These are only guidelines and in most cases these landmarks will work without any problems. However, there are clients who do have anomalies from birth or from injury that may make landmarking in this way difficult. In these cases, document any known anomaly discovered in the process of landmarking so that it may be duplicated for accurate comparison. Cervical Range of Motion Flexion With the client in a seated position, manually landmark the T1 spinous process using a washable marker.
Extension With the client in a seated position, manually landmark the T1 spinous process using a washable marker. Align the sensors in the sagittal plane and place one of the Inclinometers laterally on the T1 spinous process. Place the other over the calvarium. Take the initial reading. Have the client maximally extend the head. Take the final reading. Return the client to a neutral position and repeat these steps two more times.
Rotation Only with cervical rotation do you use a single Inclinometer. Have the client lie in a supine position (this will stabilize the client's shoulders). The shoulders should be exposed, to allow the evaluator to note excessive shoulder rotation. Align the sensor in the transverse plane and place the Inclinometer at the superior portion of the head. Take the initial reading. Have the client maximally rotate their head to one side. Take the final reading. Return the client to a neutral position.
Flexion With the client in a seated or standing position, manually landmark the T1 and T12 spinous processes using a washable marker. Align the sensors in the sagittal plane and place one of the Inclinometers on the T1 spinous process. Place the other at the T12 Spinous Process. Take the initial reading. Have the client maximally flex the thoracic spine. Take the final reading. Return the client to a neutral position and repeat these steps two more times.
Lumbosacral Range of Motion Flexion With the client in a standing position, manually landmark the T12 spinous process using a washable marker. Align the sensors in the sagittal plane and place one of the Inclinometers on the T12 spinous process. Place the other at S1 spinous process. Take the initial reading. Have the client maximally flex the lumbar spine. Take the final reading. Return the client to a neutral position and repeat these steps two more times.
extend the lumbar spine. Take the final reading. Return the client to a neutral position and repeat these steps two more times. Lateral Flexion With the client in a standing position, manually landmark the T12 spinous process using a washable marker. Aligning the sensors in the coronal plane, place one of the Inclinometers on the T12 spinous process and place the other at the sacral midpoint. Take the initial reading. Have the client maximally laterally flex the lumbar spine to one side.
The straight leg raise on the tightest side should be within 10 degrees of the total hip motion (i.e. hip flexion + hip extension). Determining the Degree of Ankylosis When the degree of ankylosis needs to be documented, the steps listed above must be slightly adjusted. The first reading should be taken against a wall or on a tabletop. Next, place the client in as close to a neutral position as possible. Place the two Inclinometers at the appropriate landmarks. Then take the second reading.
Elbow Flexion With the client in a standing position, manually landmark the lateral forearm with the hand in a supinated position. Using only the Master sensor, align it in the sagittal plane. Click the button on the Master sensor to take the initial reading. Have the client maximally flex the elbow. Click the button on the Master sensor a second time to take the final reading. ODES will automatically document the final true range. Return the client's elbow to the neutral position.
Using the Small Goniometer Feature When assessing motion in the smaller joints of the digits in the hand or foot, the Dual Inclinometers may be interlocked to form a small goniometer. Once interlocked tight together they form a perfectly level and zeroed surface. As with the landmarking instructions above, place the goniometer so that one Inclinometer is on the proximal side and the other on the distal side of the joint being assessed.
The BTE Goniometer The goniometer calculates the amount of displacement in degrees to arrive at a true range of motion value. The goniometer is used to evaluate extremity range of motion. The large goniometer setup may also be used to evaluate range of motion of the large joints, such as the knee, hip and shoulder. The small goniometer setup can be used to evaluate the range of motion of the smaller joints in the hand and foot.
To connect the Foot Pedal, locate the FP port on the back of your Data Acquisition Device. To utilize the Foot Pedal, attach its cord to the FP port. Connecting and Disconnecting the Goniometer Arms: The small and large goniometer arms can be easily removed from the device. Simply hold the goniometer in one hand and gently twist the arm off of the device.
From the ODES home page, click on ROM Test. This will bring you to the Range of Motion Test page. From here, you have access to all of the pre-programmed tests. You can add tests to clients, create new custom range of motion tests, edit tests and delete tests.
Once you have chosen a test, the following testing page appears: Shows Test Number Shows the test name and device being utilized Device being used to record readings Lists protocol instructons Test results are recorded in these fields If the device that you wish to use is not connected properly, or if the DAC box is not communicating with your computer, you will not be able to perform the test.
Double click here to switch tools Customizing the Goniometer Tests In addition to alternating between testing tools, the range of motion testing screen allows you to test in an AMA or COV format, utilize 1 or 3 trials for each movement, and it allows you to include additional initial settings that you may wish to note. Changing From AMA to COV Format In order to change from AMA to COV format, you must first go into the Range of Motion Protocols page. Click ROM Test from the ODES main menu.
The following page will appear: Shows which tool is set as the default To switch between COV and AMA, use the ‘Set guidelines’ radio buttons.
degrees or within 10% of each other. Coefficient of Variance (COV) is a statistical measurement. The current research indicates that a COV 15% or greater is an indication of invalid effort. You can also modify the number of trials from this page. Just select how many trials you wish to have (1 or 3-6). Entering In Additional Settings: In order to modify the initial settings, open the Edit Test page for the test that you wish to modify.
Performing a Range of Motion Test with the Goniometer From the ODES main menu, you must first select or create a client. You will then be able to click ROM Test to enter the Range of Motion Protocols page. Highlight the test that you wish to perform (in this case, right ankle range of motion has been selected). In order to add the protocol to your client, click Add to Client. You will now see you’re the selected test appear in the ‘Test Assigned to Client’ box.
You may now begin testing with your goniometer. Press the red button located on the bottom of the device or depress the foot pedal to begin and end each trial. The computer will prompt you during each reading. Range of Motion Protocols The following are the protocols for range of movement as outlined in the ODES software. Ankle PLANTARFLEXION: Client is sitting with the leg to be measured at right angles to the thigh and the foot at right angles to the leg.
arm parallel to the tibia. Instruct the client to pull their foot back, towards their body, as far as they can. Record the maximum extension (dorsiflexion) angle from neutral. INVERSION: The client should be seated, with the bottom of the foot to be measured parallel to the floor. (Note: If the foot cannot be placed in this 0-degree neutral position, consider rating ankylosis instead of range of motion).
