How to measure Maximum Allowable Standing Height for bilateral amputees??
This article outlines how to take the measurements require to determine the maximum allowable standing height for bilateral lower limb amputees. To determine maximum permissible standing height Prosthetist will need to take one or more of the following five measurement.Upper arm length
Forearm length
Thigh-length
Sitting height
Arm span
The first three measurements (collectively as body segment lengths) used to determine the maximum allowable standing height. Land marking of the points for measurements is essential, which needs to be done before the size of segment lengths.
A segmometer is preferred to measure lengths because it provides a line distance between two landmarks. A tape measure is not a suitable substitute because it will be distorted by the body contours and does not give a straight-line distance to measure.
Stadiometer is required for measuring the sitting height.
A seat without cushion and backrest and must have a standard straight seat. The hips should not be in excessive flexion while sitting.
Things to be considered before measurement
- Arrange the measurement tools and place. It is crucial for the comfort of the patient as well as the professional.
- The patient should wear comfortable clothes exposing the arms and legs. The dress should not be a hindrance during measurements.
- Land marking of the endpoints of each segment should be proper.
- Positioning the patient in a way so the measurement can be done without any hurdle
- Better to measure on right side preferably
Measurement of segment length
All segment length should be taken on the right-hand side of the body unless there are marked anatomical anomalies such as an amputated right Upper Limb.
Remember smaller areas in land marking or measuring technique can make a massive difference in the maximum allowable standing height. So these land marking and measurement Protocols must have adhered.
UPPER ARM LENGTH:
Land marking: Acromiale and the Radiale
Acromiale is the point on the superior part of the acromion border in line with the most lateral aspect.
Radiale is the point at the proximal and lateral border of the head of the radius.
The line should be horizontal and not vertical.
It should be on the head of the radius not in the joint space or on the humerus.
In this position, the skin of the elbow can be incredibly loose and therefore the prosthetist should take extra care
To make sure that the skin is not stretched upwards or downwards when making the indentation with the fingernail.
FOREARM LENGTH
Landmarking: the Radiale and Stylion
Stylion is the most distal point on the lateral margin of the styloid process of the radius.
The Mark should be on the lateral aspect of the styloid process, which is covered by just a thin layer of skin.
Not in the joint space.
The line should be horizontal and not vertical
THIGH LENGTH
Land Marking Trochanterion & Tibiale laterale
these landmarks will only be required for below-knee amputees not above me.
Two people are required to execute these measurements accurately. One person taking the measurements the measurer and the other to record the Moments the recorder
on some occasions, the recorder is not only responsible for recording the result but also assists with taking the measurement teaching points to reduce recording mistakes.
The measurer should call out the measurement to the recorder.
The recorder should repeat the measurement back to the measurer, and the measurer should confirm that the writer has correctly repeated the size by saying correctly.
All the measurements required in a logical order and record these as trial one all the measurements should then be taken a second time in the same order and registered as a trial to
once you have completed the double measurement check that it is not more than one percent greater or smaller than the first measurement
if there is less than or equal to 1% difference.
Between trial 1 and trial 2
the mean should be calculated and entered into the formula for calculating the maximum allowable standing height
for any measurement where there is more than one per cent difference between trial one and trial to take another Measurement & Record as trial 3.
The median result is the one that should be entered into the formula for calculating maximum.
Our both standing height teaching points
complete all measurements required for trial one before taking your measurements a second time don’t measure once and then a second time straight away
is not necessary for the head to also be in contact.
The head positioned in The Next Step
the hands or forearms.
Moves away and the measure is taken.
The sitting height of the athlete is calculated by subtracting the height of the sitting platform from the measurement obtained with the athlete sitting on the platform.
The arm span is measured as the distance from one fingertip to the other when the arms are abducted to 90 degrees at the shoulder, and the elbows wrists and fingers are fully extended to take this measurement correctly.
Please find below some good literature :
https://www2.slideshare.net/marcelosilveirazero1/apostila-isak?from_action=save
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