7. Anthropometric Measurements
PT 142: Assessment in Physical Therapy
Laboratory Session
Anthropometric Measurements
Edited for instruction by:
GILBERT O. MADRIAGA, PTRP
Minerva Zaniebeth A. Gomez, PTRP
Kristofferson G. Mendoza, PTRP
Gilbert O. Madriaga, PTRP
Authors
All Rights Reserved 2008

8. Obectives At the end of the session, the student will be able to:
Describe the general principles and methods of anthropometry
Determine the relevant anthropometric characteristic needed to be measured given a sample case
On a simulated patient, perform correctly and efficiently the following anthropometric characteristics commonly seen in the clinics: limb girth, muscle bulk, leg length, head circumference

9. Obectives Discuss the probable significance of anthropometric findings
Select the proper landmarks given a specific anthropometric measurement
Use and manipulate anthropometric tools correctly and efficiently
Discuss the probable significance of anthropometric findings
Record anthropometric findings accurately using clear and understandable language in an acceptable format

10. Obectives
Report correctly results of anthropometric measurements to a simulated patient
Identify other anthropometric measurements for edema or swelling

11. General Principles and Methods

12. What is anthropometry?
ANTROPO - human
METRY - measurement

13. What is anthropometry? The study of human dimensions
The measurement of traits that describe body dimensions

14. What is anthropometry?
The physical measurement of the human body which provides therapists with building blocks for understanding the complexities of the human form and how it interfaces with the environment

15. What to measure?
In physical therapy, anthropometry may include the assessment of
Edema
Localized swelling
Joint effusion
Muscular changes
Asymmetry of body parts
Effects of surgical procedures

16. Why measure?
Aids the clinician in determining the patients impairments and in providing the appropriate treatment
Provides a baseline to monitor the rehabilitation outcome
effective treatment vs. patient deterioration

17. Why measure? Provides feedback and motivation to patients
Aids in designing equipment and materials for special population such as children, elderly and the differently-abled

18. Why measure?
Also provides important information in the design of objects and spaces used by the normal population (i.e. ergonomics)

19. Types of Measurement Static Anthropometry
Refers to actual sizes of body components, and is taken with the body fixed or in standard positions

20. Types of Measurement Dynamic Anthropometry
Refers to the ability of the body to perform certain tasks with certain distances, spaces or enclosure
Taken with the body in various working positions and is related to body performance

21. Factors Affecting Anthropometry
Gender
Males have less fat tissue and more muscle bulk
Fat accumulation difers in reions for men and women
Aging
Stature decreases and body weight increases after 30 years
Body weight decreases after 50 (M), 60 (F)

22. Factors Affecting Anthropometry
Ethnicity
Lower body weights for those who live in tropical countries
Body proportions differ depending on ethnicity
Differences diminish due to migration
Occupation
Some occupations are self-selective

23. Factors Affecting Anthropometry
Tools
Tape measure
Steel tape
Volumeter
Anthropometer
Caliper

24. Using the Tape Measure Measure in centimeters
Lie the tape measure flat on the body part
The tape measure should be stretched out and not slack
If the segment to be measured is irregular or conical in shape, the proximal part of the tape should be flat
When measuring circumference, surround the body part without undue constricting pressure

25. Measurements Commonly Performed in the Clinics

26. Leg Length Measurement
Indications
postural deviations
gait deviations
checking for leg length discrepancy
True leg length discrepancy
vs.
Apparent leg length discrepancy

27. True Leg Length Measurement
Position
Supine with the legs cm apart (4-8 in) and parallel to each other
Pelvis is balance or in level with lower limbs
Abduction / adduction contracture?
Landmarks
ASIS to lateral malleolus
ASIS to medial malleolus affected by muscle wasting, obesity or knee deformities

28. True Leg Length Measurement
Values
A difference of 1 to 1.5 cm is still considered normal but may still cause symptoms
Validity and Reliability
Valid and reliable in measuring leg length discrepancy (Beattie, 1990)
Increase reliability by getting the mean of two measurements
Potential sources of error: muscle bulk and palpation

29. Apparent Leg Length Measurement
Position
same as true leg length measurement
Landmarks
tip of xiphisternum or umbilicus to medial malleolus
affected by muscle wasting, obesity or asymmetric positioning the xiphisternum, umbilicus or the lower limb

30. True Leg Length Measurement
Values
If true leg length measurement is normal but the umbilicus to malleolus is different, then a functional leg length discrepancy is present

31. Segmental Leg Length Measurement
Landmark:
to determine the site of occurrence of shortening
highest point of the iliac crest to greater trochanter
for changes in neck shaft angle
greater trochanter to lateral knee joint line
for femoral shaft length
medial knee joint line to medial malleolus
for tibial length

32. Leg Length Measurement

33. Muscle Bulk Measurement
Indications
conditions where a decrease (or increase) in muscle bulk is expected
Atrophy (SCI, fractures, CVA)
Hypertrophy (Duchene muscular dystrophy)

34. Muscle Bulk Measurement
Position
Supine or sitting provided that the segment be assessed is well supported
Note:
If the affectation is unilateral, measure the uninvolved extremity prior to measuring the affected part.
The muscles should be at rest when muscle bulk is measured

35. Muscle Bulk Measurement
Landmarks
Identify a stable bony landmark at the proximal part of the segment to measured (1)
Identify the area of the segment where the muscle bulk is the greatest (2)
Measure the distance between (1) and (2). Record this as the measurement landmark.