EXTERNAL ROTATION: The client should be lying supine, the knee flexed 90-degrees, with the thigh perpendicular to the transverse line across the anterior superior spines of the pelvis. The stationary arm of the goniometer is parallel to the flat surface, and the other is along the tibia. Instruct the client to rotate the leg toward the midline of the trunk with the thigh as the axis of rotation, thus producing outward rotation of the hip. Record the maximum external rotation angle.
MTP joint, and its angle is read as a baseline. The client extends (dorsiflexes) the toe maximally, and the angle subtending the maximum arc of motion is read. Subtract the baseline angle and record the angle of MP extension. IP FLEXION: The client is in a seated position. The knee is flexed to 45-degrees and the ankle and Metatarsophalangeal (MTP) joint are in the neutral position. The small goniometer is placed over the MTP joint, and its angle is read as a baseline.
extremities should be compared. Individual joints are then evaluated separately. In determining the range of motion of individual joints, the examiner must evaluate both the active and passive motion. FLEXION: The client should be standing erect, with the arm to be measured at the side of the body. Place the goniometer’s pivot on the outside of the shoulder joint to be measured with the stationary arm perpendicular to the ground. The movable arm will remain parallel to the humerus.
EXTENSION: The client should be standing with the arm to be measured extended at the elbow in forearm supination, and 90-degrees of shoulder forward flexion. The goniometer’s pivot should be centrally placed lateral to the lateral epicondyle with the stationary arm in alignment to the lateral aspect/midline of the humerus, and the movable arm in alignment to the lateral aspect/midline of the radius. Record the maximum extension angle up to the 0-degree/neutral position.
of the forearm using the lateral epicondyle of the humerus for a reference. Align the moving arm with the dorsal midline of the third metacarpal. Instruct the client to move the hand towards the little finger in the same plane as the table. Record the maximum ulnar deviation angle. Thumb In assessing motion, the examiner should first observe what an individual can and cannot do by asking them to move each joint of the extremity, from the shoulder down, through its full range of motion.
stationary arm in alignment with the dorsal midline of the middle phalanx and the movable arm in alignment with the distal phalanx. Instruct the client to extend, or straighten the DIP joint as far as possible. Record the maximum DIP extension angle. Finger Index 2 In assessing motion, the examiner should first observe what an individual can and cannot do by asking them to move each joint of the extremity, from the shoulder down, through its full range of motion. Both extremities should be compared.
stationary arm in alignment with the dorsal midline of the middle phalanx and the movable arm in alignment with the distal phalanx. Instruct the client to flex the DIP joint as far as possible. Record the maximum DIP flexion angle. Finger Middle 3 In assessing motion, the examiner should first observe what an individual can and cannot do by asking them to move each joint of the extremity, from the shoulder down, through its full range of motion. Both extremities should be compared.
Place the goniometer’s pivot over the dorsal head of the distal interphalangeal joint (DIP) with the stationary arm in alignment with the dorsal midline of the middle phalanx and the movable arm in alignment with the distal phalanx. Instruct the client to extend, or straighten the DIP joint as far as possible. Record the maximum DIP extension angle.
alignment with the dorsal midline of the middle phalanx and the movable arm in alignment with the distal phalanx. Instruct the client to extend, or straighten the DIP joint as far as possible. Record the maximum DIP extension angle. Finger Little 5 In assessing motion, the examiner should first observe what an individual can and cannot do by asking them to move each joint of the extremity, from the shoulder down, through its full range of motion. Both extremities should be compared.
stationary arm in alignment with the dorsal midline of the middle phalanx and the movable arm in alignment with the distal phalanx. Instruct the client to extend, or straighten the DIP joint as far as possible. Record the maximum DIP extension angle.
The Hand Grip Force Measurement The main force measurement device can accurately document values from 0—200 lbs. The device itself is accurate to within 0.5% over a full scale, and when combined with the software and other components is accurate to within 0.6% over the full scale (i.e. within 1.2 pounds at all times). Cables BTE uses high grade cabling to ensure durability of its connections.
Using the Hand Grip For A Pre-Programmed Strength Protocol: You are now ready to enter the Strength Test page. Click on Strength Test from the ODES main menu. The following Strength Test Protocol page will appear. From here, all of the pre-programmed tests may be accessed. Tests can be added to clients, new custom isometric strength tests may be created, and tests can be edited or deleted.
This is a list of all the tests found in the Strength Test menu. Select this icon to return to the ODES™ main menu. Double click on the test or click here to add it to the tests assigned to the client. In order to edit, create or remove tests, highlight the work simulation protocol then click on the appropriate icon. Protocol Hibernation puts unused protocols in storage without removing data. This is a short cut to return to any of the test menu screens in ODES¥.
Notice that trials alternate between the client’s right and left hands. If only one hand requires testing, simply remove the check mark beside the hand that is not required. Below is an example of a completed Standard Hand Grip test. The trial, date and time that the test was performed can be found at the top of the testing screen. The difference between the left and right hands is represented by both a pie chart and a bar The test results are displayed in a line graph format.
Retest Option “R” Button The “R” that corresponds with each trial is located to either the left or right of the initial result obtained. For example, for trial one on the left side of the body, the “R” is located to the left of the result obtained by the client. To redo this trial, click the R. ODES will then ask if this trial should be retested. Click OK and perform the trial again.
The client should optimally be positioned sitting as follows: Both feet flat on the floor Upper arm next to body Elbow flexed at 90 degrees Forearm neutral (thumb up) Hand & forearm in slight shoulder internal rotation (toward the center front of the torso) Forearm should not be resting on any surface while gripping If possible, have the client remove all rings from his/her fingers, as these can interfere with the performance of this test. Click Start Test at the top of the page.
It is important that the client does not grip the dynamometer firmly prior to beginning the test to ensure proper calculation of the starting threshold. The voice prompt will announce “Start Test Now” to indicate when firm pressure should be applied. Instruct the client to begin gripping the device in a smooth motion, steadily maintaining that grip until the prompted “Rest Period,” then direct the client to switch the device to the contra lateral hand.
