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8/22/2019 ANTHROPOMETRY MEASUREMENT.pptx
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ANTHROPOMETRY
By Shiva Prasad tiwari
Mpt 1st year
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DEFINITION:-Greek anthropos = human, metro = measurementIsthe measurement of the human body,
Measurements of the variations of the physical dimensions and thegross composition of the human body at different age levels anddegrees of nutrition
jelliffe 1966 966
Measurement of physical characteristics e.g. height, weight, bodycomposition (fat!). Compare with standards for age, sex
Anthropometric measurement is a series of standardized measuring
techniques that express quantitavely dimensions of human body
It helps in measurements for determining the size proportion,&shape of an individuals body
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Uses or need
To evaluate progress of growth;identify people whosegrowth is outside normal values suggesting under orover nutrition so its a Screening tool to identifyindividual at high risk of malnutrition or any otherdisease
To measure change over time: monitor effects ofnutrition intervention for treatment of disease, surgeryor malnutrition. Also, can track weight changes that mayindicate disease
Helps in comparison of morphological status in b/windividuals. Ex: growth status of school children Used asan outcome variable in evaluating interventions such aseffects of exs & wt reduction on body wt &sc fatness
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The measurements include
Height
weight
height and weight
BMI Girth measurements
Skin fold thickness
Waist to hip ratio
Specific segmental length Head circumference
Other method
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height
Procedure
Person in standing erect position, without shoesask person to take deep breath and hold it.Weight equally distributed on both feet tighterarms hanging side head in Frankfort horizontalplane. Taken from standing surface to thetop(vertex) of the skull,
Body wt is measured of body mass .remove theshoes and as much other clothing.
Compare the subjects height and weight
Planning and policy making
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Demispan
A measurement of skeletal size
Used as an alternative to height measurement
when difficult to obtain an upright posture
Demispan is the distance between the sternal
notch and the roots of the middle and third
fingers with the arm stretched out at
shoulder height to the side of the body
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Height
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Height for age
Height should be taken in standing position.
Length for baby at birth is about 50cm it increase byabout 25 cm during first year and 12 cm during 2nd year
Indian girls reach 98%of final height at 16.5 years and
and boys at 17.75 years Low height for age :also known
as nutritional stunting ordwarfing .which reflect
malnutrition Use of 2SD VALUE
bellow the medianreference as cut off point.
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Weight for age
Measurement of weight as reference monthly
from birth to 1 year every 2 month during 2nd
year ,3 month thereafter up to 5 .to monitor
the physical growth
Average Indian weight at birth is 2.7 to2.9 kg
Baby should gain atleast 500gm wt in 1st 3
month there after 7 kg at end of 1st year 2.5 kg
thereafter
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Weight for height
Height and weight are interrelated and
consider important then single parameter
alone(height , weight)
Low weight for height: also known as
nutritional wasting or emaciation (acute mal
nutrition)a child who is less then 70% of
expected weight for height is classed a severewasted
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Growth chart used in India
Consist 4 line 1st topmost represent 80% of medianlower line 70%,60%,50% of standard
It shows 3 degree of malnutrition
Mild or first degree between 70to 80%
Moderate or 2nd degree between 60 and 70%
Severe or 3rd degree between 50 to 60%
Use of growth chart
1)For growth monitoring
2) Evaluation or diagnostic tool
3)Planning and policy making
4)Educational tool
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BMI
BMI is also called quetelets index
Used to access weight relative to height
BMI gives a single number for comparison ,as opposedto the weight to height range or table.
BMI=weight(kg)/height(m2)
BMI provides a slightly more accurate assessment ofbody composition than simple height/weight chartsbut the same bias is present
PROBLEM:1)it doesn't differentiate fat weight from fat free weight
2)It doesn't represent an improvement over therelationship between only weight and body mass
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Waist to hip ratio an effective way to examine regional fat distribution
Pattern of body wt distribution is important predictor of health risk of
obesity Individual with more weight or circumference on trunk are at
increased risk of hypertension ,type2dibetes, hyperlipidemia and CADcompared with individual who are equal wt but have their more wtdistribution on extremities
Waist :- its the smallest waist circumference .usually 1 inch abovethe level of umlicus
Hip :- maximum circumference of the buttocks above the gluetal fold
Normal values of waist: hip ratio
Healthy young men -0.94-1.00
young women 0.80 -0.90 Fat deposit in lower body is pear shaped and abdominal is apple
shaped
Subcutaneous and visceral fat deposition
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Waist hip circumference
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Circumference or girth
Uses:
1)for estimation of body composition
2)quantify change in the muscle bulk with
training (eg.resistance weight training)
Advantage:
Easily learned
Quick to administer
Inexpensive in equipments need
A t i l it f i f
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Anatomical sites for circumference
management
1)right upper arm:2)right forearm:
3)abdomen(waist)
4)hip;
5)right thigh:
6)right calf:
7)head circumference
To estimate %of body fat uses three sites (acsm)
Young man(18 to 26yrs):arm, forearm, abdomen
Yong women(18 to 26)forearm,thigh,abdomen Older man(27 and above )forearm, buttock(waist) abdomen
Older woman abdomen, thigh ,calf% fat = - 47.372 + (.579 x abdomen) + (.252 x hip) + (.214 x
iliac) + (.356 x BW)
A i f id i t
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Arm circumferennce:midpointbetween shoulder and elbow with arm
straight ,midway between acromianand olecranon
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Forearm:
Maximum girth around the forearm with rt
arm straight ,extended in front of body and
palm up.
