Effect of heel lift insertion on gait function in a patient with total hip arthroplasty with patient-perceived leg length difference: a case report.
Toru Shiwa, Yuji Kawabata, Takako Ishii and 1 others
PMID 38304151WHAT IT FOUND
In one patient with perceived leg length difference after hip replacement, adding a heel lift improved gait symmetry and reduced the perceived difference.
Standard therapy alone improved speed and stride length. This single case does not prove the lift caused the improvement.
Key findings
01Gait symmetry (Autocorrelation-1) and patient-perceived leg length difference showed significant improvement during the heel lift phase compared to the standard therapy phase.
02Gait speed, stride length, and cadence improved gradually in both phases, with no significant difference between the heel lift phase and the standard therapy phase.
03The patient received concurrent standard physiotherapy (range of motion, strengthening, gait exercises) during both the baseline and intervention phases, making it impossible to separate the heel lift's effect from the therapy's effect.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
This is a single case report, so findings cannot be generalized to other patients. The intervention period was very short (5 days per phase). Phase A was not repeated or reversed, so it is unclear if the improvements in Phase B were solely due to the heel lift or continued learning from therapy. The patient received concurrent physiotherapy in both phases, so the specific contribution of the heel lift cannot be isolated from the effect of the exercises. Radiographic measurements were taken in a supine position, which may not reflect standing alignment.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not assume the heel lift caused the improvement in gait speed or stride length. These parameters improved in both phases, likely due to the concurrent physiotherapy and natural postoperative recovery, not the lift itself.