Overview of Height Assessment
Anthropometry, simply put, is the measurement of the human body. It is especially useful for recognizing if someone suffers from malnutrition or obesity. These measurements form a crucial part of check-ups for both children and adults. One of the key things measured is body height, which is especially important for tracking a child’s growth. The obtained value is then compared to a reference group, and checked regularly to make sure growth is on track.
Organizations like the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) have created standard procedures for height measurement to ensure accuracy and reliability. There are also alternative methods to measure height for children with physical disabilities who may not be able to stand for standard measurements.
Measuring height is simple, non-invasive, and can be very telling – it can alert healthcare professionals if children are at risk for malnutrition or obesity. However, there is still a need for accurate height measurements for everyone. In fact, in a study conducted in multiple US primary care practices, only 30% of height measurements were found to be accurate. The accuracy rate was even worse in hospital settings.
Knowing someone’s height is more than just a basic fact about them. It has important health implications, helping to calculate body mass index (BMI), identify nutritional status, and even diagnose underlying health problems in children and adults. The assessment of height is particularly tricky in patients with limb or spine deformities, trauma, skeletal dysplasia, and those who are hospitalized. This drives the need for standardized methods of height assessment to improve accuracy and health outcomes for patients.
Why do People Need Height Assessment
Physical growth is a process that continues until we reach our full adult size. If a child’s growth is slower than usual, it could mean they have problems with their genes or they’re not getting enough of the right nutrients. We can pick up on problems like this early on by regularly monitoring their height and weight. In some cases, this can even allow us to help the child catch up with their growth. In adults, measuring height can give us important information about their overall physical health. For older adults, it can tell us who might be at higher risk for certain conditions like osteoporosis and fractures, which can make their bones weak and more likely to break.
The World Health Organization (WHO) provides standards for us to track the physical growth of children and infants. These standards show us what normal, early childhood growth looks like under the best conditions. It offers us details on height for age, weight for age, weight for height, and body mass index (BMI) for age. These parameters or data points are useful to find out growth disorders, or to find out if a child is sufficiently nourished, no matter their background or diet.
According to the Child Health and Disability Prevention (CHDP) Program, all children and teenagers should have their anthropometric or body measurements taken during every routine check-up. This helps us ensure that they are growing as they should be and allows us to see if they may be at risk of becoming overweight. The measurements they take are then compared to what is average for their sex and age, using charts provided by the WHO and the Centers for Disease Control and Prevention (CDC). The most important thing is to watch these measurements over time. If the pattern of a child’s growth changes noticeably on these charts over several check-ups, this could be a sign of an abnormal growth pattern and it may be necessary to do extra tests.
In adults, these body measurements should be taken at all health check-ups, to learn about a person’s nutrition and to predict the risk of future diseases.
When a Person Should Avoid Height Assessment
Anthropometric measurements are simple methods used to measure the human body. They are safe and do not require any invasive procedures, so there are no reasons why they shouldn’t be used. However, these measurements may not always be accurate. For example, if a person is currently sick, the measurements may not accurately represent the person’s normal body measurements. Using these measurements when a person is unwell can provide data that might seem better or worse than the reality, and so, it’s best to avoid taking these measurements during such times.
Equipment used for Height Assessment
To gauge a person’s height, you can either estimate it by the length of their arms (wingspan) or measure it directly using a tape measure or a special instrument called a stadiometer. A stadiometer proves to be more precise and is considered as the gold standard way of measuring height according to the CDC. It can be adjusted to measure height up to the smallest fraction, or one-eighth of an inch.
Here are some tools commonly used to measure height:
- Measuring tape
- A horizontal length scale (HLS), a flexible horizontal scale used to measure a lying-down baby’s length.
- Infantometer, a tool that measures a baby’s length while lying down, holding the baby safely in position.
- Anthropometer rod, made up of four equal rods and measures height up to 2 meters.
- Stadiometer, a ruler with a sliding headpiece that’s placed above the head to measure height.
- Osteometric board, it’s used to measure the length of long bones, it has a flat board with a fixed end and a sliding end.
It’s crucial to compare the height measurements taken against a standard for the relevant population. The CDC and the World Health Organization (WHO) provide these standards. The CDC’s charts are based on data from children growing up under various nutritional conditions in the United States. The WHO charts represent the growth of healthy children growing under the best conditions, and therefore provide an optimal growth model to target.
CDC charts label normal growth as between the 5th and 95th percentiles. WHO charts consider normal growth as two standard deviations (a measure of how dispersed data is) above and below the mean, or z-scores between -2.0 and +2.0. This corresponds to a range between the 2nd and 98th percentiles. A study comparing the two found that WHO growth standards are less likely to label a child as undernourished than the CDC charts.
It’s important to use the appropriate growth chart based on the patient’s age and gender. If a child has a condition that affects their growth, like Down syndrome or Williams syndrome, special growth charts should be used to get more informative results.
For children born prematurely, adjustments need to be made when measuring their growth. The number of weeks the infant was born preterm is subtracted from the age. This correction is continued till they’re two years old for those born before 32 weeks of gestation and till at least a year old for those born between 32 and 36 weeks of gestation.
Recent technological developments have introduced a portable laser height meter. Its accuracy was compared to the stadiometer in 2020 and it was found to be readily reproducible and have acceptable accuracy. It can be especially helpful for people who can’t stand to have their height matched or in remote locations when using a stadiometer might be challenging.
