LLD > 1.5 cm in the DA and AL groups. The DA approach group showed a mean LLD of 4.5 mm against 7.76 mm in the AL group (p < 0.00001). There was a significantly higher rate of LLD in the AL group as compared to the DA group (LLD> 1 cm (28% vs. 8%, p = 0.0037) and LLD > 1.5 cm (7% vs. 0%, p = 0.0096). The LLD measurements showed strong correlation in terms of inter-observer (r = 0.95) and intra-observer reliability (r = 0.99) between the two investigators (p < 0.001). Conclusion In our patient cohort, the DA approach with fluoroscopic overlay technique had less LLD in comparison with the AL approach, suggesting that intraoperative fluoroscopic use does have an impact on LLD.

Dynamic leg length measurement is a valid method for detecting anatomic leg length discrepancy

2020 ◽  
pp. 1-11
Author(s):  
Sam Khamis
Keyword(s):  
Gait Cycle ◽  
Pearson Correlation ◽  
Reliability And Validity ◽  
Swing Phase ◽  
Leg Length Discrepancy ◽  
Leg Length ◽  
Functional Changes ◽  
Length Discrepancy ◽  
Leg Length Difference ◽  
Analysis System

BACKGROUND: Even though the importance of leg length discrepancy (LLD), with its potential of causing several pathological conditions or gait deviations, is well known, measuring LLD is still challenging with limited reliability and validity. OBJECTIVE: To assess the capability of the dynamic leg length (DLL) measurement in detecting the presence of anatomic LLD. METHODS: A lower limb x-ray was performed on 15 participants with suspected LLD in addition to a gait analysis study using a motion analysis system to measure DLL (the absolute distance from the hip joint centre to the heel, to the ankle joint centre and to the forefoot). Average DLLs were compared between sides for symmetry by the paired t-test at 51 sample points during the gait cycle in conjunction with the differences between the sides based on the maximal stance phase and minimal swing phase DLLs. Differences were correlated with anatomic LLD by Pearson correlation. RESULTS: No significant differences in DLLs between sides throughout the gait cycle were found. Significant differences between sides were found between the maximal stance and minimal swing phase DLLs. CONCLUSIONS: DLL measurement is capable of detecting an anatomic leg length difference based on functional changes in leg length and functional discrepancy.

scholarly journals Correlation between Gait Asymmetry and Leg Length Discrepancy—What Is the Role of Clinical Abnormalities?

2018 ◽  
Vol 8 (10) ◽  
pp. 1979 ◽  
Author(s):  
Sam Khamis ◽  
Barry Danino ◽  
Dror Ovadia ◽  
Eli Carmeli
Keyword(s):  
Lower Limb ◽  
Pearson Correlation ◽  
Leg Length Discrepancy ◽  
Leg Length ◽  
Random Forest Classification ◽  
Length Discrepancy ◽  
Forest Classification ◽  
The Difference ◽  
Joint Center ◽  
The Impact

Reducing the effect of leg length discrepancy (LLD) on gait abnormalities while other abnormal conditions such as spasticity, joint contractures or weak muscle strength are exhibited is challenging. This study aimed to evaluate the impact of mild LLD on lower limb biomechanics, on participants with anatomic LLD with and without other clinical abnormalities. A motion capture system was utilized on 32 participants to measure lower limb kinematics and dynamic leg length (DLL) throughout the gait cycle, calculated as the absolute distance from the hip joint center, either to the heel, ankle joint center, or forefoot. The Pearson correlation coefficient found that LLD was associated with 5 kinematic variables only when LLD appeared with no other clinical abnormalities present (r = 0.574 – 0.846, p < 0.05). When clinical abnormalities were present, the random forest classification accuracy was lower (64% versus 80%), implying that the used kinematics are low predictors for anatomic LLD, revealing a higher asymmetrical clearance index (the difference between the maximal stance phase and the minimal contra-lateral swing phase DLL) and a different kinematic variable importance index. Clinical abnormalities in pathological gait will in all probability significantly affect gait deviations, affirming mild anatomic LLD as inconsequential. A functional measurement can offer a better estimate as to the side and extent of the functional discrepancy.

Interobserver Reliability Using the Phonetic Level Evaluation With Severely and Profoundly Hearing-Impaired Children

1991 ◽  
Vol 34 (5) ◽  
pp. 989-999 ◽  
Author(s):  
Stephanie Shaw ◽  
Truman E. Coggins
Keyword(s):  
Interrater Reliability ◽  
Interobserver Reliability ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Hearing Impaired ◽  
Intraclass Correlation Coefficients ◽  
Assessment Measure ◽  
Impaired Children ◽  
Speech Assessment ◽  
Hearing Impaired Children

This study examines whether observers reliably categorize selected speech production behaviors in hearing-impaired children. A group of experienced speech-language pathologists was trained to score the elicited imitations of 5 profoundly and 5 severely hearing-impaired subjects using the Phonetic Level Evaluation (Ling, 1976). Interrater reliability was calculated using intraclass correlation coefficients. Overall, the magnitude of the coefficients was found to be considerably below what would be accepted in published behavioral research. Failure to obtain acceptably high levels of reliability suggests that the Phonetic Level Evaluation may not yet be an accurate and objective speech assessment measure for hearing-impaired children.

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