Click button number 1 (from 1 – 5) at the top of the screen. These buttons represent the choice of spacing positions on the grip dynamometer. The test is performed with one trial of each hand at spacing positions 1, 3, 4 and 5 on the dynamometer, and three trials of each hand for spacing position 2. The Modified Maximum Voluntary Effort Handgrip test is performed per the BTE Handgrip Protocol with a JAMAR handgrip dynamometer.
Click Yes if both graphs follow a bell-shaped distribution. Click No if one or both graph(s) does/do not correspond to the bell-shaped curve. If the evaluator does not click on Summary, the cross validation section of the report (assuming the Rapid Exchange Grip and the Standard Hand Grip tests were completed) will not be included. Rapid Exchange: The “Rapid Exchange Grip” test page has two grids for real-time graphs of the left and right-hand strength curves.
The “Hand Grip – Rapid Exchange” test is performed with a JAMAR handgrip dynamometer. This device is utilized to measure handgrip strength in both the right and left hands. The “Hand Grip – Rapid Exchange” test is performed by having the client rapidly squeeze the grip dynamometer and move it to the other hand for a series of six trials each for both right and left hands. The adjustable handle component of the grip dynamometer is to be set up in spacing position two.
It is important that the client does not grip the dynamometer firmly prior to beginning the test to ensure proper calculation of the starting threshold. The voice prompt will announce “Start Test Now” to indicate when firm pressure should be applied. The BTE Protocol for Rapid Exchange Handgrip Strength testing will automatically prompt ODES to perform a cross-reference validity check to compare the results of the Rapid Exchange or MMVE to the Standard handgrip results.
A page will then appear which will allow input of all the essential protocol information. Once all of the vital information has been entered, click Close. The test should now appear in the protocol listing.
The Pinch Grip Force Measurement The main force measurement device can accurately document values from 0—70 lbs. The device itself is accurate to 0.037% over a full scale and, when combined with the software and other components, is accurate to 0.2% over the full scale (i.e. within one pound at all times). Cables BTE uses high grade cabling to ensure the durability of its connections.
Accessories The Pinch Grip comes with the following pieces for calibration. Weight of the calibration disc = 0.3 lbs. Using the Pinch Grip For A Pre-Programmed Strength Test Protocol: The following is an example of how to perform a pre-programmed Strength Test Protocol. From the ODES main menu, click Strength Test. This will bring you to the Strength Protocols page. From here, you have access to all of the pre-programmed tests.
This is a list of all the protocols found in the Work Simulation menu. In order to edit, create or remove tests, highlight the work simulation protocol then click on the appropriate button. This is a short cut to return to any of the test menu screens in ODES¥. The test menu that is in use will appear yellow. Select this button to return to the ODES™ main menu. All of the tests that are assigned to the client will appear in this area.
Below is an example of a completed Key Pinch Grip test. The trial, date and time that the test was performed can be found at the top of the testing page. The test results are displayed in a line graph format. The difference between the left and right side is represented by both a pie chart and a bar graph. Average, peak COV values and difference between left and right are displayed. The “R” represents a retest option for that specific trial.
Retest Option “R” Button The “R” that corresponds with each trial is located to either the left or right of the initial result obtained. For example, for trial one on the left side of the body, the “R” is located to the left of the result obtained by the client. To redo this trial, click on “R”. ODES will then ask if you would like to redo this trial. Click OK and perform the trial again.
The “Pinch Grip – Key” screen has two grids for real-time graphs of the left and right hand strength curves. Each grid contains three reference lines that represent the normal values as well as upper and lower limits for the client, based on their age and gender, and hand dominance. This information is obtained through the information the evaluator provides in the Client Information screen of ODES.
The client is required to perform three trials with each hand, beginning with the right hand and alternating with the contra lateral hand between trials. Voice prompts will guide the evaluator and the client through the test. Observe the client closely to ensure they understand and have assumed correct Key Pinch-type positioning. When beginning the Key Pinch test, have the client grip the pinch gauge loosely.
Tip Pinch: The Tip Pinch strength test is performed per the protocol outlined in published research (see ODES CD for abstracts) with a Pinch Dynamometer. This Pinch Grip dynamometer measures strength in the tip (tipto-tip) pinch position of both the right and left hands. Click Tip to perform a Tip Pinch Grip Test. The Tip Pinch Grip screen has two grids for real-time graphs of the left and right hand strength curves.
The client is required to perform three trials with each hand, beginning with the right hand and alternating with the contra lateral hand between trials. Voice prompts will guide the evaluator and the client through the test. Observe the client closely to ensure they understand and have assumed correct Tip Pinch-type positioning. When beginning the Tip Pinch test, have the client grip the pinch gauge loosely.
Palmar Pinch: The Palmar Pinch Grip strength test is performed per the protocol outlined in published research (see ODES CD for Pinch Strength Protocol) with a Pinch Dynamometer. This Pinch Grip dynamometer measures strength in the Palmar Pinch position of both the right and left hands. Click Palmar to perform a Palmar Pinch Grip Test. The “Pinch Grip – Palmar” screen has two grids for real-time graphs of the left and right hand strength curves.
The client is required to perform three trials with each hand, beginning with the right hand and alternating with the contra lateral hand between trials. Voice prompts will guide the evaluator and the client through the test. Observe the client closely to ensure they understand and have assumed correct Palmar Pinch-type positioning. When beginning the Palmar Pinch test have the client grip the pinch gauge loosely.
Make sure that you press the next Pinch Grip test (i.e. key, Tip or palmar) before hitting the “Start” button. If not, you will repeat the same test that was just Creating A Custom Pinch Grip Test: The ODES software allows for the creation of custom protocols. To do so, from the ODES main menu go to either the Strength Tests or Work Simulation Tests pages from which tests can be chosen. In this case, we have entered the Work Simulation page. Along the bottom is a button labelled New Test.
Select the tool you wish to use for this particular test and add in the protocol name. The maximum trial duration, rest period between trials, and rest period between sides will be based on the type of test you are trying to create. If you are trying to develop a strength test, consideration needs to be made regarding the fatigability of the muscle(s) you are trying to test and the rest period created must be sufficient to regain energy supplies.
The BTE Algometer Force Measurement The main force measurement device can accurately document values from 0—500 lbs. The device itself is accurate to 0.037% over the full scale and when combined with the software and other components are accurate to 0.2% over the full scale (i.e. within one pound at all times). Cables BTE uses high grade cabling to ensure the durability of its connections.
