Estimating Standing Height in Pediatric Patients with Neuromuscular Disease


Clinical Management

Poster Number: T381


Kayleen Whitley, MS, RD, LD, Texas Children's Hospital, Harold Farber, MD, MSPH, Baylor College of Medicine, Elizabeth Spoede, MS, RD, CSP, LD, Texas Children's Hospital, Glenn Moore, CPFT, Texas Children's Hospital

Background: An accurate height is important for assessing a pediatric patient’s growth, pulmonary function tests, body mass index, and overall health status. However, if a patient cannot stand and extend to full length, it can be challenging to obtain an accurate standing height measurement. Moreover, patients with neuromuscular diseases may have different body proportions, which could alter their height measurements. Knee-heel, arm span, ulnar length, and tibial length are methods for estimating height in an otherwise healthy population but have not been validated for patients with neuromuscular disease.
Objective: This study aims to determine how ulnar length, tibial length, arm span, and knee-heel length are related to standing height for children with neuromuscular disease who can stand.
Methods: Children and adolescents with neuromuscular disease (ages 3-17 years old) seen at Texas Children’s Hospital pulmonary function laboratory or nutrition visits were recruited for participation. Participants were consented and enrolled in the study. A brief survey was completed, including patients’ age, sex, ethnicity, and neuromuscular diagnosis. Anthropometric measurements were obtained, including knee-heel, ulnar length, tibial length, standing height, and arm span. Models built via multivariate regression with backward elimination with criteria to eliminate as p> 0.20.
Results: Enrollment included 24 patients with neuromuscular disease with all anthropometric measurements obtained. The sample had a mean age of 11.2 (SD 3.12). Fifteen patients were Latino, 3 African American, 4 Caucasian/White, and 2 other. Age, ethnicity, and knee-heel measures did not contribute significantly to the model. The best models for standing height included arm span, ulnar length, and tibial length. The model yielded an adjusted R square of 0.96.
Conclusions: Results show that models using arm span, ulnar length, and tibial length provide best height estimation for pediatric patients with neuromuscular disease.