Lealyn A.
Tumaob Block 261
Mid-Upper Arm Circumference
Introduction:
MUAC is the circumference of the left upper arm, measured at the mid-point between the tip of the
shoulder and the tip of the elbow (olecranon process and the acromium).
Rationale:
MUAC is used for the assessment of nutritional status. It is a good predictor of mortality and in many
studies, MUAC predicted death in children better than any other anthropometric indicator. This
advantage of MUAC was greatest when the period of follow-up was short.
Instruments:
MUAC Tape
Procedure:
MUAC is the circumference of the left upper arm and is measured at the mid-point between the tips of
the shoulder and elbow. To measure:
1. Bend the left arm, find and mark with a pen the olecranon process and acromium.
2. Mark the mid-point between these two marks.
3. With the arm hanging straight down, wrap a MUAC tape around the arm at the midpoint mark.
4. Measure to the nearest 1 mm.
Interpretation:
RED COLOUR: >110mm (11.0 cm) = Severe Acute Malnutrition
The child should be immediately referred for treatment.
RED COLOUR (3-colour Tape) or ORANGE COLOUR (4-colour Tape): Between 110mm (11.0cm) and
125mm (12.5 cm) = Moderate Acute Malnutrition (MAM)
The child should be immediately referred for supplementation.
YELLOW COLOR: Between 125mm (12.5 cm) and 135mm (13.5cm) = Acute Malnutrition
Should be counselled and followed-up for Growth Promotion and Monitoring (GPM).
GREEN COLOR: Over 135mm (13.5cm) = Well Nourished
Mid- Upper Arm Muscle
Introduction:
Mid- upper arm muscle is the estimation of the area of the bone and muscle portions of the upper
arm. It is derived from the MUAMC using the following formula.
Rationale:
It give us an indication about changes in body composition and nutritional status of the patient.
Instruments:
Procedure:
Interpretation:
Bioelectrical Impedance Analysis (BIA)
Introduction:
Bio-electrical Impedance Analysis or Bioimpedance Analysis (BIA) is a method of assessing your body
composition: the measurement of body fat in relation to lean body mass. It is an integral part of a health
and nutrition assessment. These provides information of the Body Fat % and Fat Weight, Lean Mass % and
Body Lean Mass, Total Weight, Body Water % and Body Water, Plus Normal Levels , Basal Metabolic
Rate (BMR), BMR/Body Weight, Average Daily Calorie Requirement, Body Mass Index - Plus Normal
Range, Waist/Hip Ratio, and Impedance Values at 50kHz.
Rationale:
BIA allows for early detection of an improper balance in your body composition, which fosters earlier
intervention and prevention. BIA also provides a measurement of fluid and body mass that can be a critical
assessment tool for your current state of health.
Instruments:
Bodystat 1500
Procedure:
Ensure the participant is lying flat and that their hand and foot are not touching the rest of their
body
Measurement are to be taken on the right side of the body
Gently clean electrode sites with an alcohol wipe, particularly if the skin is moist or covered with
lotion (allow to dry before connecting electrodes)
Proximal (BLACK): Wrist - Place on an imaginary line from the protruding bones of the wrist
straight across to other side of wrist, ensure that the upper border of the electrodes bisects the
head of the Ulna. Ankle - Place on an imaginary line between the the protruding ankle bones
(medial and lateral malleoli) place the electrode along this line as shown in the pictures below
Distal (RED): Place on the base of the second or third metacarpal-phalangeal joints of the hand
and foot
Turn on Bodystat unit; enter participant’s height, age, weight, gender, activity levels as asked.
Keep pressing the enter button through until it says testing.
Make a note of results and the test number as they are stored on the unit so you can return to a
certain test at a later date.
Interpretation:
Normal Values
Body Fat percentage = 13-19%
Body Fat Weight (Kg) = 11-15kg
Lean Weight = 66-70kg
Total Weight = 78-84kg
Total Body Water in percentage = 55-65%
Total Body Water in Litres = 46- 54 L
Dry Lean Weight: kg
Basal Metabolic Rate: Men 1600 kcal Women 1400
BMR/ BODY WEIGHT: kcal/kg
Estimated Calorific Requirement: kcal
BMI = 20-25
Waist-Hip Ratio: @ thenotebook
Impedance 50 kHz =
Dual – Energy X- ray
Introduction:
A test that uses low-dose x-rays to measure bone mineral density, including calcium content, in a section
of bone.
Rationale:
It is used to detect osteoporosis and predict the risk of bone fracture.