Design This tool is made of aluminum and documents values via a load cell device. There is a fixed bolt in one end, and a bolt can be added at the other end so that attachments can be fixed to both ends of the tool.
wt = 0.4 lbs Strap Attachment: Bolt: Extension Piece for Hard to Reach Areas: Factors To Take Into Consideration: There are several factors that need to be taken into account when developing an isometric strength test. The evaluator should ensure that the test isolates the targeted muscle group and that it reduces the amount of accessory muscle use. Types of Strength Protocols The ODES™ 2002 software has many Strength protocols pre-programmed into the software.
Using the Pressure Algometer for A Pre-Programmed Isometric Strength Protocol: Click Strength Test from the main menu of ODES. This will bring you to the Strength Test page. From here, you have access to all of the pre-programmed strength tests. You can add tests to clients, create new custom isometric strength tests, edit tests and delete tests. This is a list of all the tests found in the Strength Test menu.
Once a test has been assigned to a client, and Perform Test has been selected at the bottom right-hand corner of the page (alternately, you may double click on the test name), your test page will appear. Click this button to return to the Strength menu. Click this button to Start the Strength test. Located in this area are the default or custom instructions for the corresponding test.
It is important to note that only one device can be linked with a static test. For example, if you have done a static shoulder abduction strength test with the FOCUS unit, you will always have to use this device for this test. This ensures that the data being recorded remains objective. If you have a larger system (a FOCUS platform and an Algometer) you should create duplicate copies of the tests.
completed static shoulder abduction strength test. There are three trials on each side, each represented by a different colour. Trial number one is blue, trial number two is pink and trial number three is yellow. Retesting Trials If there is an error in technique, inconsistent effort, or poor performance at the start or finish of a test the trials can be re-tested. There is no set number of times that this option can be utilized.
Real Time Heart Rate allows you to track the HR in a graph format. This is only for those who have the TEST, evalTECH, or ER Systems.. Creating A New Isometric Strength Protocol The ODES software allows you to create new protocols. To do so, open Strength Test _ New Test from the ODES main page.
From this page, select the Integrated Isometric Strength Protocol option in order to begin customizing your new strength test. The customization page will be displayed, which will allow you to input all of the essential protocol information. Once all of the vital information is completed on this page, click Close. Your test should now appear in your protocol listing.
Within the Self Reports page, you will see Superficial Tenderness listed as an option. To assign the test to your client, you may either double click on the protocol name, or highlight it and click Add to Client. Once the protocol has been assigned to your client, you can either double click Superficial Tenderness once again, or highlight the test name and click Perform Test.
The Superficial Tenderness Testing page will then be displayed. These buttons (below) allow you to Edit and Add new locations to your client for testing. If you choose to add a location to your client, you will be responsible for selecting the location and the units to be used. You may add multiple locations to make your assessment as specific as possible.
Results are recorded under the pressure scale heading once the test has begun. The evaluator needs to enter the client’s pain scale rating here after each reading. Once all of the locations have been selected and you are ready to perform a superficial tenderness test, you must first re-zero the Algometer (apply no weight). You may now begin testing. Make sure that your cursor is flashing in the first location underneath the Pressure Scale heading.
The template page allows you to create new templates, edit older templates and use the template for fibromyalgia. To access the pre-programmed fibromyalgia template, click on 18 Fibromyalgia Points. You will now enter the testing page for fibromyalgia clients.
However, if you wish to create your own standardized protocol for superficial tenderness, you can create a new template. To do so, click Templates, located on the superficial tenderness page. This will bring you to the template page. To create a new template, click New. You will now see another template button appear.
To edit/create this template, click Edit. You will now notice that the button changes to green ‘Cancel Edit’ and that the number template changes color to red (when you place your cursor on it). Click on the template (in this case Template 84) to begin customizing your own protocol. The following page will be displayed. This page allows you to name the protocol, add and remove locations so that you can create a custom superficial tenderness template.
You can now further customize your location list. When you have added all the locations you wish to have in your template, and placed them in the correct order, you may click Close to complete the template. Your template will now appear with the correct title. To finish template creation and to view your new template, click Cancel Edit and then select your template.
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It is important to note, that if locations are added to the client, they will always appear with that case. The maximum number of locations that can be added is 20. If you have already added this many locations to your client, you will not be able to add any more. You will have to create a second case for your client. Fibromyalgia Protocol The Fibromyalgia Protocol was developed specifically to test the 18 points used for diagnosis of this condition.
Once the protocol has been assigned to your client, you can either double click Fibromyalgia Protocol once again, or highlight the test name and click Perform Test. The Superficial Tenderness Testing page will then be displayed. Click on Start Real Time HR if you would like to record the client’s heart rate throughout the test. Click on Capture if you would like the heart rate to be captured as part of the Heart Rate Report.
Double click on the location you wish to test (Left). In this example the left side of the head is about to be tested. A yellow box will appear and the value being measured by the algometer will appear. To re-zero the algometer click on Re-Zero. Once the force measurement has been obtained indicate whether the client experienced pain, tenderness or nothing. If the client experienced pain, once selected you will be prompted to enter a value for the pain rating.
ER Platform ER incorporates a system of fully adjustable shelves, graded rulers and accessories to evaluate numerous occupational task demands. The ODES diagnostic software provides the advantage of objective evaluation through computer integration. The ER Platform has many features and capabilities. Most of the adjustments that the evaluator will perform through the ER Platform will occur on the stand or one of its arms. This manual will demonstrate the versatility of the ER Platform.
Standard Accessories These are the standard accessories that are included with the ER.
The labels are color coded as follows: Color Yellow White Red Weight 5 lbs. 10 lbs. 15 lbs. Narrow and Wide Handles The narrow and wide handles can be used for push, pull, static lift assessment, or customized tests. Protocols preprogrammed into ODES indicate to the evaluator when to use these handles; however, customized assessment protocols may be developed.
Single Handle The single handle can be used for many one-handed or task-specific activities. Straight Bar The straight bar can be used as an alternative to the double handles or during customized tests that require working with a bar or similar object(s). Multiplanar Accessory Housing Joint All accessories are attached to the ER arms through the Multiplanar Accessory Housing Joint.
