ARTICLE IN PRESS

Journal of Biomechanics 36 (2003) 13971400

Short communication

A laser-aligned method for anthropometry of hands

John Hightona,*, Peter Davidsonb, Valerie Markhama
a

Medicine Section, Medical and Surgical Science, Dunedin School of Medicine, P.O. Box 913, Dunedin, New Zealand b Injury Prevention Research Unit, University of Otago, New Zealand Accepted 25 March 2003

Abstract We have developed a laser-aligned measuring device to facilitate the measurement of linear hand dimensions. Our objective has been to make a simple, clinically applicable device for anthropometry of the hands in patients with arthritis in order to guage the progression of hand deformities. The system provides an alternative to the use of rules, tapes, photogrammetry and least-squares devices which have previously been applied to hand measurements. The system delivers results which are not signicantly different from those measured with rules and callipers and has a similar level of accuracy. The use of laser pointers for alignment facilitates measurements which necessitate picking the highest point of the hand. The device is portable and simple to use in the clinic. We have used it to measure hand dimensions in normal subjects and patients with arthritis. However, the system could equally well be used to facilitate measurement of other objects with an irregular surface prole. r 2003 Elsevier Ltd. All rights reserved.
Keywords: Laser; Measurement; Hand; Anthropometry; Arthritis

1. Introduction This paper describes a laser-aligned system for measuring hand dimensions. Lasers were used to facilitate measurement of lateral height of the hand which requires denition of the highest point. This can be highlighted with the laser light. The instrument could also be applied to measuring other irregular objects. Our interest in measuring hands has arisen from our aim to produce a simple, clinically applicable system to measure progressive hand deformities in patients with arthritis. The usual method for measuring joint damage is radiographs (Larsen et al., 1977; Sharp et al., 1985) or more recently MRI scanning (McQueen et al., 1998; Jorgensen et al., 1993; Ostergaard et al., 2001). Thus health care professionals currently rely upon high cost, technologically based assessment of joint damage despite the very visually obvious nature of arthritic hand deformities. We considered that it should be possible to demonstrate the progression of hand deformities by anthropometry. We initially used digitised images to measure 13 hand dimensions in patients including linear dimensions
*Corresponding author. Fax: +64-3-474-7641. E-mail address: john.highton@stonebow.otago.ac.nz (J. Highton). 0021-9290/03/$ - see front matter r 2003 Elsevier Ltd. All rights reserved. doi:10.1016/S0021-9290(03)00121-0

and areas. This required two steps: acquisition of the image and subsequent computer assisted measurement of the digitised image. We used the 3 most repeatable dimensions in an anatomic hand index (Highton et al., 1996). Since the selected hand dimensions were linear, we wanted a more direct way of measurement that did not require a second analysis step as for the digitised images. However, direct measurement of lateral height of the hand at the level of the metacarpo-phalangeal (mcp) joints, presented practical difculties. We found it difcult to discern the highest point of the hand with callipers and also in lateral images. This manuscript describes the laser-aligned measurement system we designed to facilitate lateral height measurements by clearly outlining the highest point with bright light. Our results present the laser-aligned measurement system as a practical alternative to previously described methods for measuring hand dimensions.

2. Methods 2.1. Subjects Subjects were 10 healthy volunteers without hand arthritis, ve women and ve men, aged 1961 years.

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The study was approved by the Otago Ethics Committee and all subjects gave informed consent. 2.2. Measurements The anatomic index used previously incorporates the open hand span, closed hand span and lateral height of the hand. These dimensions were therefore measured in the subjects dominant hand by both new and old methods. 2.3. Instruments Laser-aligned measurements. The laser-aligned instrument (Fig. 1) utilises two laser pointers attached to digital vernier callipers on a rigid frame and base 500 mm 400 mm. One laser is vertically oriented and used to measure hand-span. The laser pointer moves in a horizontal plane above the base and has two degrees of freedom of movement as constrained by two callipers at right angles. Measurement of hand span begins with positioning the pointer on the radial side of the hand so that the laser beam just makes contact with the distal phalanx of the thumb. The callipers digital scales are then set to zero and each calliper is moved until the laser is positioned on the outer edge of the fth digit. The calliper readings then represent the two shorter sides of a right-angled triangle. The hypotenuse representing the hand span can then be calculated. The second laser pointer is horizontally oriented and used to measure lateral height. The laser moves in a vertical plane and has two degrees of freedom as constrained by a single vertically oriented calliper sliding in a groove in the base. The measurement process starts with positioning the pointer so that the laser beam just skims the base surface which also veries that the laser is mounted parallel to the base plate. The digital scale is then zeroed and the calliper moved until the laser beam just contacts the highest point of the hand at the level of the mcp joints. Standard measurements. Open hand span and closed hand span were measured by marking the outer edges of the tip of the thumb and fth nger on a sheet of paper. The distance between the points was then measured with a ruler marked in mm. The paper was placed on the base plate of the laser-aligned apparatus to ensure that the hand did not have to be repositioned between the two measurements. To measure lateral height of the hand with callipers the hand had to be removed from the laser system onto a 25 mm thick base. Uncalibrated callipers were then opened wide and then progressively screwed shut so that the tips of the calliper spanned the base and the highest point of the hand previously used in the laser measurement. The distance between the ends of the calliper was then measured on the ruler and 25 mm

subtracted for the thickness of the base to give the lateral height of the hand. 2.4. Statistical methods Measurements made using the laser-aligned system and rules and callipers were compared using Students two-tailed T test.

