# Become an Expert in Spirometry

## Arm span

Standing height may be affected by disease, such as in kyphosis and kyphoscoliosis. We often want to know the impact of the distortion and limited excursion of the chest wall on lung volumes. We must then compare the actual lung volumes to the ones predicted in a subject without deformity of the trunk. One can then substitute arm span (i.e. the largest distance across the middle fingers when the arms are stretched horizontally sideways) for standing height.

Children/adolescents: Height and armspan were measured in healthy 6-10 and 8-18 year old boys and girls to assess the appropriate correction factor to be applied when height cannot be measured easily. No correction factor was found necessary, height being directly estimated from armspan (Hibbert, Torres).

Adults: in males substitute arm span/1.03 for standing height in the regression equation, in women arm span/1.01.

Ethnic differences: The trunk in Negroid and Mongoloid people is shorter or longer, respectively, than in Caucasians; hence the relationship between arm span and standing height differs somewhat between ethnic groups. Aggarwal et al. found an arm-span/height ratio of 1.024 in North Indian subjects. Parker et al. found sex, age and race related differences, and recommend the following equation when there is racial and gender heterogeneity:

Height = 67.90 + 0.664182·Arm span- 2.816·Sex - 4.05·Race - 0.0709·Age, R²0.8659, RSD 3.772,
where Sex 1 = male, 2 = female, and Race 1=white, 2=black, height and arm span in cm, and age in yr.

For homogeneous populations the following equations are recommended by Parker et al.:

White males: Height = 68.74 + 0.63008·Arm span - 0.1019·Age, R² = 0.7219, RSD 4.122;
White females: Height = 33.14 + 0.79499·Arm span, R² = 0.7684, RSD 3.391;
Black males: Height = 60.13 + 0.0.65336·Arm span - 0.08399·Age, R² =0.8137, RSD = 3.044;
Black females: Height = 59.07 + 0.61442·Arm span, R² = 0.6113, RSD 3.693.

Example: white woman (standing height 1.48 m, arm span 1.78 m, age 65 year) with severe kyphoscoliosis.

 Predicted from Index Measured Height Arm span FEV1 (L) 0.84 1.75 2.95 IVC (L) 0.98 2.27 3.69 FEV1%IVC 86 77 77

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J Hum Nutr Diet 2003; 16: 13–20. 13 Iwatsuki H, Iwatsuki J. Relationship of the lung volume to height, arm span, upper arm length and the second digital proximal phalangeal length. J Phys Ther Sci 1999; 11: 101-104. 14 Jalzem PF, Gledhill RB. Predicting Height from arm measurement. J Pediatr Orthop 1993; 13: 761-65. 15 Lee TS, Chao T, Tang RB, Hsieh CC, Chen SJ, Ho LT. A longitudinal study of growth patterns in schoolchildren in one Taipei District. II: Sitting height, arm span, body mass index and skinfold thickness. J Chin Med Assoc 2005; 68: 16-20. 16 Leech JA, Dulberg C, Kellie S, Pattee L, Gay J. Relationship of lung function to severity of osteoporosis in women. Am Rev Respir Dis 1990; 141: 68–71. 17 Linderholm H, Lindgren U. Prediction of spirometric values in patients with scoliosis. Acta Orthop Scand 1978; 49: 469-474. 18 Mitchell CO, Lipschitz DA. Arm length measurement as an alternative to height in nutritional assessment of the elderly. J Parenter and Enteral Nutr 1982, 6: 226.. 19 Mohanty SP, Suresh Babu S, Sreekumaran Nair N. The use of arm span as a predictor of height: A study of South Indian women. J Orthop Surg 2001; 9: 19-23. 20 Parker JM, Dillard TA, Phillips YY. Arm span-height relationships in patients referred for spirometry. Am J Respir Crit Care Med 1996; 154: 533-536. 21 Reeves SL, Varakmin C, Henry CJ. The relationship between arm-span measurement and height with special reference to gender and ethnicity. Eur J Clin Nutr 1996; 50: 398-400. 22 Sathyavathi K, Agarwal KN, Rao NSN, Reddy PR. Arm-span and height measurement during adolescence. Ind Pediatr 1979, 14: 839–847. 23 Shahar S, Pooy NS. Predictive equations for estimation of stature in Malaysian elderly people. Asia Pac J Clin Nutr 2003; 12: 80-84. 24 Steele MF, Mattox PV. Correlation of arm-span and height, in young women of two races. Ann Hum Biol 1987; 14: 445-447. 25 Steele MF, Chenier TC. Arm-span, height, and age in black and white women. Ann Hum Biol 1990;17: 533-541. 26 Teramoto S, Matsuse T, Ouchi Y. Substitution of arm span for standing height is important for the assessment of predicted value of lung volumes in elderly people with osteoporosis. Chest 1999; 116: 1837-1838. 27 Ter Goon D, Toriola AL, Musa DI, Akusu S. The relationship between arm span and stature in Nigerian adults. Kinesiology 2001; 43: 38-43. 28 Torres LAGMM, Martinez FE, Manco JN. Correlation between standing height, sitting height, and arm span as an index of pulmonary function in 6–10-Year-Old children. Pediatric Pulmonology 2003; 36: 202–208. 29 Yabanci N, Kiliç S, Simsek I. The relationship between height and arm span, mid-upper arm and waist circumferences in children. Ann Hum Biol 2010;37: 70-55.. 30 Yun DI, Yun DK, Chang YY, Lim SW, Lee MK, Kim SY. Correlations among height, leg length and arm span in growing Korean children. Ann Hum Biol 1995; 22: 443-458. 31 Zverev Y, Chisi J. Estimating height from arm span measurement in Malawian children. Coll. Antropol 2005; 29: 469–473. Example modified from: Longfunctie-onderzoek. Technieken, toepassingen, interpretaties (p. 19, table 3). Ed. M. Demedts and M. Decramer. Garant, Leuven/Apeldoorn, 1998. ISBN 90-5350-630-6. Further references.
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