When facing the ER Stand, located on the right hand side of the upper or lower ER arm is a short black handle. Above this handle is a round silver pin. These two components are used to attach the Multiplanar Accessory Housing Joint to either of the ER arms. Attaching the Multiplanar Accessory Housing Joint 1. Locate the short black handle on the right-hand side of the upper or lower ER arm. The right side refers to the right when facing the ER stand. 2.
Once the Multiplanar Accessory Housing Joint is attached to either of the ER arms, any of the standard accessories can be attached to it. When facing the ER Stand, with the Multiplanar Accessory Housing Joint inserted, there will be two handles on the right hand side of Multiplanar Accessory Housing Joint. The handle on top is used when attaching and removing the various accessories.
Grip the handle, and pull it outward (further to the right), while maintaining a firm grip on it. This will unlock the accessory housing mechanism, by creating a space in the slot at the end of the Multiplanar Accessory Housing Joint. While holding the handle in this position, gently twist it in any direction. This will keep the handle in an unlocked position while you insert an accessory. Select the accessory to be attached. On the end of the accessory there is a flattened side and a slightly rounded side.
into the Multiplanar Accessory Housing Joint. It can be used to measure force during lifting, carrying or other simulated tasks using the shelf.. The second shelf has an attachment at its base and can be inserted directly into either the upper or lower accessory arm of the ER. This shelf is inserted into the accessory arms of the ER in the exact same manner that the Multiplanar Accessory Housing Joint is inserted into the ER arms.
mechanism. The lip on the top of the shelf should be at the back to prevent the lifting crate from being pushed off the back of the shelf. Twist the handle on the Multiplanar Accessory Housing Joint again until a clicking sound is heard. The shelf should be gripped with both hands and shaken gently to ensure that it is firmly secured within the accessory housing mechanism. Removing the Accessory ER shelf Locate the top handle on the right-hand side of the Multiplanar Accessory Housing Joint.
Attaching the Independent ER shelf Identify the Accessory arm to which the ER shelf will be attached (upper or lower arm).Ensure that the Multiplanar Accessory Housing Joint is not attached to the desired arm. Locate the short black handle on the right hand side of the accessory. Grip the handle and gently give it a ¼ turn in a counterclockwise direction. Locate the small silver pin adjacent to the short black handle. Grip the pin and pull it outward (further to the right).
If any difficulty is experienced attaching the ER shelves, check the ends of the shelves to ensure that the Independent shelf is not attached to the Multiplanar Accessory Housing Joint, or that the Accessory shelf is attached directly to an ER arm. Changing the location and orientation of ER accessories Rotating the Multiplanar Accessory Housing Joint The Multiplanar Accessory Housing Joint can be rotated in the sagittal and coronal planes.
Rotating the Multiplanar Accessory Housing Joint in the coronal plane Once the Multiplanar Accessory Housing Joint is inserted into the appropriate ER arm, locate the short black handle at the end of the ER arm. Turn the handle in a counterclockwise direction approximately ¼ rotation. Locate the small silver pin adjacent to the short black handle. Grip the pin and pull it out to the right. While maintaining the pin in an outward position, twist it gently in any direction.
The Multiplanar Accessory Housing Joint, the shelves and all of the accessories can be attached to the end of either of the ER arms. Interchanging different ER accessories or attachments has been described in detail in the previous section on the Multiplanar Accessory Housing Joint. Adjusting the height of the lower ER arm The height of the lower ER arm is controlled by two mechanisms, which are both located on the left side of the ER stand (left is defined as your left when you are facing the ER).
Identify the round safety button at the end of the lower ER arm (this button has a symbol of a hand on it). Push and hold down the safety button. While holding down the safety button, raise or lower the ER arm to the desired position, then let go of the button. Grip the long handle and turn it clockwise to securely lock the lower ER arm in its new position.
Upper Arm Ruler When you insert an accessory into the Multiplanar Accessory Housing Joint, the height of the accessory arm is recorded as the height of the accessory (from the platform), which is 7.25 inches higher than the actual accessory arm. 14.5 Inches 7.25 Inche Accessory in the UP If you place an accessory in the down position, the accessory will be an extra 14.5 inches lower than the reading on the vertical ruler (twice the height of the accessory Multiplanar Accessory Housing Joint).
In addition to the graded vertical rulers, there are two graded rulers at the top of the ER stand to measure rotation of the upper and lower arms. Each ruler provides measures in increments of 5 degrees, up to 110 degrees to the left and 110 degrees to the right. The upper ruler indicates the angle of rotation of the lower arm. The lower ruler indicates the angle of rotation of the upper arm.
Isometric Strength Testing The curved strength-testing pad is used to cushion contact surfaces on the client when assessing strength in various postures. Using the accessory housing joint and accessory arms, the strength-testing pad can be positioned in various planes and angles. This allows the assessor complete versatility in the assessment of many joints and many ranges. To complete a static strength test using the FOCUS, click Strength Test from the main menu of ODES.
This is a list of all the tests found in the Strength Test menu. Click this button to return to the ODES™ main Select the test and click here to add it to a client, or double click on it. In order to edit, create or remove tests, click on the appropriate button. All of the tests that are assigned to the client will appear in this area. Protocol Hibernation puts unused protocols in storage without removing data These are short cuts to return to any of the test menu pages in ODES¥.
It should be noted that once the Start button is clicked, a message will appear stating that the force meter needs to be zeroed. This is seen in the diagram below. As there are many attachments for each load cell, ODES¥ will account for the weight of the accessory attachment during each test. No force should be applied to the force meter. To create a new strength protocol, click New Test and then click Integrated Isometric Strength Protocol.
entered on the screen and included in the report. Select the rest of the parameters for the test. Once Close is clicked the test will be saved and can be assigned to clients. Work Simulation Tests There are a number of different accessories that can be placed in a variety of positions to simulate various work tasks.
