Validation of a New Method Developed to Measure the Height of Adult Patients in Bed

Abstract

We present the performance of a new instrument developed to measure the height of patients in bed (Luft Ruler). Methods: Standing height was the gold standard measured in 116 hospitalized adults with a stadiometer, compared with measurements from the Luft Ruler and calculated estimates. Results: Using the Luft Ruler in women, men, < 60 years old, and> 60 years old, the mean difference from the gold standard was, respectively, 1.5 cm (P = .02), 1.3 cm (P = .06), 1.2 cm (P = .07), and 1.6 cm (P = .02); total arm span: 6.7 cm, 7.7 cm, 5.4 cm, and 9.0 cm (P < .01 for all strata); 2× half arm span: 7.8 cm, 10.2 cm, 7.7 cm, and 10.3 cm (P < .01 for all); World Health Organization (WHO) equation: 5.5cm, 6.2 cm, 4.7 cm, and 6.9 cm (P < .01 for all); and the Hospital de Clínicas de Porto Alegre equation: 1.9 cm (P < .01), 2.5 cm (P < .01), 1.1 cm (P = .12), and 3.3 cm (P < .01). The proportion of differences >5 cm was 0.9% (n = 1) using the Luft Ruler, 62.9% using total arm span, 71.6% using 2× half arm span, 64.7% using the WHO equation, and 27.6% using the Hospital de Clínicas de Porto Alegre equation. Conclusions: The Luft Ruler was the only method that presented minor mean differences in relation to the gold standard in both gender and age strata. The other estimates are not recommended because of high frequency of relevant errors.

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References

World Health Organization. Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. World Health Organ Tech Rep Ser.1995 ;854:1 -452.

Harris J, Benedict F. A Biometric Study of Basal Metabolism in Man. Washington, DC: Carnegie Institute of Washington; 1919.

Kouno T, Katsumata N, Mukai H, Ando M, Watanabe T. Standardization of the body surface area (BSA) formula to calculate the dose of anticancer agents in Japan. Jpn J Clin Oncol.2003 ;33:309 -313.

Ghio S, Freemantle N, Serio A, et al. Baseline echocardiographic characteristics of heart failure patients enrolled in a large European multicenter trial (CArdiac REsynchronisation Heart Failure study). Eur J Echocardiogr.2006 ;7:373 -378.

American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) Board of Directors and the Clinical Guidelines Task Force. Guidelines for the use of parenteral and enteral nutrition in adult and pediatric patients [published correction appears in JPEN J Parenter Enteral Nutr. 2002;26(2):144]. JPEN J Parenter Enteral Nutr.2002 ;26:1SA -138SA.

Brown JK, Whittemore KT, Knapp TR. Is arm span an accurate measure of height in young and middle-aged adults? Clin Nurs Res. 2000;9:84 -94.

de Lucia E, Lemma F, Tesfaye F, Demisse T, Ismail S. The use of armspan measurement to assess the nutritional status of adults in 4 Ethiopian ethnic groups. Eur J Clin Nutr.2002 ;56:91 -95.

Kwok T, Whitelaw MN. The use of armspan in nutritional assessment of the elderly. J Am Geriatr Soc.1991 ;39:492 -496.

Mohanty SP, Babu SS, Nair NS. The use of arm span as a predictor of height: a study of South Indian women. J Orthop Surg.2001 ;9:19 -23.

10.

Reeves SL, Varakamin C, Henry CJ. The relationship between arm span measurement and height with special reference to gender and ethnicity. Eur J Clin Nutr.1996 ;50:398 -400.

11.

Brown JK, Feng JY, Knapp TR. Is self-reported height or arm span a more accurate alternative measure of height? Clin Nurs Res. 2002;11:417 -432.

12.

Hickson M, Frost G. A comparison of 3 methods for estimating height in the acutely ill elderly population. J Hum Nutr Diet. 2003;16:13 -20.

13.

World Health Organization. Management of Severe Malnutrition: a Manual for Physicians and Other Senior Health Workers. Geneva, Switzerland: World Health Organization;1999 .

14.

Chumlea WC, Guo SS, Wholihan K, Cockram D, Kuczmarski RJ, Johnson CL. Stature prediction equations for elderly non-Hispanic white, non-Hispanic black, and Mexican-American persons developed from NHANES III data. J Am Diet Assoc.1998 ;98:137 -142.

15.

Sampaio HAC, Melo MLP, Almeida PC, et al. Aplicabillidade das fórmulas de estimativa de peso e altura para idosos e adultos. Rev Bras Nutr Clin.2004 ;17:117 -121.

16.

Beghetto MG, Fink JS, Luft VC, de Mello ED. Estimates of body height in adult inpatients. Clin Nutr.2006 ;25:438 -443.

17.

HRSA–Health Resources and Services Administration. Accurately weighing and measuring infants, children, and adolescents: technique. United States Department of Health and Human Services Web site. http://depts.washington.edu/growth/module5/text/contents.htm. Accessed July 1, 2005.

18.

McGraw KO, Wong SP. Forming inferences about some intraclass correlation coefficients. Psychol Methods.1996 ;1:30 -46.

19.

Taggart H, Craig D, McCoy K. Healthy elderly individuals do not inevitably lose bone density and weight as they age. Arch Gerontol Geriatr. 2004;39:283 -290.

20.

Zverev YP. Relationship between arm span and stature in Malawian adults. Ann Hum Biol.2003 ;30:739 -743.

21.

Keller TS, Nathan M. Height change caused by creep in intervertebral discs: a sagittal plane model. J Spinal Disord. 1999;12:313 -324.

22.

Cheng JC, Leung SS, Chiu BS, et al. Can we predict body height from segmental bone length measurements? A study of 3647 children. J Pediatr Orthop. 1998;18:387 -393.