Effect of both-leg and one-leg support on lateral shift in patients with lumbar discopathy

Aim of the work. The aim of the work was to study the effect of both-leg and one-leg standing on the course of the plumb-line projection with regard to the vertebral column in patients with lumbar discopathy depending on the direction of lateral shift. Material and methods. The research study was performed in 15 healthy volunteers (control group) and in 20 subjects suffering from lumbar discopathy at the L4-L5 level and/or L5-S1 level who were diagnosed with lateral shift and radicular symptoms present in one of the lower limbs. Depending on the lateral shift direction the patients were divided into two groups: one with the shift towards the limb into which the pain irradiated, so called ipsilateral patients, and the others with the shift towards the direction opposite to the limb into which the pain irradiated, so called contralateral patients. Apart from the medical history and clinical observations the research study included the measurement of so called plumb-line shift [cm] in three positions: when standing on both legs and when standing on one leg, left then right. Results. It was observed that in the majority (87% of subjects) of healthy volunteers standing on both legs the plumb-line is not along the gluteal cleft, but it is shifted towards left or right. It was reported that the plumb-line shift when standing on both legs is the greatest in contralateral patients, and smaller in ipsilateral patients. In ipsilateral patients the plumb-line shift is even greater (the trunk shift is more pronounced) while standing on the sick leg, whereas while standing on the healthy leg the plumb-line projection shifts towards this limb. In contralateral patients in whom the greatest value of the plumb-line shift was observed while standing on the healthy leg the plumbline projection approaches the medial line of the body (the body silhouette is corrected to some extent.) While standing on the sick leg the plumb-line projection shifts towards this limb. Conclusions. The greatest trunk “deformation” (shift) is observed in contralateral patients. Attention should be drawn to the possibilities of correcting the trunk position depending on the load on the sick or healthy leg with regard to functional positions (i.e. gait.) In addition, attention should be drawn to persisting erroneous patterns of body position with regard to the rehabilitation process, during both conservative and post-operative treatment.