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Proximal thigh:
Subject standing leg slightly apart(10cm)
maximum circumference at hip just bellow
the gluetal fold
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Right calf: subject standing erect(feet apart
20cm )horizontal measure is taken at the
level of maximum circumference between
knee and ankle usually midpoint.
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Head circumference
Also known occipitofrontal circumference
Widest anteroposterior diameter
Normal 32 to 38 Vary with age and sex .
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Skinfold measurement
Procedure for measuring fat fold thickness is to grasp afold of skin and subcutaneous fat firmly with thethumb and forefingers. Pulling it away from theunderlying muscle tissue following the natural contourof the fat fold. The calliper is applied worth it jaws
exerting constant tension of 10gm/mm2
at the point ofcontact with the skin. The thickness of the double layerof skin and subcutaneous tissue is then read directlyfrom the calliper dial and recorded in millimetreswithin several seconds after applying the calliper
principle :the amount of subcutaneous fat isproportional to total amount of body fat .
the proportion of subcutaneous fat to body fat mayvary with gender, age so regression equation
considering to predict body density or %of body fat
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Skin fold technique
Layers of subcutaneous
fat are measured at
different sites of body
to estimate total body
fat levels
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Benefits
Easy to perform
Inexpensive
Widely used method
Gives reasonable accuracy
Measurement errors
Poor technique
Inexperienced examine
Improper calibrated caliper
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Triceps
Vertical fold on the Midline of the posterior
aspect of the arm over the triceps muscle.
Halfway between the acromian and olecranon
process
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bicep
Vertical fold on anterior aspect of arm 1 cm
above level used to mark the tricep
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sub scapular
Diagonal fold (at45degree) at 1 to 2 cm bellow
the inferior angle of scapula.
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Suprailliac
Diagonal fold in line with the natural angle of
iliac crest taken in anterior axillaries line
immediately above iliac crest.
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abdomen
Vertical fold 2cm right to the umbilicus
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thigh
Vertical fold on anterior midline of the thigh
,midway between proximal boarder of patella
and inguinal crease
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Chest /pectoral
Diagonal fold one half the distance between
anterior axillary line and nipple in man
In women one third of distance between
anterior axillary line and nipple.
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Medial calf
Vertical fold at the maximum circumference of
calf on midline of its medial boarder
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midaxillary
Vertical fold on mid axillary line at level of
xiphoid process of sternum .alternatively
horizontal fold at level of xiphoid sternal
boarder in mid axillary line
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Skin fold prediction equation
Jackson pollock 7 site formula Men and women sites:(chest,midaxillary,tricep
,sub scapular ,abdomen,suprailliac ,thigh)
For man BD=1.112-0.00043499(sum of sevenfold)+0.00000055(square of sum of seven fold )-
0.00028826(age)
For women BD=1.097-0.00046971(SUM OFseven skin fold +0.00000056(square of sum of
seven skin fold)-0.00012828(age)
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Jackson pollock 3 sites skin fold formula
For man(chest, thigh ,abdomen)
Body density (BD)=1.10938-0.0008267(sum
of three skin fold)+0.00000016(square of sumof three skin fold)-0.0002574(age)
For women site are tricep,suprailliac,thigh
BD=1.099421-0.0009929(sum of three skinfold)+0.0000023(square of sum of three sites)-0.00001392(age)
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How to identify %of body weight
Siri equation
%of body fat=(495/BD)-450
Brozek equation
%of body fat=(457/BD)-414.2
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Body fat % rating
Male Female Rating34 Poor
Body fat% using Jackson Pollock equation
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Limb length measurement
1)true limb length2)apparent limb length
Procedure
Patient position: supine lying the distance between 2
medial malleoli should be 15 to 20 cm Squaring of pelvis : bilateral measurement from lower
boarder of umbilicus to iliac crest if their is significantdifference in measurement that suggest either the leg
is in abduction or adduction Then correct it by doing adduction or abduction to
opposite side leg respectively.
