Evaluation of the elbow carrying angle in healthy individuals / Evaluación del ángulo de desplazamiento del codo en individuos sanos

SUMMARY: Carrying angle, or cubital angle defined as the acute angle formed by the median axis of the arm when forearm is in fully extended and supinated position. This angle changes with skelatal growth and maturity. This study was aimed to investigate the correlation of carrying angle with bi-acromial diameter and bi-acromial diameter/bi-trochanteric diameter in our healthy young adult population. This was a cross-sectional study that included 400 (204 male, 196 female) young adult students selected from Çukurova University aged between 18-25 years (mean±standard deviation of females: 20.11±2.05 years; mean±standard deviation of males: 20.45±1.82 years) which originated from different cities in Turkey. After recording demographic data, carrying angle, forearm length, arm length, bi-trochanteric diameter and bi-acromial diameter were measured by using nonelastic tape measure, pelvimeter and manuel goniometer. In addition, body mass index and bi-acromial diameter/bi-trochanteric diameter were calculated for each participants. The mean values of body height and weight were in following respectively for both genders: 178.53±6.40 cm (male), 163.88±5.73 cm (female); 74.89±10.81 kg (male), 57.56±8.61 kg (female). Whereas on dominant arm this angle was as in males 9.77°±2.82° and 13.94°±3.97° in females. The mean value of the carrying angle on nondominant arm in males was 9.85°±2.95° and 14.03°±4.08° in females. The mean carrying angle was 9.81°±2.82° in males and 13.99°±3.97° in females. There are linear relationship between the carrying angle and height (r=-0.474, p<0.001, bi-acromial diameter (r=-0.490, p<0.001), bi-acromial diameter/bi-trochanteric diameter (r=-0.449, p<0.001), forearm length (r=-0.366, p<0.001) and arm length (r=-0.273, p<0.001). We believe that the reference values of carrying angle will help the clinician in the management of elbow displacements, fractures, prosthetic design and diagnosis of epicondylar diseases.

RESUMEN: Se estudió el ángulo de sustentación o ángulo cubital definido como el ángulo agudo formado por el eje mediano del brazo al estar en posición completamente extendido y supinado el antebrazo. Este ángulo cambia con el crecimiento esquelético y la madurez. El objetivo de este estudio fue investigar la correlación del ángulo con el diámetro biacromial y el diámetro bi-acromial / diámetro bi-trocantérico en una población adulta joven y sana. Se realizó un estudio transversal que incluyó 400 (204 hombres, 196 mujeres) estudiantes adultos jóvenes seleccionados de la Universidad de Çukurova con edades comprendidas entre 18-25 años (media ± desviación estándar de las mujeres: 20,11 ± 2,05 años; media ± desviación estándar de los hombres: 20,45 ± 1,82 años) que se originaron en diferentes ciudades de Turquía. Después de registrar los datos demográficos, el ángulo de desplazamiento, la longitud del antebrazo, la longitud del brazo, el diámetro bi-trocantérico y el diámetro biacromial se midieron utilizando cinta métrica no elástica, pelvímetro y goniómetro manual. Además, se calcularon el índice de masa corporal y el diámetro bi-acromial / diámetro bi-trocantérico para cada participante. Los valores medios de la altura y el peso corporal fueron respectivamente para ambos sexos: 178,53 ± 6,40 cm (masculino), 163,88 ± 5,73 cm (femenino); 74,89 ± 10,81 kg (masculino), 57,56 ± 8,61 kg (femenino). Mientras que en el brazo dominante este ángulo fue como en los hombres 9,77° ± 2,82° y 13,94° ± 3,97° en las mujeres. El valor medio del ángulo de transporte en el brazo no dominante en los hombres fue de 9,85° ± 2,95° y de 14,03° ± 4,08° en las mujeres. El ángulo medio de desplazamiento fue de 9,81° ± 2,82° en hombres y 13,99 ° ± 3,97 ° en mujeres. Hay una relación lineal entre el ángulo de desplazamiento y la altura (r = -0,474, p <0,001, diámetro bi-acromial (r = -0,490, p <0,001), diámetro biacromial / diámetro bi-trocantérico (r = -0,449, p <0,001), longitud del antebrazo (r = -0,366, p <0,001) y longitud del brazo (r = -0,273, p <0,001). Creemos que los valores de referencia del ángulo de carga ayudarán al clínico en el manejo de los desplazamientos del codo, las fracturas, el diseño protésico y el diagnóstico de enfermedades epicondilares.

