Measuring Ulna Length in Pediatric Neuromuscular Disease

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Measuring Ulna Length in Pediatric Neuromuscular Disease
Tina Duong, MPT Childrens National Medical Center

Measuring Ulna Length

Diseases included under the pediatric neuromuscular umbrella
Cerebral palsy Congenital muscular dystrophy Congenital myopathy Duchenne muscular dystrophy Spina bifida Spinal muscular atrophy

Why obtain accurate height measurements in pediatric neuromuscular disease?
To trend growth To trend and calculate Body Mass Index (BMI) To trend and calculate conversion from Forced Vital Capacity (FVC) to % predicted Forced Vital Capacity (FVC) While FVC provides important data, % predicted FVC may demonstrate earlier declines in respiratory capacity.

Ulna Length Measuring height in a uniform manner across all children with pediatric neuromuscular disease allows for: standard data collection aggregate data and meta-analysis ability to reach statistically significant results in rare disease analysis

Ulna length serves as a mathematical proxy for height.
Why ulna length? In children with neuromuscular disease, it can be difficult to obtain an accurate height measurement due to: Contractures Scoliosis Weakness Ulna length serves as a mathematical proxy for height.

Measuring Ulna Length Upper Extremity
Support and position the arm in pronation with 90 – 110 degrees of elbow flexion. Palpate the distal tip of the ulnar styloid process Palpate superiorly on the wrist to avoid mistaking the tendon of the extensor carpi ulnaris for the distal tip of the ulna. Palpate the tip of the olecranon and place one arm of the segmometer on the olecranon. Place the other end of the segmometer at the tip of the ulnar styloid. Measure in cm, to the nearest millimeter (e.g. 19.7cm)

Where can I find references to calculate height and % predicted FVC based on ulna length?
Gauld LM, Kappers J, Carlin JB, Robertson CF. Height Prediction from ulna length. Dev Med Child Neurol Jul: 46 (7): Gauld LM, Kappers J, Carlin JB, Robertson CF. Prediction of childhood pulmonary function using ulna length. Am J Respir Crit Care Med Oct 1:168 (7): Epub 2003 Jul 17

What device is needed to measure ulna length?
Segmometer

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