THE TEAM
"Are brilliant research results being left unused? We ensure that these results can be applied so that health may be promoted. "
Cesare Mannhart, Head of Business Development, Idiag AG
Curiosity is our motivation
Idiag sees itself as a bridge builder between research centers and the market. Out of the heart of Europe, Switzerland, untapped potential is being evaluated and developed step by step to commercial maturity - always in close cooperation with leading universities such as ETH Zurich, Switzerland.
"Ambitious goals can only be
achieved with top people at
all levels."
Kurt Glaus, CEO Idiag AG
Diversity is our strength
The Idiag team, which consists of different specialists, develops medical products from scientific ideas with great potential - always with the aim of promoting people's health, performance and overall quality of life.
"Customer support is like jogging. A performance that requires enthusiasm! "
Reto Glaus, Head of Production and Logistics, Idiag AG
Health and exercise is our passion
Idiag's business goals are in line with the lifestyle of the Idiag team that works for them. Active amateur athletes are represented as well as nutrition-conscious gourmets.
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THE EMPLOYEES
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Kurt Glaus
CEO
Andri Feldmann
Product Management
Cees Roording
Sales
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Cesare Mannhart
Head of Business Development
How does the Idiag M360® detect each vertebral body?
The Idiag M360® does not detect the underlying segment when it is simply held against a random segment. If recording is started at an incorrect position (too high or too low) it is not possible for the equipment to correct the error. Therefore it is essential that the examination is carried out correctly (the correct starting and stopping points are fundamental to achieving accuracy). Important: The vertebrae are not actually detected; a recursive calculation is carried out. However, data comparisons with X-ray analysis demonstrated good reliability and validity (see Seichert 1999). The detailed assessment principle is part of our industrial secret.
The Idiag M360® does not detect the underlying segment when it is simply held against a random segment. If recording is started at an incorrect position (too high or too low) it is not possible for the equipment to correct the error. Therefore it is essential that the examination is carried out correctly (the correct starting and stopping points are fundamental to achieving accuracy). Important: The vertebrae are not actually detected; a recursive calculation is carried out. However, data comparisons with X-ray analysis demonstrated good reliability and validity (see Seichert 1999). The detailed assessment principle is part of our industrial secret.
PRACTICE - HANDLING
How to ensure both C7 and S3 are palpated? Additional anatomical points of reference?
To make sure that the position of C7 is correctly palpated, the examiner should ask the subject to extend the head. The examiner keeps his right forefinger on C7 and his ring finger on C6. If C7 is correctly determined, then C7 won’t be, but C6 will disappear during maximal extension of the head. S3 can be palpated; however this is somewhat difficult and not always possible. This is why recording must be stopped at the beginning of the buttock cleft.
To make sure that the position of C7 is correctly palpated, the examiner should ask the subject to extend the head. The examiner keeps his right forefinger on C7 and his ring finger on C6. If C7 is correctly determined, then C7 won’t be, but C6 will disappear during maximal extension of the head. S3 can be palpated; however this is somewhat difficult and not always possible. This is why recording must be stopped at the beginning of the buttock cleft.
Should I push very hard on the Idiag M360 ®? Does the pressure affect the result?
The pressure does affect the result. Do not push too hard, but pay attention to keeping both wheels in full, close-fitting and uniform contact with the spinous processes.
The pressure does affect the result. Do not push too hard, but pay attention to keeping both wheels in full, close-fitting and uniform contact with the spinous processes.
Are the markers on the skin just used for demonstration and are not necessary during the actual test?
The markers on the skin are necessary to ensure the correct start and end points are used while recording. They assure the same length is used for all recordings.
The markers on the skin are necessary to ensure the correct start and end points are used while recording. They assure the same length is used for all recordings.
How can I clean the markers off the client’s skin – taking sensitive skin into consideration?
If you use eyeliner (cosmetic kohl: the pencil women use for eye makeup) to make the marks, removing them it is easy and skin-friendly. Just wipe them away with your hands or use a little makeup remover.
If you use eyeliner (cosmetic kohl: the pencil women use for eye makeup) to make the marks, removing them it is easy and skin-friendly. Just wipe them away with your hands or use a little makeup remover.
Must the orange mark and the incision on the housing be lined-up during the test?
No, that indicates the starting position to ensure the neutral position of the green rocker without contacting the outer housing and thus limiting range of motion and flexibility.