3. Results The laser apparatus was easy to use in the clinic. Measurement of open hand span, closed hand span and lateral height of the hand could easily be completed within 5 min. The highest point of the hand at the mcp joints is easily dened by bringing the laser down until the beam just skims the surface at the highest point. The beam can then be moved to check that there are no higher points nearby. With callipers it is less easy to be sure that the highest point has been picked for measurement. Thus, the new system was quick and easy to apply and demonstrated advantages in facilitating the measurement of lateral height in particular. Ten measurements of the length and width of a rectangle and the height of a block with the laser system and vernier callipers gave comparable results. Length of rectangle, laser 7SD vs. calliper, 159.970.1 mm vs. 159.371.1 mm; width 79.770.15 mm vs. 79.870.15 mm; height 57.570.98 mm vs. 57.67 1.1 mm. There was no signicant difference between the measurements with Students T test: p 0:21; 0.99 and 0.35, respectively. Measurement of open hand span, closed hand span and lateral height of the hand also showed similar results using the two different systems. Open hand span, laser vs. ruler 193.1717.1 mm vs. 193.6716.5 mm; closed hand span 105.2713.7 mm vs. 105.6714.0 mm; lateral height 35.877.5 mm vs. 35.477.4 mm. There was no signicant difference between these values when compared with Students T test: p 0:95; 0.95 and 0.91, respectively.

4. Discussion We have developed a laser-aligned system for measurement of linear hand dimensions. Our objective has been to develop a clinically applicable method to measure the progression of hand deformities in patients with arthritis. The use of laser pointers facilitated denition of measurement points in hands. However, the principle would be equally applicable to the measurement of other irregular objects. A variety of methods have been used previously to measure hands. Measurements of the straightened at

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(a)

(b)
Fig. 1. The gures show the construction and layout of the laser-aligned measurement system. (a) The hand is positioned for measurement using the vertical bar as an aid to location of the hand in a standard position. It shows the two vernier scales and laser used to measure hand span. (b) Shows the vernier scale used to measure lateral height. To measure lateral height of the hand, the laser pointer would rst be zeroed with the laser just skimming the base plate and then raised so that the beam just intersected the highest point of the hand at the level of the metacarpo-phalangeal joints.

hand have been used to dene standard anthropometric dimensions. Typically studies used measuring boards, tapes and callipers (Garrett, 1971; Davies et al., 1980). We found it difcult to measure lateral height of the hand at the mcp joints using rules or callipers. A minimum square device used to dene the minimum space through which a hand would t (Courtney and Davies, 1979) could also be used for measuring the depth of the hand. Our device applies a similar principle but uses a moveable laser beam instead of a moveable rigid edge. Stereo photography has been applied to measurement of the hand (Ghosh and Poirier, 1987) and we used digitised images and computer measurement in

a previous study. This method has much to recommend it but needs a second step so that results are not immediately available which is a disadvantage in a clinic setting. We also experienced some difculty in discerning the highest point of the hand in lateral images. We have subsequently found that a laser pointer can easily be moved so it just touches the highest point of the hand. The use of the laser-aligned system therefore provides for simple direct measurements of hand dimensions with results which are immediately available. It provides an alternative to direct measurements using callipers or rulers and the least-squares device which have been used previously.

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In constructing our instrument we used standard laser pointers tted tightly into plastic mounts attached to digital callipers. Such laser pointers form quite a wide point of light and precision might be improved with a ner beam and rigid mounting. Despite this testing with blocks showed the difference between mean measurements made with the laser system and standard methods to be 0.10.2 mm, with standard deviations in the laser system of 1 mm or less. Similarly, differences of mean measurements of hand dimensions were 0.40.5 mm. The laser-aligned system therefore delivers measurements closely comparable to measurements made with rules and callipers and has acceptable accuracy. In conclusion, we have developed a laser-aligned apparatus, with acceptable accuracy, for measurement of hand dimensions. This is a portable and practical alternative to the use of rules and callipers or photography based systems. The use of laser pointers makes it easy to visually dene the highest point of the hand so that the instrument facilitates measurements such as lateral height. Although we have used the laser-aligned system for measuring hands it could as easily be used to facilitate measurement of other irregular objects.

References
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Acknowledgements This grant was supported by a grant from the Health Research Council of New Zealand. We wish to thank Dr. Peter Herbison for his statistical advice on the design and analysis of this study. Construction of the laserometer was by United Engineers Ltd. 23 Thomas Burns St. Dunedin, New Zealand, under the supervision of R. Somerville.