Exposing the Inclinometer

22 September 2014 / Uncategorized / Comments Off on Exposing the Inclinometer

Pronunciation: /ˌinkləˈnämitər

Besides being fun to say, an inclinometer is nothing more than a fancy level with a protractor on it. The AMA Guides 5th Edition tells us that an inclinometer used by  a physician “should be marked off in 2 degree increments or less..”(Page 400).

Inclinometers are utilized in medical impairment rating to determine angles of motion, particularly in measuring the spine.

Because the spine has motion at both the upper and lower segments it's necessary that 2 inclinometers be used simultaneously for recording dynamic motion. One inclinometer is placed at the upper part of the measured spine segment, and the other at the lower spine location. The measurement value of the lower spine is subtracted from the upper spine value. This results in what's known as the “true angle”.

Inclinometers are either manual and digital.

Digital inclinometers have been gaining some popularity because of ease of use and automatic calculation of the true angle. Digital inclinometers are two electronic gravity sensors which have ability to standardize a zero measuring reference with the click of a button. They are approximately the size of a pocket-watch and are typically connected by an electronic cord. One end is the measurement reading end (typically referred to as the “master”) placed at the top of the spine. The other device is placed at the lower segment of the spine section (typically referred to as the “slave”). The upside of the digital inclinometer is the ease of use during exam, and it automatically calculates the true angle. The downside is the device may not have an auto off feature.  This means it is easy to leave on, and may be found dead for the next exam. Additionally, digital inclinometers are expensive and can range into the hundreds of dollars.
The manual inclinometer, sometimes called a “bubble inclinometer” has a fluid filled face in a circle. The fluid is a combination of a colored fluid and a clear fluid. The fluid interface moves with gravity, and the movement of the interface is used to read the measurement off a rotating 360 degree face dial.

Measuring the motion of the spine with the manual inclinometer requires a bit of practiced talent. The patient is instructed to stand in the upright position and the dial faces are set to the 0 degree position. The user must then hold the two inclinometers at once on the spine while movement is measured. It sounds easy, but in practice for the first several exams, it is difficult. You also must coordinate the physical control of the inclinometer while performing the calculations and documenting the findings. Using the dual manual inclinometers for the first time can be like trying to catch a falling snake. Patience is a virtue and persistence is necessary to capture accurate and consistent measurements.  The upside of the manual inclinometer is that they are relatively inexpensive ($50 each on Amazon as of the writing of this article), and no batteries are necessary. The down side is they do take some practice and can be difficult to read due to the small print face. A good pair of reading glasses may be necessary.

Regardless of the style of inclinometer used, understanding the inclinometer and its function is essential for accurate and well supported impairment report (PR-4 Report) conclusions. The time invested in becoming familiar with the inclinometer will result in faster and more accurate report for patients, workers’ compensation insurance carriers, employers, and administrators.

Check out RateFast today and see how easy it is to create accurate, fast and correct PR-4 impairment reports.

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