No, that indicates the starting position to ensure the neutral position of the green rocker without contacting the outer housing and thus limiting range of motion and flexibility.
Does the fluency with which the Idiag M360 ® is run along the spine affect the result?
In 2004 Mannion et al. found systematic errors due to the varying speed of the rolling motion of the device. Since then the Idiag M360® has undergone improvements in respect of its recording velocity. This should no longer be a problem. If an examiner records too fast or if the movement is irregular, the equipment detects this and a dialogue pops up with information on what to do. The most important issue is to maintain the same pace you start with during the whole process of recording the spine from C7 to S3. The conditions for achieving accurate recordings are:- Exact identification of landmarks as starting and stopping points (this was a problem that arose, but was recognised in Mannion’s study in 2004)- Slow and constant speed - Both wheels of the Idiag M360® need to stay in contact with the skin at all times- Apply a constant, very light pressure
In 2004 Mannion et al. found systematic errors due to the varying speed of the rolling motion of the device. Since then the Idiag M360® has undergone improvements in respect of its recording velocity. This should no longer be a problem. If an examiner records too fast or if the movement is irregular, the equipment detects this and a dialogue pops up with information on what to do. The most important issue is to maintain the same pace you start with during the whole process of recording the spine from C7 to S3. The conditions for achieving accurate recordings are:- Exact identification of landmarks as starting and stopping points (this was a problem that arose, but was recognised in Mannion’s study in 2004)- Slow and constant speed - Both wheels of the Idiag M360® need to stay in contact with the skin at all times- Apply a constant, very light pressure
How can I clean the Idiag M360 ® after contact with a patient’s skin during the assessment?
The fastest and easiest way to clean the wheels of the Idiag M360® is to roll it over a disinfection pad. Please consider the following when choosing a detergent: - Use only water and soap when cleaning the plastic surfaces- Detergents that contain certain ingredients (e.g. alcohol) will tarnish the material or make it brittle- DO NOT use corrosive or abrasive detergents, sponges or clothsDo the following when cleaning:- Be sure the Idiag M360® “power” is OFF- Make sure NO liquids run into the Idiag M360®, this can cause corrosion or internal damage- Use a lint free cloth moistened only with soap and water- The docking station should be cleaned after each 50 uses, but at least once a month - The Idiag M360® should be cleaned frequently and as required- Clean both wheels of the Idiag M360® after each 50 uses, but at least once every two months: 1. Pull the small wheel carefully from its attachment. 2. Clean the small wheel, the axle and the attachment. 3. Press the small wheel carefully into the attachment until it latches. 4. Be sure the small wheel can move freely.
The fastest and easiest way to clean the wheels of the Idiag M360® is to roll it over a disinfection pad. Please consider the following when choosing a detergent: - Use only water and soap when cleaning the plastic surfaces- Detergents that contain certain ingredients (e.g. alcohol) will tarnish the material or make it brittle- DO NOT use corrosive or abrasive detergents, sponges or clothsDo the following when cleaning:- Be sure the Idiag M360® “power” is OFF- Make sure NO liquids run into the Idiag M360®, this can cause corrosion or internal damage- Use a lint free cloth moistened only with soap and water- The docking station should be cleaned after each 50 uses, but at least once a month - The Idiag M360® should be cleaned frequently and as required- Clean both wheels of the Idiag M360® after each 50 uses, but at least once every two months: 1. Pull the small wheel carefully from its attachment. 2. Clean the small wheel, the axle and the attachment. 3. Press the small wheel carefully into the attachment until it latches. 4. Be sure the small wheel can move freely.
How can I disinfect the Idiag M360®?