Who is needed to perform Height Assessment?
Nurses and their helpers are skilled and dependable when it comes to taking height measurements for kids and adults. It’s usually noticed that parents or caregivers who take measurements at home often have a lot of mismatch and mistakes, but these can be fixed with the right training. In today’s world, where we have lots of remote or online medical care, this training can be very helpful. A recent study shows that with proper training, we can also accurately measure height and weight remotely, such as over a video call, with only slight differences from traditional ways of measuring.
How is Height Assessment performed
Measuring a baby’s length, or “recumbent length,” can be tricky because they’re so tiny, they can’t control their movements well, and they can’t understand instructions. You can use devices like a simple scale, a tape measure, or an infantometer to measure from the top of their head to their heels. Before starting, remove any clothes, diapers, or other objects. The baby should be lying down with the top of their head touching the backboard and their feet against the footboard. Write down the length to the nearest millimeter. It’s helpful to have the parent or caregiver nearby to comfort the baby if they get upset.
Another way to estimate a baby’s length involves using their arm span (the distance from their left to their right fingertips) or the length of their ulna bone (one of the bones in the forearm). These measurements often give more accurate results than full-length measures. They can also provide information about how different parts of the body are growing in relation to things like the baby’s age, sex, ethnicity, and any health conditions they might have.
For children aged 3 or more, you can use a device called a stadiometer or an anthropometer rod to measure their height. The child should stand up straight against the stadiometer with their feet flat and their bottom, shoulder blades, and the back of their head touching the backboard. Their head should be lined up so that a horizontal line from their ear canal to the lower border of their eye socket is parallel to the floor. This line should also form a right angle with the vertical backboard. Ask the child to stand up as tall as possible and take a deep breath (this makes the spine straight for an accurate height measurement). Note down the measurement to the nearest tenth of a centimeter.
Children with conditions that affect their skeletal growth require special techniques to measure their height accurately. One of these methods involves comparing their sitting height to their standing height to check for unusually short stature. It’s also useful to measure the child’s arm span, especially for children suspected of having a height condition. Arm span is measured by stretching both arms out sideways and marking the tips of the middle fingers. The distance is then measured once the child is moved. Other methods for assessing growth in children with severe cerebral palsy or known spinal or skeletal deformities include upper arm length and knee height measurements.
Measuring height in adults and older people often involves using a stadiometer or an anthropometer. Other methods, such as measuring how far someone can reach (arm span), length of lower leg, foot length, or length when lying down (recumbent length) can be used when standing height can’t be measured. X-rays and CT scans of long bones can also be used. In some cases, height can be estimated from bony bits left when a person dies. This involves adding up measurements of all the skeletal parts and then adding an extra amount to account for the height of the skin and muscles.
Possible Complications of Height Assessment
Your height can actually change slightly over the course of a day, by up to 2 centimeters. This is because the spongy discs between your backbone bones (vertebrae) and the muscles around your spine can become less elastic during the afternoon and evening. This makes you a bit shorter compared to when you first woke up in the morning.
As we age, these changes can become more permanent and we might get a bit smaller because of a process called senile degeneration. This is a normal part of aging, but it’s something that doctors keep in mind. Why? Well, when doctors need to figure out who someone is (like in forensics) or make a diagnosis, height can be an important clue. But, because your height can change depending on the time of day and your age, they have to take this into account to avoid any mistakes.
What Else Should I Know About Height Assessment?
Keeping track of a person’s height is important for monitoring their overall health and growth. This is especially true for babies and young children, as measurements like height and body mass index (BMI), which is a weight-to-height ratio, can help identify if a child is malnourished.
In adults, a decrease in height can be a sign of coming health problems. For instance, older women who lose height over time are at a higher risk of getting osteoporosis – a condition that weakens bones and makes them prone to fracture – and could face increased health risks. Regular monitoring of the adults’ height can detect the loss early and help prevent future bone fractures.
Considering the growing issue of childhood obesity, accurately measuring a child’s height becomes even more important. Along with the weight, height is used to calculate a child’s BMI and their waist-to-height ratio (WHR). Both these measurements are crucial in detecting obesity in growing children, particularly central obesity which is excess fat around the waist and abdomen. This can have serious implications for their future health. There are also methods available to estimate a child’s body fat based on their height and weight which are as accurate as advanced techniques but more cost-effective.
In the field of anthropology, which studies humans and their societies, measuring height is important for understanding physical growth patterns and changes over time within different population groups. To get accurate results, it’s crucial to use data specific to each population rather than general information. For example, if the average height in a particular population is decreasing, it needs to be investigated to identify the causes of this trend.
When a child’s height does not follow the expected growth pattern, it’s important to properly analyze and understand the cause of this abnormal growth. One single measurement at a specific point in a child’s life is not enough. Growth patterns that show faster or slower growth compared to the average could indicate a potential issue and may need further investigation. It’s important to remember that growth is not a continuous process but happens in specific periods, so what may seem like slow growth might actually be a normal pause in a child’s growth.
As for shorter children with normal growth rates and bone age, they might just be genetically shorter and may not require any special intervention. However, children who have shorter stature than average and show slower growth rates may need a thorough check-up to rule out any underlying medical conditions. Conversely, an unusually rapid increase in height is rare, but should also be evaluated.