36. Muscle Bulk Measurement
Procedure
Measure the circumference of the segment around the identified measurement landmark.
Measure the other extremity using the same landmarks
Limitation
Individual muscles cannot be measured

37. Limb Girth Measurement
Indications
Swelling
Joint effusion
Edema

38. Limb Girth Measurement: Swelling / Joint effusion
Position
Supine or sitting provided that the segment be assessed is well supported
Landmarks
Identify a stable bony landmark closest to the area of swelling

39. Limb Girth Measurement: Swelling / Joint effusion
Procedure
Measure the circumference of the segment around the identified measurement landmark
Measure every 4 cm (2 inches) proximally or distally depending on the extent of the swelling
Measurement should extend beyond the obviously involved area in both directions if at all possible

40. Limb Girth Measurement: Swelling / Joint effusion
Procedure
Measure the other extremity using the same landmarks to compare
Measurement should preferably be from a point of zero difference to another point of zero difference

41. Limb Girth Measurement: Edema
Position
Supine or sitting provided that the segment be assessed is well supported

42. Limb Girth Measurement: Edema
Edema up to…
Landmarks
…fingers
base of the fingers
PIPs (together) 2nd & 5th digits as reference
DIPs (together) 2nd & 5th digits as reference
…wrist
The previous landmarks plus…
MCPs
thumb webline
wrist joint (radial styloid)
…elbow
The radial styloid then measure every 4 cm (2 inch) proximally

43. Limb Girth Measurement: Edema
Edema up to…
Landmarks
…shoulder
The previous landmarks plus…
The lateral epicondyle then measure every 4 cm (2 inch) proximally

44. Limb Girth Measurement: Edema
Edema up to…
Landmarks
…toes
base of the toes
PIPs (together) 2nd & 5th digits as reference
DIPs (together) 2nd & 5th digits as reference
…ankle
The previous landmarks plus…
The MTP then measure every 4 cm (2 inch) proximally
…knee
The lateral malleolus then measure every 4 cm (2 inch) proximally

45. Limb Girth Measurement: Edema
Edema up to…
Landmarks
…hip
The previous landmarks plus…
The lateral knee joint then measure every 4 cm (2 inch) proximally

46. Head Circumference
Indications
Hydrocephalus
Microcephalus

47. Head Circumference Position
Supine or sitting provided that the patient is able to maintain the head upright
Landmarks
Inion (external occipital protuberance) to the forehead just above the supraorbital ridge

48. Head Circumference Values at birth 35 cm (13.8 inches) 1 year
33% increase
6 years
50% increase
10 years
twice from birth

49. Head Circumference Values at birth 35 cm Normal caucasian 1st 4 months
plus 0.5 inch per month
5 to 12 months
plus 0.25 inch per month
2 years
plus 1 inch per whole year or
plus 0.25 inch per 3 months
3 to 5 years
plus 0.5 inch per year
6 to 20 years
plus 0.5 inch per 5 year

50. Other anthropometric measures

51. Volumetric Displacement
For edema and swelling
Uses a volumeter
Patient dips the extremity in the volumeter filled with water while the therapist takes note of the amount of water displaced
Highest reliability and validity among measures of edema/swelling
Clinics don’t usually have volumeters

53. Static Measurements Indication Usually for ergonomics Position
Standing
Person stands erect and looks straight ahead, with arms in relaxed position on the side

54. Static Measurement Position Seated
Person sits erect and looks straight ahead.
Thighs are parallel to the floor, and the knees are bent to 90 degrees flat on the floor.
Upper arm is relaxed and perpendicular to the horizontal plane, while forearm is at a right angle to the upper arm
Measurements are done using a horizontal reference point, ground, seat, vertical reference point

55. Antrhopometer

56. Static Measurement Conventions Height – vertical measurement
Length – horizontal measurements in the sagittal plane
Breadth – horizontal measurements in the coronal plane

57. Static Measurement Most Common Measurements Stature Eye height
Shoulder height
Elbow height
Hip height
Knuckle height
Sitting height
Sitting eye height
Sitting shoulder height
Shoulder elbow height
Thigh thickness
Buttock-knee length
Buttock-popliteal length
Knee height
Popliteal height
Shoulder breadth
Hip breadth
Shoulder-elbow length
Elbow-fingertip length

58. Static Measurement Upper limb length Shoulder-grip length
Most Common Measurements
Upper limb length
Shoulder-grip length
Standing vertical grip reach
Sitting vertical grip reach

59. Dynamic Measurement Rapid Upper Limb Assessment (RULA) –
survey method developed for use in ergonomic investigations of workplaces where work related upper limb disorders are reported.
screening tool that assesses biomechanical and postural loading on the whole body with particular attention to the neck, trunk and upper limbs.

60. Steps Step 1 ­ Observing and selecting the posture(s) to assess
A RULA assessment represent a moment in the work cycle.
Step 2 ­ Scoring and recording the posture
Decide whether the left, right or both upper arms are to be assessed.
Longest held versus the worst posture
Step 3 ­ Action Level
At risk to MSD’s?

62. Assembly line

64. Thank You