We recommend that you disinfect the Idiag M360® before and after every patient examination, thus preventing cross-contamination between patients. Clean using a dry or slightly damp cloth. To minimise the risk of explosion, disinfection should be performed according to the rules and guidelines below. We strongly recommend that you use detergents which feature in the list of tested and approved disinfection agents and procedures from the Robert Koch Institute’s department of chemo-thermal disinfection procedures. A disinfectant should be used to clean the Idiag M360®, its surfaces and equipment. The Idiag M360® wheels and the patient’s back should be disinfected before commencing the test.- Switch the device “OFF” before disinfecting- The Idiag M360® and docking station may only be disinfected by wiping them- The use of sprays is not recommended because disinfectants could enter the interior of the device- Never use corrosive or abrasive disinfectants - Never use disinfectants containing high-strength alcohols - Do not use Toluol based resolvents - Never sterilize or expose the Idiag M360® or the docking station to high temperatures - Never expose the Idiag M360® or docking station to any disinfectants that contain alcohol for longer than 5 minutes- DO NOT wash or submerse the Idiag M360® or docking station in any liquids or disinfectants- Use a lint free cloth moistened only with disinfectant- Use a disinfectant specifically suited for plastics or synthetics
We recommend that you disinfect the Idiag M360® before and after every patient examination, thus preventing cross-contamination between patients. Clean using a dry or slightly damp cloth. To minimise the risk of explosion, disinfection should be performed according to the rules and guidelines below. We strongly recommend that you use detergents which feature in the list of tested and approved disinfection agents and procedures from the Robert Koch Institute’s department of chemo-thermal disinfection procedures. A disinfectant should be used to clean the Idiag M360®, its surfaces and equipment. The Idiag M360® wheels and the patient’s back should be disinfected before commencing the test.- Switch the device “OFF” before disinfecting- The Idiag M360® and docking station may only be disinfected by wiping them- The use of sprays is not recommended because disinfectants could enter the interior of the device- Never use corrosive or abrasive disinfectants - Never use disinfectants containing high-strength alcohols - Do not use Toluol based resolvents - Never sterilize or expose the Idiag M360® or the docking station to high temperatures - Never expose the Idiag M360® or docking station to any disinfectants that contain alcohol for longer than 5 minutes- DO NOT wash or submerse the Idiag M360® or docking station in any liquids or disinfectants- Use a lint free cloth moistened only with disinfectant- Use a disinfectant specifically suited for plastics or synthetics
PRACTICE – TESTING
When would you assess the spinal posture paravertebrally?
Some published studies assessed the spine paravertebrally, others only if the subjects were slim and had very prominent spinous processes. We only recommend paravertebral examination in cases where proper recording is not possible because of very prominent spinous processes. Otherwise vertebral examination is advisable.
Some published studies assessed the spine paravertebrally, others only if the subjects were slim and had very prominent spinous processes. We only recommend paravertebral examination in cases where proper recording is not possible because of very prominent spinous processes. Otherwise vertebral examination is advisable.
Do the markers on the spinal processes move away when the patient flexes laterally?
By using the same marker you can detect the difference in relation to the upright position since the skin will move with the vertebrae. Another possibility is to always use the spinal processes, but as these rotate in the horizontal plane as well, they are not easy (and sometimes not possible at all) to detect.
By using the same marker you can detect the difference in relation to the upright position since the skin will move with the vertebrae. Another possibility is to always use the spinal processes, but as these rotate in the horizontal plane as well, they are not easy (and sometimes not possible at all) to detect.
How can I instruct a patient in a seated position?
The patient should be sitting on a stool without a backrest, with his arms hanging freely at the sides of his body and he should be looking straight ahead. From our perspective there is no recommendation for the angle formed by the thigh and hip. In order to generate comparable data, try to instruct patients to always adopt the same position. This is basically the key to reliability.
The patient should be sitting on a stool without a backrest, with his arms hanging freely at the sides of his body and he should be looking straight ahead. From our perspective there is no recommendation for the angle formed by the thigh and hip. In order to generate comparable data, try to instruct patients to always adopt the same position. This is basically the key to reliability.
What is the Matthiass Test for?
Postural competence can be examined using a method modelled on the Matthiass Test. During this test, a defined stress is used to provoke a change in the posture of the upper body that can be determined objectively from the Idiag M360® recording. The assessment of an abnormal posture involves the evaluation of the extent and location of the postural change in the standing position under stress by raising the arms for 30 seconds. By raising the arms, the centre of gravity of the body is displaced backwards. If the back muscles are weak then this is usually compensated by the backward bending of the upper body axis. The shoulder girdle is displaced backwards, the hips move forward and the lumbolordosis becomes more pronounced.
Postural competence can be examined using a method modelled on the Matthiass Test. During this test, a defined stress is used to provoke a change in the posture of the upper body that can be determined objectively from the Idiag M360® recording. The assessment of an abnormal posture involves the evaluation of the extent and location of the postural change in the standing position under stress by raising the arms for 30 seconds. By raising the arms, the centre of gravity of the body is displaced backwards. If the back muscles are weak then this is usually compensated by the backward bending of the upper body axis. The shoulder girdle is displaced backwards, the hips move forward and the lumbolordosis becomes more pronounced.