Height and Body Mass Index Estimated by Alternative Measures in Children with Spastic Quadriplegic Cerebral Palsy and Moderate/Severe Malnutrition.

Objective: To demonstrate that alternative measures are reliable predictors of height in children with spastic quadriplegic cerebral palsy (CP) and moderate/severe malnutrition and in healthy children. Methods: In an intervention study, thirteen patients with CP (10 females and 3 males, with an average age of 9 y 11 m±2 y 3 m) with Gross Motor Function Classification System level V and moderate/severe malnutrition were included. They were compared with 57 healthy participants (31 females and 26 males with an average age of 8 y 7 m±10 m). Weight, height and alternative measures to height were obtained. ANOVA, Student’s t test, the Mann-Whitney U test, the Wilcoxon test, and the Pearson correlation were used. Results: Significant differences were observed in weight, height and alternative measures between children with CP and healthy children (p < 0.001). In healthy children, knee height (KH) and lower-leg length (LLL) were similar to standing height. The correlation coefficients between height and alternative measures as well as correlations between the heights estimated by alternative measures were higher in children with CP than in healthy children. Conclusion: KH was the most appropriate measurement to estimate height in children with spastic quadriplegic CP and in healthy children. In the absence of a segmometer, height can be estimated by LLL in children with spastic quadriplegic CP and healthy children. The anthropometric indexes height/age and BMI were more appropriately obtained by the height estimated by KH or LLL.

The Relation of Paraspinal Muscles and Degenerative Lumbar Spondylolisthesis / 대한정형외과연구학회지

OBJECTIVES: To evaluate the cross-sectional area (CSA) and the moment arm length (MAL) of the paraspinal muscles in the degenerative lumbar spondylolisthesis patients compared to the matched control patients, which is through contribution to the stability of the back. MATERIALS AND METHODS: We studied a comprised of 25 degenerative lumbar spondylolisthesis on L4/5 patients and a controlled group with 42 chronic lower back pain patients. In both groups, we measured body mass index (BMI, kg/m2). On the standing lateral radiographs, we measured the total lumbar lordosis, and segmental lumbar lorodosis using Cobb's methods. We measured the degree of slippage by Meyerding classification. The CSA of erector spinae (CSA) and CSA of psoas were measured at the L4/5 level by using the MRI. The statistical analysis were performed to know the relationship between the CSA and the MAL of erector spinae, and the BMI. Multifidus and erector spinae atrophy were evaluated at the L4/5 level and the degree of fatty atrophy was estimated using three grades : mild, moderate, and severe. RESULTS: The patient group and the controlled group BMI (kg/m2) were 25.27+/-3.8 and 24.47+/-3.24. In patient group, Meyerding classification grade I was 92%. Total lumbar lordosis and each segmental lordosis were measured mean angle 44.54degrees(24.9degrees~70.4degrees), and each 9.23degrees(L3/4), 10.27degrees(L4/5), 18.81degrees(L5/S1). Pearson's rho indicated a positive association between the CSA and BMI (rho=0.603, p= 0.001), between the CSA of psoas and BMI (rho=0.445, p=0.026), and between the CSA and MAL (rho=0.627, p=0.001) in the degenerative lumbar spondylolisthesis patients. In terms of the CSA versus MAL, there was a positive association in the both groups (rho=0.627, p=0.001, MAL=0.0008 CSA+/-5.293 in the degenerative lumbar spondylolisthesis group; rho=0.812, p=0.000, MAL=0.001 CSA+/-5.245 in the control group with using linear regression analysis). Independent t-test revealed that both groups had statistically different mean values (p=0.038) in terms of the CSA. Proportion of fat deposits in the multifidus and erector spinae muscle at the L3/4 level were all mild grades. CONCLUSION: The patients with degenerative lumbar spondylolisthesis had atrophied erector spinal muscles, which means harmful because of the poor compensation for the lower back load and poor assists to the lumbar stability. This suggests that the biomechanical factor of the muscles influence to the lumbar disability.

