Carlos Chirivella Moreno; José Montero Vilela; David Garrido Jaén; Ignacio Bermejo Bosch*; Mª Francisca Peydro de Moya; Clemente Pastor Tendero; Álvaro Page del Pozo*; Purificación Castelló Mercé
Instituto de Biomecánica (IBV). Universitat Politècnica de València.
Edificio 9C. Camino de Vera s/n. (46022) Valencia. Spain
* IBV’s Healhcare Technology Group, CIBER in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN)
The Instituto de Biomecánica (IBV) has developed the NedRangos/IBV application to help experts assess the range of motion of the joints. This application allows the user to perform an assessment of the upper limb, lower limb and spine.
NedRangos/IBV records the ranges of both active mobility and passive mobility and can assess the ranges of one side versus the contralateral one, active ranges versus passive ranges, and active ranges versus normal ranges values.
INTRODUCTION
Since the beginning of 2000, the Instituto de Biomecánica (IBV) offers the application NedDiscapacidad/IBV, which assesses, among other body systems, the disorders of the musculoskeletal system. For that purpose, it evaluates the range of motion of the joints, among other factors. The main objective of NedDiscapacidad/IBV is to make an assessment of the disability according to the scales set out in Annex I of Royal Decree 1971/1999 by using strict protocols in order to obtain the degree of disability.
With the aim of providing a more versatile solution for those professionals dealing with health care, leave reinstatement, bodily harm prevention or assessment, the IBV has developed the new NedRangos/IBV application.
NedRangos/IBV allows you to assess the range of movement apart from disability, focusing on a more overall assessment, which improves the results and makes them more flexible.
NedRangos/IBV records the ranges of both active mobility and passive mobility, obtaining assessments of the ranges of one side versus the opposite side, assessments of active ranges versus passive ranges, and of active ranges versus the reference values from the Practical Guide to Range of Motion Assessment published by the American Medical Association (AMA).
The NedRangos/IBV application uses the NedSGE/IBV electronic goniometry system as a recording tool for the upper and lower limbs, and uses an electronic NedMCV/IBV double inclinometer to record the mobility of the spine. The application can also be used with alternative manual equipment.
DESCRIPTION
The NedRangos/IBV application is executed from the Laboratory of Biomechanical Assessment and provides a centralized management of patients and assessment sessions. This management software also allows the user to store additional information about both patients and sessions (images, reports, ...).
The assessment screen of NedRangos/IBV allows you to access a body area by using a simple tab system (Figure 1):
♦ Summary, which shows a summary of the assessments performed.
♦ Upper limb, which contains tabs to assess the shoulder, elbow, wrist and fingers.
♦ Lower limb, which contains tabs to assess the hip, knee, ankle and fingers.
♦ Spine, which includes three tabs to assess the cervical, dorsal and lumbar spine.
Figure 1. NedRangos/IBV main screen
Each assessment tab contains a data table with the results and the graphs associated with them; Figure 2 shows an example of the assessment tab for the active mobility of the shoulder. Each tab allows you to toggle the display of the active and passive mobility (by clicking the View Passive button), and to access the assessment (by clicking the Assess button).
In addition, NedRangos/IBV offers the following results both numerically and graphically for each movement assessed (Figure 2):
Maximum range: Maximum angle measured in degrees for the active movement of the specified side.
LM versus contralateral: Percentage of loss of active mobility in the specified side versus the opposite side.
LM versus AMA reference: Percentage of loss of active mobility in the specified side versus the reference values of the AMA guides.
Passive maximum range: Maximum angle measured in degrees for the passive movement of the specified side.
Passive LM versus contralateral: Percentage of loss of passive mobility in the specified side versus the opposite side.
Active LM versus passive: Percentage of loss of active mobility versus passive mobility of the specified side.
Figure 2. Shoulder assessment tab
The NedRangos/IBV application helps the evaluator to record data by means of user-friendly screens (Figures 3 and 4) that include graphical help to monitor the protocols offered by the application, based on the AMA guidelines, and allow you to use and record alternative protocols.
Figure 3. Screen to record the shoulder range of motion
Figure 4. Screen to record the range of motion of the cervical spine
NedRangos/IBV allows you to generate custom reports for the joints assessed by selecting the results you want to display versus reference values, versus the contralateral limb, passive mobility and attachments. These reports can be stored in both PDF and Word format.
CONCLUSIONS
NedRangos/IBV allows you to easily assess the range of motion of any joint or body area and provides the following options:
- To use protocols based on the AMA guidelines or alternative protocols.
- To compare the loss of mobility of one side versus the other side (except for the spine) for both active and passive mobility.
- To compare the loss of active mobility versus reference values of the AMA guidelines.
- To compare the loss of active mobility versus passive mobility.
- Generate custom reports in PDF and Word format.
The NedRangos/IBV application has proved to be very useful for the members of the IBV User Community, that is, mutual insurance companies that collaborate with the Social Security, hospital services with rehabilitation and physiotherapy units, and any professionals specialized in Bodily Harm Assessment.