What is the Idiag Spine-check Score© for?
The Idiag Spine-check Score© is an overall evaluation of the different functions of the spine (posture, mobility, postural competence) and is assessed by evaluating different criteria (segmental angle differences, paradoxical angles, values out of reference range, segmental/global hyper or hypomobility). So if the score is low, e.g. in flexibility, this represents an overall finding and we do not know if it is caused by a hyper or hypomobile segment for instance – or something else. In order to find specific indicators you must look at the details in the data table or the vertebral graph.
The Idiag Spine-check Score© is an overall evaluation of the different functions of the spine (posture, mobility, postural competence) and is assessed by evaluating different criteria (segmental angle differences, paradoxical angles, values out of reference range, segmental/global hyper or hypomobility). So if the score is low, e.g. in flexibility, this represents an overall finding and we do not know if it is caused by a hyper or hypomobile segment for instance – or something else. In order to find specific indicators you must look at the details in the data table or the vertebral graph.
How can I detect axial rotation in scoliosis?
The Idiag M360® offers an option for providing indirect information about the axial rotation of the vertebral bodies. This is a limited assessment and does not correspond with a direct assessment of axial rotation.Patients bend forward until the most pronounced hump of the costal arch is reached. Two assessments in the sagittal plane are conducted in this position, at approx. 1-2cm left and right of the spine (see figure 1). A difference in the two assessments shows rotations within a certain region of the back, but cannot indicate axial rotations of a single vertebral body. The assessed rotation is a first indication in scoliosis, further examination for a clear diagnosis might be required.
The Idiag M360® offers an option for providing indirect information about the axial rotation of the vertebral bodies. This is a limited assessment and does not correspond with a direct assessment of axial rotation.Patients bend forward until the most pronounced hump of the costal arch is reached. Two assessments in the sagittal plane are conducted in this position, at approx. 1-2cm left and right of the spine (see figure 1). A difference in the two assessments shows rotations within a certain region of the back, but cannot indicate axial rotations of a single vertebral body. The assessed rotation is a first indication in scoliosis, further examination for a clear diagnosis might be required.
SPECIAL CIRCUMSTANCES
How to assess if the standard posture contradicts with a patient’s habitual posture?
The posture should not contradict with a patient’s habitual posture. See instruction:- Stand with the feet about hip-width apart- Feet are parallel- Distribute bodyweight evenly on both feet- Knees should be straight- The patient should adopt his habitual posture- The arms should be allowed to hang relaxed at the sides of the body- Look straight ahead (horizontally).
The posture should not contradict with a patient’s habitual posture. See instruction:- Stand with the feet about hip-width apart- Feet are parallel- Distribute bodyweight evenly on both feet- Knees should be straight- The patient should adopt his habitual posture- The arms should be allowed to hang relaxed at the sides of the body- Look straight ahead (horizontally).
What to consider when interpreting data of an overweight patient?
The contour line of the thoracic region of the spine in overweight patients is similar to that of normal weight patients. Overweight people are not categorically excluded, but the bias due to the soft tissue must be taken into account. The less additional adipose tissue is present, the more accurate the assessment will be. However, data recordings will still deliver accurate progress assessments – provided the person is not losing or gaining a lot of weight.
The contour line of the thoracic region of the spine in overweight patients is similar to that of normal weight patients. Overweight people are not categorically excluded, but the bias due to the soft tissue must be taken into account. The less additional adipose tissue is present, the more accurate the assessment will be. However, data recordings will still deliver accurate progress assessments – provided the person is not losing or gaining a lot of weight.
Are there age limitations?
Fundamentally, Idiag M360® recordings can be carried out on patients from the age of 6. It has not yet been tested on children below 6 years of age. This is why there are no reference values so far, but this doesn’t mean that the recording is invalid. Reference values are a guideline to allow interindividual comparisons. If there are no reference values you might still be able to make intraindividual comparisons and relative interindividual comparisons. The gap between 12 and 17 years is a tricky issue because it is well known that during this time, substantial morphological changes to vertebral dimensions occur in the spine. Actually, because the Idiag M360® System assumes constant vertebra dimensions, reference values for this age group are not as valid as those for patients aged below 12 and above 17. For the group between 12-17 years however, reference values for the age band 18-35 are shown. However, it based on practical experience, that these references values are interlinked with the age group of 12-17 years.