The trial, date and time that the test was performed can be found at the top of the testing page. The results are displayed in a bar graph. In addition, the total elapsed time is displayed. The test results are displayed in a line graph Avg., peak and COV values are listed for right and left comparison. The “R” represents a retest option for each trial that is performed by the The comments button allows the evaluator to enter their observations of the test.
entered on the screen and included in the report. Select the rest of the parameters for the test. Once Close is clicked the test will be saved and can be assigned to clients. Integrated Dynamic Lifting and Carrying Tests To create new lifting and carrying tests click on New under the Work Simulation section of the software. Click on Integrated Dynamic Protocol. The following screen will open up. Insert a protocol name and select whether you would like the test to be a carrying or lifting test.
carry the object. If lifting is selected, the box to include the distance for carrying changes to Measure the Upper Shelf Height. Select whether you would like the tests set up for anthropometric values or not. If anthropometric measurements are selected the option of knee, knuckle, waist, elbow, shoulder, and crown are available for selecting upper and lower shelf heights. If you do not wish to use anthropometric values click on No and enter in specific heights in inches.
The ODES software has pre-programmed into it dynamic lifting and carrying tests: Dynamic Lifting – Floor to Waist Occasional Dynamic Lifting – Waist to Shoulder Occasional Dynamic Lifting – Floor to Shoulder Occasional Dynamic Lifting – Floor to Waist Frequent Dynamic Lifting – Waist to Shoulder Frequent Dynamic Lifting – Floor to Shoulder Frequent Dynamic Carrying To use these protocols or any you programmed yourself click on Work Sim from the main menu of ODES.
Either double click on the test name or highlight it and click on Perform Test to go in to the test screen. The following screen will appear if the client’s heart rate and blood pressure have not been measured and entered into Cardiovascular Intake. This must be done before you can continue with testing. If this has been done the following screen will appear. The first thing to do is to click on Weight Verification.
For the knuckle to shoulder occasional and frequent tests, the crate starts on the middle shelf with the load cell. Once Start has been clicked on, if the correct weight is in the crate (refer to the Current Weight box on the right hand side of the screen for more details), the computer will say continue. Once the weight is returned to the shelf it will count the repetition. For all the other sub-tests, the crate is placed on the lifting platform.
EPIC Lifting Capacity Protocol (Optional Upgrade) To be able to complete this lifting protocol, the evaluator must attend an EPIC course and complete the certification process by EPIC. As well the clinic must obtain a site license from EPIC to ensure they are using the correct equipment. Please refer to your EPIC Training manual for more details on the specifics on completing the EPIC protocol.
Determine which of the six subtests you would like to complete. Automatically all are selected when you open the test screen. Click on them to de-select particular sub-tests. If you de-select an occasional protocol, automatically the frequent protocol and possibly another occasional protocol will be de-selected based on the EPIC protocol. Before completing weight verification set the shelf heights. The shelf heights are based on the height you entered in the client’s case information.
feature off. Once the weight has been lifted to the load cell and taken off the computer will count the repetition. When the weight is lifted the required times a screen will appear prompting you to enter in the client’ rate of perceived exertion, whether they can lift the weight 8 to 12 times per day, whether they can lift more weight, and the rating for their horizontal displacement and stance.
Based on the EPIC protocol select whether the client did or did not provide a maximal acceptable effort during testing.
The Universal Task Master The Universal Task Master (UTM) system allows the evaluator to measure both hands simultaneously while replicating the client’s required task. The UTM allows for independent hand spread, supination/pronation positioning, and force measurement. The UTM also rotates in the saggital and coronal planes, allowing for extended versatility.
UTM Handle Position Lock UTM Center Housing, Bar, and F.O.C.U.S Arm Insert Bar Center Housing F.O.C.U.S Arm Insert Bar Position Locking Pin UTM Bar Position Locking System Bar Position Locking Handle In order to rotate the bar, the locking handle will need to be loosened first (half turn counterclockwise). In order to lock the bar into position, tighten the locking handle (turn clockwise until tight). Inserting the UTM into the F.O.C.U.S. Arm Place the F.O.C.U.
Connecting the UTM to the Data Acquisition Box First connect the gray UTM integration cable from the UTM to the ‘TM’ port on the Data Acquisition Box. Then connect the black coil cable from the left force scale to the center of the UTM and the black coil cable from the right force scale to the center of the UTM. Integration cable port Right force scale cable port Left force scale cable port The black force scale cables should not cross at the center of the UTM.
Designing a Custom Universal Task Master Test The software allows for great flexibility in customizing strength and work simulation tests using the UTM tool. A new custom integrated UTM test may be created in either the Strength Test or the Work Sim Test functions of ODES. Enter either the Work Sim Test menu or the Strength Test menu, whichever applies to the test to be created, from the ODES main menu. On the next page, click New Test.
The next page allows you to input information required to customize a test. Important things to note: x The starting threshold limit is the force required on at least one side to start the test. x When choosing between average or maximum force per trial, please note that the average will disregard the first and last half-second of the trial and average out the samples in between; the maximum force will simply be the peak force applied during the trial.
Suggestions on Designing / Performing Custom UTM Tests The most important rule in designing / performing a test, whether using the UTM system or other components of ER Platform, is to try to replicate the position of the task as closely as possible. Replicating the job requirements will ensure an appropriate comparison of ability to demand, and will more accurately determine whether or not the individual can Once all of the information has been entered, click Close to return to the previous page.
On the first page of the new test, click Settings . If a red ‘X’ is displayed next to an item, there is a problem reading that device or position. See the troubleshooting section of this manual. Set up the UTM based on the settings selected when the test was created. Once the UTM settings are correct, click OK to go to the test screen. After clicking Start a window will pop up reminding you to make sure the client is not touching the UTM, so the device can zero itself. Click OK and the test will begin.
Once testing is complete click on the R button to the right of a trial if you need to redo that trial. Click on Comments to add specific comments regarding the client’s performance on the test. To start a new test click New or to delete the current test data click Delete. To close this page, click Close or to go to a new test in sequence click Next Protocol.
Functional Range of Motion The Functional Range of Motion (FROM) pegboard allows an evaluator to determine the positional tolerances of a client. The FROM system utilizes Methods Time Measurement (MTM), allowing the evaluator to extrapolate for occasional, frequent or constant demands. What is Methods Time Measurement? Methods Time Measurement (MTM) is the industrial engineering-based method for determining time-motion performance in conjunction with work-related activities.
employability of the test subject may also be classified using the results of the MTM-based tests . The classifications and the associated ranges for the tests are as follows: Exceeding Above Competitive Above Competitive Competitive Entry Level Below Competitive Above 140% 101-140% 80-100% 70-79% 0-69% Does MTM replace the Functional Capacities Evaluator? The use of MTM standard scores is not intended to replace the functional capacities evaluator.