Estimation of Body Height in Korean Elderly

BACKGROUND: Height is essential variable for assessing nutritional status, estimating glomerular filtration rate, and drug dosage besides in epidemiologic study. In old age, spinal deformity and thinning of the intervertebral discs may produce a spurious decrease in height. In the nonambulants, standard methods of height measurement may be impractical. The present study has been designed to predict the height using regression analysis by long bone measurement. METHODS: One hundred twelve persons in one elderly welfare facility were studied. Standing height was measured. Total arm length, upper arm length, forearm length, tibial length in erect and supine position were measured. A nomogram has been prepared from these data to predict height. RESULTS: Multiple regression analysis was used to measure relationship between measured height, age, sex, and each of the measured parameters. Among the parameters in the erect position, height was best predicted by erect tibial length(ETL)(p<0.01). Among the parameters in the supine position, height was best predicted by supine total arm length(STAL)(p<0.05). Estimation of height was calculated by linear regression analysis. Estimation of height(cm)=93.036+2.383 x ETL(cm)-0.233 x age-5.747 x sex(R2=.815). Estimation of height(cm)=87.985 + 1.775 x STAL(cm)-0.151 age-6.787 x sex(R2=.803). CONCLUSION: In the present study it has been shown that erect tibial length and supine total arm length may be a good predictor of total height. The nomogram may provide the prediction of height in the nonambulant elderly.

Factors Associated with Korean Version of Instrumental Activities of Daily Living (K-IADL) in a Community Dwelling Elderly Population

BACKGROUND: The diagnosis of dementia is dependent on the decline of cognitive and functional ability. To measure the functional ability, a Korean version of Instrumental Activities of Daily Living (K-IADL) was developed and validated. However, the characteristics of the instrument were not fully evaluated. The study was conducted for the purpose of investigating which of the variables were associated with the K-IADL scores. METHODS: The study group from Namwon, Korea, consisting of 235 participants aged 65 years and over, was given the K-IADL to evaluate the functional ability of the participants. The independent variables included sociodemographic data (age, sex, education), vascular factors (blood pressure [BP], history of hypertension and type 2 diabetes mellitus, smoking, alcohol intake, and heart rate), and anthropometric measurements (height and arm length). RESULTS: Age, female gender, low educational attainment, high systolic BP, shorter height and arm length were significantly associated with higher K-IADL scores in univariate analyses. Among the results, age, education, systolic BP, and arm length showed independent associations with the K-IADL in multivariate analysis. CONCLUSIONS: The K-IADL was not influenced by gender in adjusted regression analyses, however education and arm length affected the functional scores, which could suggest a possibility of functional reserve. Also, it was suggested that vascular risk factors could be associated with functional ability.

Effect of Height and Arm Length on Simple Reaction Time / 대한산업의학회지

To identify the relation between simple reaction time and height and arm length, simple reaction time was performed to medical students with measurement of height, and arm length. Participants should answer questions about Smoking, drinking, sleep deprivation, history of diseaseand drug, whether to use computer or hot Mean height of men(n=98) was 173.0+/-4.79 cm, that of women (n-22) 161.7+/-4.33 cm. Mean arm length of men was 73.5+/-3.09 cm, and that of women 68.0+/-2.93 cm respectively. Height and arm length were statistically significantly different between-men and women (plt;0.01). Mean simple reaction time of men was 265.4+/-25.03 msec, that of women 286.8+/-28.48 msec. Mean simple reaction time was also statistically significantly different(p<0.01). As a result of correlation analysis, for men. None was significant. However, for women, height and arm length showed statistically significant, correlation with mean reaction time. Correlation coefficient of height and arm length were 0.45 (p<0.05) and 10.57 (p<0.05) respectively.