Fundamentally, Idiag M360® recordings can be carried out on patients from the age of 6. It has not yet been tested on children below 6 years of age. This is why there are no reference values so far, but this doesn’t mean that the recording is invalid. Reference values are a guideline to allow interindividual comparisons. If there are no reference values you might still be able to make intraindividual comparisons and relative interindividual comparisons. The gap between 12 and 17 years is a tricky issue because it is well known that during this time, substantial morphological changes to vertebral dimensions occur in the spine. Actually, because the Idiag M360® System assumes constant vertebra dimensions, reference values for this age group are not as valid as those for patients aged below 12 and above 17. For the group between 12-17 years however, reference values for the age band 18-35 are shown. However, it based on practical experience, that these references values are interlinked with the age group of 12-17 years.
DATA ANALYSIS
Analysis of the data and explanation of the figures (i.e. data table)
Sac/Hip J: Designates the “sacral angle”. This is defined as the angle between the superficial contour line via the sacrum in comparison to the plumb line. Because the connection of the sacrum to the pelvis via the sacroiliac joint is relatively immobile, the sacral angle is an assessment of the position of the pelvis in space (pelvis and sacrum move synchronously). Large positive sacral angles signify pelvic tilting, small positive or even negative sacral angles signify an upright position of the pelvis (pelvic tilting means ventral lowering of the pelvis, an upright pelvis signifies the opposite movement). The change in the sacral angle in the last three columns corresponds to the associated movement in the hip joints.
Thoracic spine: Represents the posture or mobility of the entire dorsal spinal column from Th1 to Th12. Positive angles signify kyphotic posture or flexion, negative angles lordotic posture or extension. The value corresponds to the sum of the 11 segmental angles from Th1/2 to Th11/12. The software adds up the raw data which can result in a minimal difference between the manually calculated sum and the automatically generated sum.
Lumbar spine: Represents the posture or mobility of the entire lumbar spinal column from Th12/L1 to L5/S1. It starts at Th12/L5 because this angle has a generally high mobility. Positive angles signify kyphotic posture or flexion, negative angles lordotic shape or extension. The value corresponds to the sum of the 6 segmental angles from Th12/L1 to L5/S1. The software adds up the raw data which can result in a minimal difference between the manually calculated sum and the automatically generated sum.
Incl.: The connection between Th1 and S1 is referred to as the line of inclination. The angle between this line of inclination and the plumb line is called the angle of inclination or for short, inclination. This has a very graphic meaning; in a “military-upright posture” one is “in the plumb line”. That means that a plumb line dropped from Th1 bisects the trochanter major and runs through the middle of the supporting area of the feet. In this case the inclination is zero degrees. In the usual posture, healthy volunteers often stand bent somewhat forward, so that the inclination is between 5° and 10°. A negative inclination signifies a total bending backwards or a reclination.
Sac/Hip J: Designates the “sacral angle”. This is defined as the angle between the superficial contour line via the sacrum in comparison to the plumb line. Because the connection of the sacrum to the pelvis via the sacroiliac joint is relatively immobile, the sacral angle is an assessment of the position of the pelvis in space (pelvis and sacrum move synchronously). Large positive sacral angles signify pelvic tilting, small positive or even negative sacral angles signify an upright position of the pelvis (pelvic tilting means ventral lowering of the pelvis, an upright pelvis signifies the opposite movement). The change in the sacral angle in the last three columns corresponds to the associated movement in the hip joints.
Thoracic spine: Represents the posture or mobility of the entire dorsal spinal column from Th1 to Th12. Positive angles signify kyphotic posture or flexion, negative angles lordotic posture or extension. The value corresponds to the sum of the 11 segmental angles from Th1/2 to Th11/12. The software adds up the raw data which can result in a minimal difference between the manually calculated sum and the automatically generated sum.
Lumbar spine: Represents the posture or mobility of the entire lumbar spinal column from Th12/L1 to L5/S1. It starts at Th12/L5 because this angle has a generally high mobility. Positive angles signify kyphotic posture or flexion, negative angles lordotic shape or extension. The value corresponds to the sum of the 6 segmental angles from Th12/L1 to L5/S1. The software adds up the raw data which can result in a minimal difference between the manually calculated sum and the automatically generated sum.
