Anthropometry

Definition
Is the measurement of human body dimensions such as lengths,
breadths, girths & skin folds using surface landmarks for reference. The
core elements of anthropometry are height, weight, head circumference,
body mass index (BMI), body circumferences to assess for adiposity
(waist, hip, and limbs), and skinfold thickness.
Anthropometry provides the data used in the indirect appraisal of
body composition. Girths and skin folds can be entered into several
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.
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.
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.

The most common method used for measuring height in the case of adults
and the elderly is:

1. Anthropometer rod: The anthropometer rod consists of four

equal rods and can be used to measure height up to a range of
2
meters.
 2. Stadiometer: The stadiometer consists of a ruler and a sliding
horizontal headpiece which can be fixed above the head to
measure height.

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 betaken 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”.
Bony landmarks of the lower limb
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.
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.

1) Long measurements:
* Whole lower limb length:
TESTS FOR LEG LENGTH DISCREPANCY :

In normal individual, we can observe the mild difference in the leg

length. If the leg length difference is less than one inch. It is considered as
normal, but the difference goes more than one and half inches is
considered as
abnormal. It needs the proper corrective treatment.

First, the reason for the leg length discrepancy is analyzed before the

treatment is carried out.

Causes :

1- Congenital deficiency of limb, e.g. congenital shortening of femur,

congenital shortening of tibia .

2- Trauma, e.g. malunited fracture, premature epiphyseal closure in

fracture, loss of bony fragment after open fracture

3- Poliomyelitis

4- Pelvic tilt or drop (weakness of gluteus Medius muscle)

5- Scoliosis

6- Gout disease like osteomyelitis

7- Soft tissue shortening or contracture

8- Bony abnormalities, e.g. coxa vara, coxa valga, genu varum and genu
valgum .

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.
There are two types of leg length measurements:

- True Leg Length Discrepancy

- Apparent Leg Length Discrepancy

True Leg Length Discrepancy:

- 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, for the tape measure may slide if pressed directly
onto the spine. Unequal distances between these fixed points verify
that one lower extremity is shorter than the other.
 If there is an unequal limb length, the physical therapist must
determine where the difference is via measuring:
• Segmental measurement :
- 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).
- 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).
* 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: If one knee projects further anteriorly than the
other, the femur of that extremity is longer.

- From the anterior view: If one knee appears higher than the other, the
tibia of that extremity is longer.
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 junction) to
the medial malleolus (from anon-fixed point to a fixed bony point).

- Unequal distances signify an apparent leg length discrepancy, if the

true leg length measurements are equal.
2) Round (girth or circumference) measurement:
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.
As the tension applied to the tape varies, skin surfaces should not be
compressed or an observable space between the skin and the tape left.
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 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.

Waist hip ratio (WHR): is the ratio of waist circumference to hip

circumference.
This is calculated as waist measurement divided by hip measurement ( W ⁄ H ).
For example, a person with a 75 cm waist and 95 cm hips has a WHR of
about 0.79.
Health Risk in Women
• Women are at low risk if the Waist to Hip Ratio is 0.80 or lower.
• They are at moderate risk if the ratio is between 0.81 and 0.85.
• Anything above 0.86 means they are at higher risk.
Health Risk in Men
• Men are at low risk if the Waist to Hip Ratio is 0.95 or lower.
• They are at moderate risk if the ratio is between 0.96 and 1.00.
• Anything above 1.00 means they are at higher risk.
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.
Round measurements