Progressive Strengthening And Postural Training In A Patient With Leg Length Discrepancy And Anterior Pelvic Tilt In A Physical Therapy Outpatient Setting: A Case Report

Background & Purpose: Leg length discrepancy (LLD) is a frequent orthopedic problem that presents as either shortening or lengthening of one of the lower limbs. Patients with LLD often present with gait compensation pattern, scoliosis, back and/or lower extremity pain. The purpose of this case report is to describe the physical therapy management of a patient with LLD who experienced pain in the left lower extremity and a left anterior pelvic tilt. Case Description: MT was a 15 year old male who presented to outpatient PT clinic accompanied by his mother with the chief complaint of pain in his left hip. The patient reported the onset of pain in the left hip for one year with no recollection of trauma. The examination showed impairments in muscular strength. Procedural interventions included therapeutic exercises with the focus on strengthening of bilateral lower extremities and postural re education. Outcomes: MT’s Lower Extremity Functional Scale and lower extremity muscle strength showed major improvements. Additionally, his endurance and aerobic capacity improved as demonstrated by his ability to run on a treadmill for two miles with no pain presentation in his left hip. However, MT continued to have mild difficulty with running on uneven surfaces. Discussion: MT made improvements in muscle performance throughout his 8 week course of physical therapy. Positive factors of treatment included good family support and compliance with plan of care as well as following the home exercise program provided by the physical therapist