Incl.: The connection between Th1 and S1 is referred to as the line of inclination. The angle between this line of inclination and the plumb line is called the angle of inclination or for short, inclination. This has a very graphic meaning; in a “military-upright posture” one is “in the plumb line”. That means that a plumb line dropped from Th1 bisects the trochanter major and runs through the middle of the supporting area of the feet. In this case the inclination is zero degrees. In the usual posture, healthy volunteers often stand bent somewhat forward, so that the inclination is between 5° and 10°. A negative inclination signifies a total bending backwards or a reclination.
What are the reference zones related to?
The reference ranges for patients were provided through standardized assessments on healthy persons without back problems. Reference ranges are matched to gender and age categories. The reference ranges can be defined in the software as 1 or 2 standard deviations from the arithmetical mean of the study population.
The reference ranges for patients were provided through standardized assessments on healthy persons without back problems. Reference ranges are matched to gender and age categories. The reference ranges can be defined in the software as 1 or 2 standard deviations from the arithmetical mean of the study population.
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Why use angles of >7° or <1° for investigations with the Idiag M360®?
First of all, let us clarify an important but often misunderstood term: A motional or functional segment consists of two adjacent vertebrae with the corresponding intervertebral disk. The angle between the two vertebrae is usually termed the segmental angle.The respective software tool is designed to mark jumps in segmental angles from one segment to the other of more than 7°. If you look at the reference values there is a mean standard deviation, depending on the segment, of approximately 2-6°. This is therefore deemed the “normal” variability. The values based on practical experience showed that this statistically “normal” variability and therefore the deviations of angles >7° and <1° are appropriate for practical application. Therefore jumps from one segment to the other that are greater than this variability (e.g. 7°) may be an indication of e.g. hypermobility.
The 1° tool is empirically determined too. If within a segment (between one vertebra and the adjacent vertebra), there is an angle equal or smaller than 1°, then it is marked. This may be an indication of hypomobility of the respective segment.
Important: The Idiag M360® data must be used solely as a guideline towards achieving a correct diagnosis. As for all other clinical instruments, the Idiag M360® must not be used blindly in the sense of an "expert system", where deviations from the reference values are uncritically interpreted as signs of pathology. In an individual case, only the complete clinical information available, together with the physician's individual experience, is capable of allowing a reliable clinical assessment to be made. Neither the technical device nor the software is able to interpret the results – only an expert can be responsible and capable of making the most reliable interpretation of the data.
First of all, let us clarify an important but often misunderstood term: A motional or functional segment consists of two adjacent vertebrae with the corresponding intervertebral disk. The angle between the two vertebrae is usually termed the segmental angle.The respective software tool is designed to mark jumps in segmental angles from one segment to the other of more than 7°. If you look at the reference values there is a mean standard deviation, depending on the segment, of approximately 2-6°. This is therefore deemed the “normal” variability. The values based on practical experience showed that this statistically “normal” variability and therefore the deviations of angles >7° and <1° are appropriate for practical application. Therefore jumps from one segment to the other that are greater than this variability (e.g. 7°) may be an indication of e.g. hypermobility.
The 1° tool is empirically determined too. If within a segment (between one vertebra and the adjacent vertebra), there is an angle equal or smaller than 1°, then it is marked. This may be an indication of hypomobility of the respective segment.
Important: The Idiag M360® data must be used solely as a guideline towards achieving a correct diagnosis. As for all other clinical instruments, the Idiag M360® must not be used blindly in the sense of an "expert system", where deviations from the reference values are uncritically interpreted as signs of pathology. In an individual case, only the complete clinical information available, together with the physician's individual experience, is capable of allowing a reliable clinical assessment to be made. Neither the technical device nor the software is able to interpret the results – only an expert can be responsible and capable of making the most reliable interpretation of the data.
In the Matthiass Test, why 30 seconds?
The Matthiass Test functions similarly to a standardized test for postural competence. For more details see:http://www.ncbi.nlm.nih.gov/pubmed/7610701 Predictive value of Matthiass' arm-raising test. A. Klee. Article in German
The Matthiass Test functions similarly to a standardized test for postural competence. For more details see:http://www.ncbi.nlm.nih.gov/pubmed/7610701 Predictive value of Matthiass' arm-raising test. A. Klee. Article in German
What do signs like ")" or "(" mean in viewing results of frontal assessments?
The single brackets indicate whether there is a segmental inclination to the left “)” or to the right “(“. ) = convex to the right( = convex to the leftThis is similar to the sagittal plane where you have an inclination forwards and backwards. The arrows in the range of motion column (3 columns on the right hand side) indicate whether there is a net angular change to the right “►” or to the left “◄”.