Many large manufacturing concerns employ industrial engineers that have derived time-motion standards for the employer’s work site. If an accurate analysis of the work determines that the employee must perform kneeling activities on an occasional basis, but the work flow is at a rate equivalent to a 95 MTM standard, then the evaluator has the means to determine if the worker is capable of returning to the job and the specific demands of the workplace.
the possibility of tremor associated with overhead work affecting proprioception activities Obviously, some of the most unique observations will be in the area of work conducive and nonconducive behaviors. Pain related behaviors and the consistency of the report to the impairment are critical to an appropriate evaluation of the test subject. Distraction plays an important role in the FROM system’s test protocols, in order to facilitate the client’s performance of the activity without focusing on the pain.
F.R.O.M. Stooping with 36'' Displacement – Occ PREREQUISITES The test requires the placement of the 28" high work surface table in front of the BTE Functional Range of Motion System. The test subject is allowed the opportunity to lean against the table while placing the pins in the proper holes. The test subject is also advised that he/she may return to an erect posture subsequent to the completion of a test cycle.
F.R.O.M. Stooping – Occ PREREQUISITES The test subject is advised that he/she may return to an erect posture subsequent to the completion of a test cycle. PROCESS The test subject is instructed to move the five rows of pegs from Panel 2 - Row 2 - Zone C through Panel 2 - Row 1 - Zone B to the corresponding row of holes in Panel 3.
F.R.O.M. Upper Level Reach – Occ PREREQUISITES The test subject is asked to stand next to the side panel of the BTE Functional Range of Motion System and raise his/her right arm with fingers extended to the highest level of the test apparatus while remaining with both feet flat on the floor. The highest row reached with the distal tip of the middle finger exceeding the top of the peg hole will be the highest row used during the evaluation.
F.R.O.M. Crouching Reach – Occ PREREQUISITES The test subject is advised that he/she must remain in the crouching/squatting position and may touch only one knee down to the ground after the completion of a cycle. The knee must return to the crouch/squat position prior to the transfer of any pegs for the next cycle. PROCESS The test subject is instructed to move the five rows of pegs from Panel 1 - Zone C to the corresponding row of holes in Panel 2 - Zone C.
F.R.O.M. Axial Rotation – Occ PROCESS The test subject is instructed to move five rows of pegs from Panel 1 - Zone B to Panel 6 - Zone B. The transfer process requires the test subject to take the peg out of the hole with the left hand, transfer it to the right hand while the peg is out of the hole, and then place the peg into the corresponding hole with the right hand. The test subject commences with the highest level row and then proceeds in order to the lowest level row.
F.R.O.M. Kneeling – Occ PREREQUISITES The test subject is allowed the opportunity to wear knee pads if desired. The test subject is also advised that he/she must remain in the kneeling position during the course of the test until it is completed. PROCESS The test subject is instructed to move the five rows of pegs from Panel 1 - Zone C to the corresponding row of holes in Panel 2 - Zone C.
F.R.O.M. Kneeling to Standing and Back – Occ PREREQUISITES The test subject is allowed the opportunity to wear kneepads if desired. PROCESS The evaluator sets up one row of pegs in each of the lowest rows (yellow) in Panel 2 - Zone B and Panel 2 - Zone C. The test subject is instructed to move a row of pegs from Panel 2 - Zone C at the lowest row to the next highest row directly above the row from which the activity started. The pegs will be moved to the corresponding hole directly above.
the pegs downward, one row at a time employing the same process. Upon reaching the lowest row of holes in Zone C another cycle has been completed. The test is concluded when a total of twenty eight cycles are completed. A ten second rest period is provided after the completion of each seven cycles until the test is completed. F.R.O.M. Standing Position – Occ PROCESS The test subject is instructed to move five rows of pegs from Panel 1 - Zone B to Panel 4 Zone B.
F.R.O.M. Multi-Level Axial Rotation Reach - Occ PROCESS The test subject is instructed to move five rows of pegs from Panel 6 – Zone A (Height Adjusted) to Panel 5 – Zone B. The five rows of pegs in Panel 5 – Zone B are then transferred directly across to Panel 6 – Zone B. Then, the five rows of pegs in Panel 6 – Zone B are transferred to the five rows in Panel 5 – Zone A (Height Adjusted). Finally, the five rows of pegs in Panel 5 – Zone A are transferred to the same rows in Panel 6 – Zone A.
The client should be instructed in the proper technique prior to starting the test. The instructions need to emphasize that the client is required to work as quickly as possible. It is recommended that two rows of the protocol be completed, prior to starting the actual test, to make sure that the instructions were understood. Click Examiner Instructions to switch to Patient Instructions. Click on the speaker button to have the instructions read aloud by the computer. Click Start Test to start the test.
The test will end once you indicate (using the counter) that the final cycle is complete, or if you click End Test or Unable to Continue. If the client is unable to continue the time will still be displayed but an MTM rating will not be calculated, as the task was not completed.
BTE Digital Radio Frequency Heart Rate Monitor The BTE Digital Radio Frequency Heart Rate Monitor is fully integrated with the Data Acquisition Box. The use of the Heart Rate Monitor provides the ability to monitor a client’s heart rate. Unlike other heart rate monitors, the BTE Heart Rate Monitor allows for constant monitoring during the work simulation tests while remaining fully integrated with the computer. The range of the BTE Heart Rate Monitor has been tested to be accurate for up to 30-50 feet.
Components BTE Digital Radio Frequency Transmitter BTE Digital Radio Frequency Receiver Polar Belt and Two Straps Two extra 9 Volt batteries and a battery charger Connecting the Heart Rate Receiver to the Data Acquisition Box The BTE Heart Rate Monitor is designed to be readily attached to the Data Acquisition Box. Please follow the instructions below: Step 1: Attach the cable of the Receiver to Port 12. Step 2: Place the Receiver in the Heart Rate Monitor holder on the BTE Computer Station.
For optimal signal, the use of electrode conductor gel or water on the heart rate monitor chest strap is recommended. For alternative placements, please see the troubleshooting section of this manual. Please note that the Hanoun Heart Rate Monitor does not operate like a Polar Heart Rate Monitor. The transmitter does not store the values, so the readings are more accurate and updated constantly.