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. Whole upper limb length:
Measurement is taken from most superior lateral point of acromion
process (acrmorial landmark) to the lower and lateral border of styloid
process of radius (radial landmark). The arm is positioned in theanatomical position, relaxed at the side of the subject
Segmental measurement:
- Upper arm length: With arm flexed at 90, 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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.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) tothe medial malleoli of the ankles (from one fixed bonypoint to another). Begin measurement at the slightconcavity just below the anterior superior iliac spine, as
the tape measure may slide if pressed directly onto thespine. If there is tilting of pelvis. Measurement will betaken from the umbilicus to the medial or lateralmalleolus. If there is shifted umbilicus, measurement isthen taken from xyphoid process to the medial or lateral
malleolus. Apparent shortening (due to pelvic tilt)should be differentiated from true shortening (bony).Unequal distances between these fixed points verify thatone lower extremity is shorter than the other.
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. To determine in short order where the
discrepancy lies (whether in the tibia or in the
femur), ask the patient to lie supine, with hisknees 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(telescopic view or gallent sign). A true
shortening may be due to poliomyelitis or a
fracture that crossed the epiphyseal plate
during childhood
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Segmental
For neck of femur: From asis to greatertrochanter
For femoral shaft : from greater trochanter to
lateral epicondyle of femur For tibia length:from medial tibia tubercle to
medial malleolus
Foot length: It is the distance between themost posterior part (center) of the heel to themost anterior part of the longest toe (2nd toe).
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Apparent leg length discrepancy: Before testing for apparent leg length discrepancy, no true
leg length discrepancy should be confirmed (no true bonyinequality). Apparent shortening may arise from pelvicobliquity, hip adduction or flexion deformity. During
inspection, pelvic obliquity manifests itself as uneven ASISor PSIS while the patient is standing. While the patient is insupine with his legs in the neutral position, measurement istaken from the umbilicus (or xiphi-sternal juncture ) ifobese 2 cm bellow the umbilicus to the medial malleolus
(from a non-fixed point to a fixed bony point). Unequaldistances signify an apparent leg length discrepancy, if thetrue leg length measurements are equal
O h h d b d
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Other method to measure body
composition
Direct method Two approaches have been used for direct assessing body
composition
In one the body is literally dissolved in the chemical solutionand the fat and non fat component mixture is determined
The other techniques involves the physical dissection ofvariety of body component such as fat, fat free adiposetissue, muscle &bone
Disadvantage
Time consuming & tedious Specialized lab equipments needed
Ethical &legal problems in obtaining cadavers for research
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Indirect method
Anthropometry
Hydrostatic weighing
Air plethysmography
Bioelectric impedance analysis
dexa
h
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Hydrostatic weighting Its an technique where the density of a persons
body is measured .Use to be a gold standard Based on Archimedes principle which states A
body immerses in a fluid experience a loss in
weight equals to the weight of displaced fluid
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Procedure The subject to be submerged in water & body
volume is determined by displacement of water.
Calculating body density &volume of waterdisplaced .Density=Weight/Volume
Compute relative fat, fat mass &fat free mass
Relative fat estimated using siri equation
%fat=495/BD-450
Lean weight= body weight-fat weight
Fat weight = (%fat /100)*body weightSource of error
Residual lung volume
Body density varies with age& activity level
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Air Pletsmography
Bod pod
Dual chambered plethysmography
In contrast to hydrostatic weighing,Bodpod
uses air displacement rather than waterdisplacement to determine body density
Th l f t t h b
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The volume of empty measurement chamber
is determined first
The test is then perfomed with the subjectinside, and that volume is measured
In the second measurement the chamber
volume has been reduced by an amount equalto the subjects volume So by subtraction ,the
volume of the subject can be calculated
To obtain an accurate volume, thoracic gasvolume(residual gas)to be taken into account
Normal value:0.003-.007g/cc
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Bioelectrical impendence
Based on resistance to current flow
Lean tissue has more water So less resistance.
Fat tissue has less water So more resistance
A small portable instrument is used to pass anelectric current of
50 x 10 -6A at 50 KHzSources of error
Temperature Hydration status
DEXA
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DEXA
Dual energy x-ray absorptiometry
High technology procedure
Mostly used for bone density assessment for
osteoporosis diagnostic purposes
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Used to estimate regional bone mineral
content and bone mineral density primarily
spine, pelvis, femur
Advantage;-
Precise
Reliable
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estimates bone density and mineral content
Normal bone mineral density
Males:3.88g/cm3
Females:2.90g/cm3
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Rest is yours