The single brackets indicate whether there is a segmental inclination to the left “)” or to the right “(“. ) = convex to the right( = convex to the leftThis is similar to the sagittal plane where you have an inclination forwards and backwards. The arrows in the range of motion column (3 columns on the right hand side) indicate whether there is a net angular change to the right “►” or to the left “◄”.
What is the acceptable range of error if I test the same patient several times consecutively?
Acceptable errors for segmental angles are <4° and for the length <20mm (in the data table). Errors can be minimised by giving the patient detailed and precise instructions and by exactly marking the start and end points for recording.
Acceptable errors for segmental angles are <4° and for the length <20mm (in the data table). Errors can be minimised by giving the patient detailed and precise instructions and by exactly marking the start and end points for recording.
What does it mean if the value of the angle between the sacrum and the hip is out of range (less than min or more than max) in the upright position?
The Sac/Hip value represents the angle between the sacrum and the plumb line. If it is less than min (more versus 0) there is a tendency towards hypolordosis. If the angle is more than max there is a tendency towards hyperlordosis (hollow-back).
The Sac/Hip value represents the angle between the sacrum and the plumb line. If it is less than min (more versus 0) there is a tendency towards hypolordosis. If the angle is more than max there is a tendency towards hyperlordosis (hollow-back).
Can the thoracic or lumbar spine (in the expert report of the Spine-check Score©) be hypomobile when some segments are hypermobile (red)?
The expert report of the thoracic or lumbar spine corresponds to the REGIONAL analysis. The thoracic or lumbar mobility (thoracic/lumbar spine) might have a range of motion which indicates hypomobility (reference is between 50°-74°). In the same recording the red segments in the table may show an uneven distribution of range of motion between the segments. This is segmental hypermobility which is also indicated in the expert report LOCAL.
The expert report of the thoracic or lumbar spine corresponds to the REGIONAL analysis. The thoracic or lumbar mobility (thoracic/lumbar spine) might have a range of motion which indicates hypomobility (reference is between 50°-74°). In the same recording the red segments in the table may show an uneven distribution of range of motion between the segments. This is segmental hypermobility which is also indicated in the expert report LOCAL.
Is there a standardised approach for assessing one test position?
Several different approaches are possible. Multiple flexions or extensions during multiple assessments form a kind of warm-up and thus possibly enhance range of motion throughout the assessments. It is therefore recommended that sufficient warm-up time is allowed (e.g. 1-2 flexion-extension movements) before the assessment commences. Following warm-up, two assessments per position are recommended. To check the quality, compare the two assessments in the comparison mode (optimally, there should be angular differences of less than 4° and the length should differ by less than 20 mm).
Several different approaches are possible. Multiple flexions or extensions during multiple assessments form a kind of warm-up and thus possibly enhance range of motion throughout the assessments. It is therefore recommended that sufficient warm-up time is allowed (e.g. 1-2 flexion-extension movements) before the assessment commences. Following warm-up, two assessments per position are recommended. To check the quality, compare the two assessments in the comparison mode (optimally, there should be angular differences of less than 4° and the length should differ by less than 20 mm).
Are there any special requirements for an interval period between two tests on the same person?
No. Good opportunities are at the end of intervention periods and after a period where you believe you may be able to detect a change. Do not discourage your patient by making recordings at intervals that are too short, where he/she may not see any result from his/her efforts.
No. Good opportunities are at the end of intervention periods and after a period where you believe you may be able to detect a change. Do not discourage your patient by making recordings at intervals that are too short, where he/she may not see any result from his/her efforts.
What is the degree of data comparability if participants are tested at different times of day?
A slight diurnal change in spinal column posture and mobility is indeed possible, but this may vary from person to person. Therefore, for scientific purposes, we suggest that the assessments are undertaken at approximately the same time of day and that care is taken to ensure the conditions are equal. If this is not possible, then make sure that the subject adopts exactly the same positions and that the recording is made by the same investigator.
A slight diurnal change in spinal column posture and mobility is indeed possible, but this may vary from person to person. Therefore, for scientific purposes, we suggest that the assessments are undertaken at approximately the same time of day and that care is taken to ensure the conditions are equal. If this is not possible, then make sure that the subject adopts exactly the same positions and that the recording is made by the same investigator.
CLINICAL PRACTICE
How can I detect underlying pathologies?