Instruments:
DXA SCAN
Procedure:
Ensure that the patient has removed all jewellery and is not wearing
clothing with buckles, belts or metal fasteners
Ensure that the patient is positioned to move to and from the table with
the scan arm to the left (foot-end) of the table, for stability and access.
Ensure that the patient is lying on his/her back with their head at the right end of the table and
that they are positioned within the scan limit borders marked on the mattress. The feet of taller
patients may have to hang over the edge of the bed.
Ask the patient to place their arms by their sides with their palms facing downwards but not
touching their thighs. This might be difficult to achieve in large/obese patients, in which case
their arms should be by their sides with palms touching their thighs.
Ensure that the patient’s feet are rotated slightly inwards, leaving a gap between the toes. If
movement may be a problem, thin tape may be placed around the toes to support the legs in
position.
Ask the patient to breathe normally and keep as still as they can.
Scanning is started in accordance with the operating procedure detailed in the Hologic Discovery
Training Manual.
The operator should inform the patient that they need to keep as still as possible until the scan
arm has completed 7 passes of their body. Explain that this should take approximately 7.5
minutes
The DXA machine is operated using the settings and techniques described in the Hologic
Discovery training Manual, which is stored in the scan room.
The scan is then analysed using the Whole Body Fan Beam analysis algorithm and the results are
printed.
Interpretation:
Arm Span or Total Arm Length
Introduction:
Physical measurement of the length from one end of an individual's arms (measured at the fingertips) to
the other when raised parallel to the ground at shoulder height at a 90° angle.
Rationale:
To measure arm length, as long arms may be advantageous for some sports which involve reaching and
tackling. Also, Used when a height measurement is needed but the individual cannot stand on a
traditional stadiometer or against a wall due to abnormalities of the back or legs, such as scoliosis,
osteoporosis, amputations, or those who are confined to a bed or wheelchair.
Instruments:
Tape measure
Procedure:
Arm Length
Stand up straight with your arms relaxed and at your sides.
Place one end of a measuring tape at the base of your neck.
Measure your arm over the shoulder and down your arm.
Take your measurements to the area just past your wrist bone for clothing.
Continue measuring to your fingertips if measuring your full arm length.
Arm Span (Double Demi Span: fingertip to fingertip)
Get a partner to measure your arm span.
Stand upright with your back to a wall.
Stretch your arms out as far as they will go.
Measure between both of your middle fingers.
Compare your arm span to your height.
Interpretation:
Arm span is approximately equal to height.
In males it averages about 5cm (about 2 inches) more than the height.
In females it is 1.2cm (about 0.5 inches) greater than height
Frame Size
Introduction:
Body frame size is determined by a person's wrist circumference in relation to his height. For example, a
man whose height is over 5' 5" and wrist is 6" would fall into the small-boned category.
Rationale:
Simple measurements can help you determine whether you are large or small boned. Accurately judge
your body frame size to develop a reasonable goal weight, understand how your clothing fits and improve
your overall body image.
Instrument:
Tape Measure
Procedure:
3 Methods to Determine Frame Size
Elbow Measurement
Bend your elbow 90 degrees.
You want to take the measurement of the width of the widest part of the bone at your elbow.
Simply use your middle finger and thumb to get an estimate, and then check this estimate with a
ruler/measuring tape
Measuring Wrist with Tape Measure:
Place the tape around your wrist in the same area you wear a watch -- above the ball joint of your
ulna -- to determine the circumference of your wrist in inches.
Use the following chart to determine whether the person is small, medium, or large boned.
Measuring Your Wrist With Your Fingers
Wrap your thumb and forefinger around your wrist in the area you normally wear a watch.
Interpretation:
Elbow Measurement
table
Measuring Wrist with Tape Measure:
Women:
Height under 5'2"
Small = wrist size less than 5.5"
Medium = wrist size 5.5" to 5.75"
Large = wrist size over 5.75"
Height 5'2" to 5' 5"
Small = wrist size less than 6"
Medium = wrist size 6" to 6.25"
Large = wrist size over 6.25"
Height over 5' 5"
Small = wrist size less than 6.25"
Medium = wrist size 6.25" to 6.5"
Large = wrist size over 6.5"
Men:
Height over 5' 5"
Small = wrist size 5.5" to 6.5"
Medium = wrist size 6.5" to 7.5"
Large = wrist size over 7.5"
Measuring Your Wrist With Your Fingers
Fingers overlap= Small Frame
Fingers touch tip to tip= Medium Frame
Space between your thumb and index finger= Large Frame