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ANTHROPOMETRY
Anthropometry provides the data used in the indirect appraisal of body
composition. Girths and skin folds can be entered into a number of equations to
estimate the body density, total body fat and the overlying subcutaneous fat.
Moreover, trunk and limb girths provide estimates of relative muscle mass.
Assessment and monitoring of growth:
Growth in stature and weight are frequently used as markers of health,
nutritional status and developmental progress. Both absolute and proportional changes
in specific body measures may influence strength, movement mechanics and
physiological parameters in addition to the effects of training or detraining.
The anthropometrical techniques of proportionality assessment can be applied
to the identification of the common physical characteristics of the athletes within any
given sport. Within the collection of sufficient data, anthropometrical prototypes for a
certain sport can be created. Such prototypes assist in talent identification, training
protocol and equipment design.
Advantage of anthropometrical measurement:
- It is non- invasive.
- It is relatively easy to carry out with a modest amount of training.
- It is possible to become skilled at acquiring reliable measures.
- Most techniques utilize inexpensive equipment that is generally portable.
Growth characteristics related to anthropometry:
Growth is a major, highly variable aspect of infancy, childhood and
adolescence. Somatic growth is more than the regular increase of tissue mass in that it
includes dramatic alterations in size and proportion. The physique changes that
accompany growth may affect the skill, exercise tolerance and injury potential of an
individual overtone. These changes can have a profound influence on the mechanics
of movement and the physiological capacities of the growing organism. One must
consider the individual’s potentials and variations.
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Heights and weights are available on specific tables of:
- Height for age.
- Weight for age.
- Weight for height.
Measuring stature:
The recommended method for measuring the stature is to position the subject
barefoot on a level directly against a vertical wall or door. The subject stands erect
with heels and toes together and the arms hanging by the sides. The measurement is
taken as “the maximum distance from the floor to the vertex of the head”, which is
from the floor to the highest point on the skull.
To measure the stretch stature, gentle upward traction is applied from this
position. Hair clips and ribbons must be removed before the stature is measured. A
pencil mark is made on the level of the headboard. The subject then stands away from
the wall and the vertical distance from the floor to the pencil mark is measured by a
measuring tape.
Measuring sitting height:
“It is the distance from vertex to the surface on which the erect subject is
seated”. There is no consensus as to whether the feet should hang freely or be
supported. However, in either instance thighs should rest on a horizontal position,
with knees flexed over the edge of the sitting surface. The subject is directed to sit up
straight. Care must be taken to ensure that the subject does not reposition or push
upwards with hands or legs. Measurement is taken from posterior of the patient. “The
sub-ischial height (the length of the lower limbs) is derived by subtracting sitting
height from stature height”.
Measuring limb lengths:
Length of limb segments can be measured either directly between two skeletal
landmarks or as vertical distance between a constant flat surface (as the floor) and a
skeletal landmark. This latter is preferred as projected lengths, which through
subtraction gives a number of derived segment lengths (e.g. trochanteric height minus
total tibial height gives an estimate of the length of the femur or thigh; although not
accurate).
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The use of tape measurement is the most valid tool for measuring limb length
(long measurement). Upper limb length discrepancy affects the cosmetic appearance,
while lower limb length discrepancy affects both cosmetic appearance and function.
Inequality of lower limb length will:
* Affect gait pattern (function).
* Create degenerative changes in weight bearing joints.
* Cause deformities, which may be non-structural at first, then become structural.
Unilateral shortening of lower limb leads to pelvic tilt, scoliosis, dropping of shoulder
and tilting of head.
Tape measurement is also used for round measurement or the contour of the:
- Muscle to detect atrophy or hypertrophy.
- Joint to determine swelling.
- Chest to determine its mobility.
1) Long measurements:
a. Upper limb length:
* Whole upper limb length:
Measurement is taken from most superior lateral point of acromion process
(acromial landmark) to the lower and lateral border of styloid process of radius (radial
landmark). The arm is positioned in the anatomical position, relaxed at the side of the
subject.
* Segmental measurement:
- Upper arm length: With arm flexed at 90º, so that ulnar surface of forearm and hand
are horizontal and palms facing medially with fingers extended, measurement is taken
from acromial landmark to the posterior surface of olecranon process of ulna.
- Forearm length: It is the distance from the head of radius (upper radial landmark) to
the most distal point of the styloid process of radius (or styloin).
- Hand length: With hand extended and the palm rested in the direction of the
longitudinal axis of forearm, measurement is taken from styloid process at base of
thumb to the tip of middle finger.
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b. Lower limb length:
* Whole lower limb length:
To determine true leg length, first place the patient's legs in precisely
comparable positions and measure the distance from the anterior superior iliac spines
(ASIS) to the medial malleoli of the ankles (from one fixed bony point to another).
Begin measurement at the slight concavity just below the anterior superior iliac spine,
as the tape measure may slide if pressed directly onto the spine. If there is tilting of
pelvis. Measurement will be taken from the umbilicus to the medial or lateral
malleolus. If there is shifted umbilicus, measurement is then taken from xyphoid
process to the medial or lateral malleolus. Apparent shortening (due to pelvic tilt)
should be differentiated from true shortening (bony).
* Segmental measurement:
If during inspection, one of the patient's legs appears shorter than the other, the
following procedures will assist in determining whether the discrepancy is true or
only apparent.