The Idiag M360® is a device for obtaining fast, valid and reliable information about the position, mobility and postural competence (Matthiass Test) of the spine in a format that is easy to understand. It is possible to find indications for malfunctions and spinal pathologies. However, it is NOT possible to diagnose a medical condition with the Idiag M360® itself. This means that it is too delicate to diagnose e.g. osteoporosis. Taking an anamnesis together with the knowledge of a medical physician or clinician, e.g. physical therapist, osteopath, physiotherapist or chiropractor into account is advised.
The Idiag M360® is a device for obtaining fast, valid and reliable information about the position, mobility and postural competence (Matthiass Test) of the spine in a format that is easy to understand. It is possible to find indications for malfunctions and spinal pathologies. However, it is NOT possible to diagnose a medical condition with the Idiag M360® itself. This means that it is too delicate to diagnose e.g. osteoporosis. Taking an anamnesis together with the knowledge of a medical physician or clinician, e.g. physical therapist, osteopath, physiotherapist or chiropractor into account is advised.
Would an abnormally thick spinal disc or a spinal disc extrusion patient affect the accuracy?
If there is only one segment with an abnormally thick disc, the system cannot identify it because of the recording principle. You will see small deviations in this part of the spine. If all discs are abnormally thick, then the system will compensate for that with the predicted dimension of each vertebral body and accuracy will not be affected.
If there is only one segment with an abnormally thick disc, the system cannot identify it because of the recording principle. You will see small deviations in this part of the spine. If all discs are abnormally thick, then the system will compensate for that with the predicted dimension of each vertebral body and accuracy will not be affected.
EMPIRICAL VIEW & PROGRAM ISSUES
Is there relevant research which indicates the scientific and diagnostic value of an assessment?
There are a number of validation studies regarding the clinical usage of the Idiag M360®. These show that the Idiag M360® delivers consistently reliable values for standing curvatures and range of motion (Post, Leferink 2004; Mannion 2004). The reproducibility of assessments obtained with the Idiag M360® is comparable than that of X-ray evaluations in the inter-rater and intra-rater comparison (Schulz 1999).
There are a number of validation studies regarding the clinical usage of the Idiag M360®. These show that the Idiag M360® delivers consistently reliable values for standing curvatures and range of motion (Post, Leferink 2004; Mannion 2004). The reproducibility of assessments obtained with the Idiag M360® is comparable than that of X-ray evaluations in the inter-rater and intra-rater comparison (Schulz 1999).
How good is validity in the lumbar region?
Validity in the thoracic region is better than validity in the lumbar region. The overlying fat tissue in the lumbar region can produce a different reading compared to X-rays, but only if a lot of additional tissue is present. Since the Idiag M360® is primarily used for measuring the progress of treatment this does not interfere with the quality of progress assessments, provided the patient does not lose or gain a lot of weight.
Validity in the thoracic region is better than validity in the lumbar region. The overlying fat tissue in the lumbar region can produce a different reading compared to X-rays, but only if a lot of additional tissue is present. Since the Idiag M360® is primarily used for measuring the progress of treatment this does not interfere with the quality of progress assessments, provided the patient does not lose or gain a lot of weight.
Which file format is the most appropriate for backing-up my recorded data?
Open C:\MM60\Data. This directory contains the database Data60.MDB. Save the database file Data60.MDB on an external storage medium and rename the file to avoid confusion, e.g. Data60_02.08.2011.mbd.The file which you currently use with the software must be located in the folder C:\MM60\Data with the name Data60.mdb.If you want to use a backup version of your database with the software you must rename it back to Data60.mdb and replace it into the folder C:\MM60\Data.
Open C:\MM60\Data. This directory contains the database Data60.MDB. Save the database file Data60.MDB on an external storage medium and rename the file to avoid confusion, e.g. Data60_02.08.2011.mbd.The file which you currently use with the software must be located in the folder C:\MM60\Data with the name Data60.mdb.If you want to use a backup version of your database with the software you must rename it back to Data60.mdb and replace it into the folder C:\MM60\Data.
What is the procedure for deleting unwanted files (from “Select Client”)?
If you want to delete a specific recording or a specific client, mark the recording or client in the overview list and delete it by clicking the bin icon at the top of your menu (or F5 at the bottom).
If you want to delete a specific recording or a specific client, mark the recording or client in the overview list and delete it by clicking the bin icon at the top of your menu (or F5 at the bottom).