Operation of Monitor When attaching the battery to your transmitter and depressing the on/off switch, the red light on the front surface of the transmitter should light up indicating that the battery is good. The rechargeable batteries need to be charged for a minimum of 12 hours before use. The batteries are not charged when you first receive your system. After charging them they will be good for up to 4 hours of testing in the Heart Rate Monitor.
Heart Rate Receiver Testing The Receiving unit performs a self-diagnostic on a continuous basis, indicated by the red light on the back of the unit. 1 282 When the unit is attached to the Data Acquisition Box the red light will be illuminated to indicate that it is receiving power.
Recommended Care and Maintenance Schedule The following outlines the recommended maintenance schedule for your Hanoun System. A maintenance log should be kept for the equipment. It is recommended that if your computer is going to be used for other applications than ODES or if the computer is connected to a network or the Internet, anti-virus software be installed. After each Client x Clean handles with an antibacterial wipe or rubbing alcohol (70% Alcohol) for sanitary reasons.
Upon request circuit diagrams, parts lists, descriptions and other information required to repair parts may be provided to a qualified technical person.
Transporting the Equipment The following is required for shipping/transporting the BTE Evaluation and Rehabilitation System or components to ensure its safe arrival at its final destination: 1) Package the computer monitor, CPU, printer, and speakers in the original packaging you received them in. If you no longer have the original packaging material, it is recommended you take the equipment to a postal center to have it packaged properly.
BTE MEDICAL INC. SOFTWARE - End User License Agreement IMPORTANT—READ CAREFULLY: This BTE Medical Inc. End-User License Agreement (“EULA”) is a legal agreement between you (either an individual or a single entity) and BTE Medical Inc. for the ODES software product. The ODES software product includes computer software and may include associated media, printed materials, and “online” or electronic documentation (“SOFTWARE PRODUCT”).
x Software Transfer. You may NOT transfer the SOFTWARE PRODUCT, either in whole or in part, at any time. If you transfer the SOFTWARE PRODUCT, either in whole or in part, you may be forced to pay for each additional copy or part thereof. x Termination. Without prejudice to any other rights, BTE Medical Inc. may terminate this EULA if you fail to comply with the terms and conditions of this EULA. In such event, you must destroy all copies of the SOFTWARE PRODUCT and all of its component parts.
CUSTOMER REMEDIES. BTE Medical Inc.’s and its suppliers’ entire liability and your exclusive remedy shall be, at BTE Medical Inc.’s option, either (a) return of the price paid, if any, or (b) repair or replacement of the SOFTWARE PRODUCT that does not meet BTE Medical Inc.’s Limited Warranty and which is returned to BTE Medical Inc. with a copy of your receipt. This Limited Warranty is void if failure of the SOFTWARE PRODUCT has resulted from accident, abuse, or misapplication.
Trouble Shooting Data Acquisition Box “Error in initialization to BTE Data Acquisition Device”: Click Auto in Administration | Environment Settings Is the light on in the back of the box (red)? If so, turn box off for 30 seconds, then go to Administration | Environment Settings, turn the box on and click Auto. If the red light still does not go off, unplug all the tools, turn off the Data Acquisition Box and turn it back on. Click on Auto and add one tool at a time and then click Auto.
Inclinometer and Goniometer If the interface system cannot be launched when using the BTE Dual Inclinometers, ensure that: The cords are properly connected (into the Data Acquisition Box and between the Master and the Remote) The Range of Motion test that is selected in ODES is designed for use with either the Inclinometers or the Goniometer, or is non-integrated. Check the top left corner of the test page to determine which tool the software is looking for.
Hand Grip, Pinch Grip, Algometer, and FOCUS “No Testing can be done until this device has been calibrated or verified”: Has the tools been calibrated and verified? If not, calibrate and verify. Is the Calibration/Verification reminder set to “must be done” or “reminder” in Administration | Environment Settings? If on “must be done”, calibration must occur prior to performing a test. If set to “reminder” tests can be performed without a new calibration.
Do you have the correct tool selected? Only one strength tool can be associated with a protocol. You have to create a duplicate test to utilize both the FOCUS and Algometer for a given protocol. To check if the correct tool is selected, highlight the test from the Strength Protocol Screen. Click Edit Test and see which tool is selected. NOTE: If you have previously done testing with this protocol, you will receive a warning prior to entering the Edit Test screen.
If the wrong tool is selected, create a new test using the same values (just a different name) If the correct tool is selected, ensure that your DAC box is set up successfully. If you still cannot perform the test, contact our customer service department at (800) 461-6888 X2. Evaluator/CIRES Systems: Ensure that your device settings are both set to PORT 6 in Administration _ Environmental Settings.
You are now able to modify the number located beside ‘F’ to ‘6’. To do this, click on the number 3 until it reads 6. You have now set the Algometer to read in only port 6 for both strength and fibromyalgia tests. Ensure that the Algometer is plugged into port 6.
Grip the accessory and pull it out of the Accessory Housing mechanism. You may need to gently rotate the accessory and pull it upward in order to remove it. Locate the short black handle on the right side of the upper or lower accessory arm. This handle is located at the end of each accessory arm. Turn the handle in a clockwise direction. This will tighten the opening in the accessory arm, and secure the Multiplanar Accessory Housing Joint.
Universal Task Master When I go into a UTM test, I get a message that says “Click OK to Calibrate” but I just calibrated my UTM. ODES and the UTM perform a self-calibration each time you use the UTM load cells. Since you calibrate your UTM system without any accessories attached, the computer needs to first measure the accessory prior to commencing a test. This will re-zero the load cell to include the accessory. Once you click OK, you may proceed with the test.
Heart Rate Monitor Why am I not getting a reading with my Transmitter? Is the red light on the back of the Transmitter flashing? Is the receiver plugged into PORT 12 on the DAC box? Under Help~About do you see HR=117? If not call BTE to unlock your Heart Rate Monitor.
BTE Training Programs BTE Medical Inc provides superior training to complement its leading technology. Introductory and advanced courses are available. ER Level One This two day training course is for any individual who will be using the BTE functional testing technology. Training will cover the use of each individual tool, basic principles of functional evaluations, how to use the protocol grid and evaluations handbook, testing analysis, report writing and more.