- True leg length discrepancy:
Unequal distances between these fixed points verify that one lower extremity
is shorter than the other. To determine in short order where the discrepancy lies
(whether in the tibia or in the femur), ask the patient to lie supine, with his knees
flexed to 90° and his feet flat on the table. If one knee appears higher than the other,
the tibia of that extremity is longer; while if one knee projects furthers anteriorly than
the other, the femur of that extremity is longer. A true shortening may be due to
poliomyelitis or a fracture that crossed the epiphyseal plate during childhood.
- Apparent leg length discrepancy:
Before testing for apparent leg length discrepancy, no true leg length
discrepancy should be confirmed (no true bony inequality). Apparent shortening may
arise from pelvic obliquity, hip adduction or flexion deformity. During inspection,
pelvic obliquity manifests itself as uneven ASIS or PSIS while the patient is standing.
While the patient is in supine with his legs in the neutral position, measurement is
taken from the umbilicus (or xiphi-sternal juncture) to the medial malleolus (from a
non-fixed point to a fixed bony point). Unequal distances signify an apparent leg
length discrepancy, if the true leg length measurements are equal.
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If there is an unequal limb length, the physical therapist has to determine where the
difference is via measuring from the anterior superior iliac spine to the greater
trochanter of femur, then:
.. From the greater trochanter of femur to the lateral articulation of the knee joint
(shortening of femur).
.. From the lateral articulation of knee joint to the medial malleolus (shortening of
tibia).
* Quick test for measuring lower limb length:
From crook lying position, shortening or lengthening of femur can be detected via
determining the height of both knee joints. Placing the two anterior superior iliac
spines at the same level shows shortening or lengthening of the femur or tibia:
- From the lateral view: A forward projection of knee denotes shortened tibia and
lengthened femur.
- From the anterior view: An upward projection of knee denotes shortened femur and
lengthened tibia.
* Other tibial length measurements:
- From the prone lying position with the knees flexed to 90º, relative heights are
determined from the medial articulation of the knee joint to the most distal border of
the medial malleolus (legs must be perpendicular to the plinth).
- The subject is seated with the tested leg resting on opposite knee, so that the medial
aspect of tibia faces upwards. With an anthropometer, measurement is taken from
medial articulation of the knee joint to the medial malleolus.
* Foot length:
It is the distance between the most posterior part (center) of the heel to the most
anterior part of the longest toe (2nd toe).
2) Round (girth or circumference) measurement:
This length is looped around the part to be measured and held so that the
printed notches on the scale are next to each other (the stub end is pulled superior to
the easing end). As tension applied to the tape varies, skin surfaces should not be
compressed or an observable space between the skin and the tape left. Tapes with
spring easing are not recommended.
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a. Head girth:
It is the maximum circumference of the head when the tape is located
immediately superior to the eyebrows and positioned at the back of the head, so that
the maximum parameter is measured.
b. Neck girth:
The tape is located perpendicular to the long axis of the neck, slightly superior
to the larynx.
c. Upper limb girth:
* Mid-arm girth:
It is also known as arm circumference, upper arm circumference, biceps
circumference or relaxed arm girth. The tape is applied around the mid-upper arm.
* Forearm girth:
This measurement is the maximal girth of the forearm. It is taken around the
upper third of forearm.
* Wrist girth:
It is the perimeter of the wrist taken distal to the styloid process of the radius
and ulna.
d. Trunk girth:
* Chest girth:
The chest should be bare and the subject stands in a natural erect posture.
Measurements are taken from under the axilla and around the chest, passing by the
xyphoid process:
- Just below the axillary fold.
- At the level of the nipple.
- At xyphoid process.
* Waist girth:
It is measured at the narrowest part of the torso. The subject should be
standing comfortably erect with hands by the side, neither intentionally contracting
abdominal muscles nor breath-holding. The tape is placed around torso, so that it is
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snug but not compressing the skin and the underlying tissues. The measurements
should be taken halfway between the ribs (12th rib) and the iliac crest.
* Abdominal circumference:
This measurement is sometimes confused with the waist girth. It is the perimeter
distance around the torso at the level of the umbilicus.
* Gluteal girth:
It is also known as the buttocks or hip circumference. This is the perimeter at the level
of the greatest posterior protuberance of the gluteals. The subject stands erect with
minimal clothing, with the feet together and no intentional contraction of the gluteal
muscles. The tape is placed compressing any overlying clothing but not the soft
tissues.
e. Lower limb girth:
* Thigh girth:
It is the circumference of the thigh, which is measured when the subject stands
erect with the legs slightly parted and his weight distributed equally on both feet. The
tape is looped around the lower leg.
- Proximal or upper thigh girth: About 1 cm below the gluteal fold, horizontal to the
long axis of femur.
- Mid-thigh: It is the mid-distance between the inguinal crease and the proximal
border of patella.
- Distal thigh: From just proximal to femoral epicondyles.
* Knee girth:
It is taken around the knee at the level of mid-patella (for joint swelling) and 5
cm above the upper border of patella and 5 cm below the level of patella (for muscle
wasting).
* Calf girth:
It is the maximum circumference of the calf, when the subject is positioned as
for the thigh circumference. Measurements are taken around the bulky area of the calf
(two bellies of the gastrocnemius muscles).
* Ankle girth:
It is the minimum circumference of the lower leg, just proximal to the
malleoli.
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