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Prediction of Childhood Pulmonary Function Using Ulna Length

Department of Respiratory Medicine, Royal Children's Hospital, Parkville, Victoria; and Department of Paediatrics, University of Melbourne, Melbourne, Australia

Correspondence and requests for reprints should be addressed to Leanne M. Gauld, M.B.B.S., F.R.A.C.P., Respiratory Laboratory, Sydney Children's Hospital, High Street, Randwick, New South Wales 2031, Australia. E-mail: lmgabk{at}hotmail.com

Pulmonary function is important in neuromuscular weakness. In children, height determines normal values. Height measurement is unreliable when neuromuscular weakness or spinal deformity is present. The aim of this study was to accurately predict pulmonary function from a limb segment measurement that is precise and reproducible. Normal males (n = 1,144) and females (n = 1,199), 5.3 to 19.6 years old, were recruited from Melbourne schools. Height, weight, ulna, forearm, tibia, and lower leg lengths were measured using a Harpenden stadiometer and calipers, and electronic scales. Three maximal expiratory maneuvers were performed. Limb measurements were highly reproducible. Linear regression on log-transformed FEV₁ and FVC was used to develop prediction equations from limb measurements and age. In males FEV₁ = exp (0.071 x U + 0.046 x A - 1.269), r² = 0.86; FVC = exp (0.77 x U + 0.041 x A - 1.285), r² = 0.86 and in females FEV₁ = exp (0.072 x U + 0.041 x A - 1.272), r² = 0.84; FVC = exp (0.078 x U + 0.037 x A - 1.315), r² = 0.83 (U refers to ulna length and A refers to age). Precision is similar to equations using height. Ulna measurement is accessible in wheelchair-bound children. Using ulna length to predict pulmonary function should facilitate respiratory assessment in children whose height is difficult to measure.

Key Words: pediatrics • anthropometry • respiratory function tests • neuromuscular diseases • scoliosis

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