The Plurimeter allows rapid, accurate and reproducible measurements. It is a precision built, light weight, low cost liquid pendulum inclinometer. It was awarded the Gold Medal in the International Inventors Fair in Basel in 1986, and has been further improved since then.
Many hundreds of Plurimeter inclinometers are used in Australia by physiotherapists, doctors & occupational health practitioners. Some physiotherapists have been using their original Plurimeter for over 20 years.
Compared to conventional goniometers, it has many advantages, including:
- It can be operated with only one hand;
- Has proven repeatability: with straight leg raising tests it has a repeatability of 1.6 degrees.
- There is no need to locate the axis of joint motion;
- Easily read large dial which can be fully rotated 360 degrees. The dial is lockable at 90 degree intervals so that horizontal and vertical positions can be determined. There is no need to subtract angles to calculate joint angles of motion.
Check out more details in this extract from published literature: Plurimeter References
This device consists of a pair of inclinometer sensors which can be linked by a cable, or linked wirelessly. One sensor is called the Master, the other is called the Slave. The Master can be used independently as a stand alone digital inclinometer. Alternatively the Master can be zeroed in relation to the Slave, so if the Slave moves the Master only reads the angle between itself and the Slave.
- Decreases examination time by 50% over single inclinometers when measuring spinal ROM.
- Hold button freezes the display.
- Magnetic rails for precise alignment
- Certain versions of these inclinometers can be linked via an interface box with software programs for report writing and validity checks
Plurimeter reliable for measuring hip & spine ROM
Mayer, T. G. et. al. (1984) Spine 9 (6): 588 595. “ in this paper. The authors present a simple, single inclinometer [technique]… which offers the opportunity to separate the components of the compound motion of hip and spine. Analysis of the motion of normal and chronic low-back pain patients allow differentiation of groups, demonstration of progress of rehabilitation programs, Determination of impairment, and provides tests of patient compliance and level of motivation… Both normal subjects and patient groups were studied… inclinometer measurements (of patients) at the time of radiographic flexion – extension films showed a mean lumbar motion of 60.5 degrees (S.D, 16.7 degrees). The motion measured on flexion – extension X-rays showed a mean range of motion of 58.5 degrees… we should note the accuracy of the method in comparison to … radiographs.” Several types of inclinometers were used, including a Plurimeter.
Guides to the Evaluation of Permanent Impairment
Guides to the Evaluation of Permanent Impairment. Third Edition- 2nd Printing February 1989. American Medical Association. Forward to Third Edition. “ The evaluation of the spine uses inclinometers, rather than Goniometers, for the measurement of range of motion, a technique that provides more accurate, reproducible result.” Addendum to Chapter 3: “ Sections 3.3a through 3.3e introduce the inclinometer technique in evaluating impairments due to loss of range of motion of the spine. … This addendum should be used only until the examiner develops the skills to use the inclinometer technique- we recommend that such skills should be in place by one year after publication date of this third edition of the Guides. After that time only the inclinometer will be valid ….”
Plurimeter reliable for measuring Straight Leg Raise
Porter, R.W. et. Al. (1990) Spine 15 (2): 103-106. “ (We) first established an acceptable intra-observer repeatability using an oil-filled precision goniometer… The intra-observer repeatability of straight leg raising for 60 paired measurements from six patients was 1.6 degrees, SD 1.4 degrees.”
Not that they used the ‘Rippstein’ goniometer (plurimeter).
This extract highlights the inaccuracy of eyeballing
Chesworth, B. M et. al. (1991) Physiotherapy Canada 43 (4):13 – 18
“ Ten physiotherapists with experience in manual therapy volunteered to evaluate a fractured ankle patient for passive stiffness into DF (Dorsiflexion) and document their findings. (They had an average of 12 years clinical experience and over 8 years manual therapy experience) … The clinicians were initially asked to estimate the limit of the available ROM (range of motion) to 15 degrees of DF (…S.D: 15 degrees DF) … (thus) there was considerable variability in the therapists estimation of… the end ROM ( … the real limit of DF was degrees).”
Assessment of knee and hip osteoarthritis with Plurimeter
Theiler R, Stucki G, Schutz R, Hofer H, Seifert B, Tyndall A, Michel BA, (1996) Osteoarthritis Cartilage, Mar 4(1):35-42. The aim of this study was to evaluate the interobserver reliability of parametric and non-parametric variables in the clinical assessment of hip and knee osteoarthritis (OA). Three rheumatologists examined 49 patients with different radiological stages of OA using different assessment tools such as a tape measure, a goniometer, a plurimeter and a hand-held pull gauge. The reliabilities of parametric variables calculated by analysis of variance (ANOVA) showed much higher values than the non-parametric ones calculated by Kendall's tau beta…
Plurimeter reliable for measuring hip ROM
Croft PR, Nahit ES, Macfarlane GJ, Silman AJ, (1996) Spine 55(5):320-3.
OBJECTIVE: To determine reliability of the measurement of hip movements (flexion, internal rotation, and external rotation) between medical practitioners. METHODS: Six clinicians carried out measurements of hip movements on each of six patients with osteoarthritis of one hip, using a specifically designed plurimeter. RESULTS: There was no evidence of any systematic difference between medical practitioners in the measurement of hip flexion, internal rotation, or external rotation…This study has shown that measurement of range of movement at the hip is repeatable between practitioners using a simple plurimeter and may represent an examination that is suitable for monitoring progress and treatment.
Plurimeter reliable for shoulder ROM
Green S, Buchbinder R, Forbes A, Bellamy N, (1998) Arthritis Care Res, Feb 11(1):43-52. OBJECTIVE: To develop a standardized protocol for measurement of shoulder movements using a gravity inclinometer [Plurimeter-V] designed for use in clinical trials, and to assess its intra- and interrater reliability in a group of manipulative physiotherapists. METHODS: After instruction, 6 manipulative physiotherapists independently assessed 8 movements of the shoulder, including total and glenohumeral flexion (TF, GHF), total and glenohumeral abduction (TA, GHA), external rotation in neutral (ERN) and abduction (ERA), internal rotation in abduction (IRA), and hand behind back (HBB)… RESULTS: The intra- and interrater reliability of the different movements varied widely. Reliability was higher for TF and TA than for the corresponding glenohumeral movements…CONCLUSION: The measurement of the active range of TF, TA, ERN, and HBB, measured by manipulative physiotherapists [using a Plurimeter-V] following the standardized protocol, has intra- and interrater reliability acceptable for use as an outcome measure in clinical trials assessing interventions for shoulder pain.
Plurimeter for pelvic tilt
Alsancak S, Sener G, Erdemli B, Ogun T, (1998) Prosthet Orthot Int. 1998 Apr; 22(1):17-24. The aim of this study was to determine the degree of pelvic tilt in the three dimensions, the trunk muscle strength and effects on gait in trans-tibial amputated patients. This study comprised of 22 unilateral trans-tibial amputated patients who were seen at the authors' Prosthetics and Orthotics Laboratory for the purpose of prosthetic provision. Measurements were made using plurimeter and caliper and gait observations were made by video camera.
Plurimeters reliable for measuring Supination & Pronation
Urban V, Kalberer F, Roos M, Dumont CE, (2002) Spine 140(1):72-6. AIM: The aim of this study is to prove the intra- and interobserver reliability of three different methods to measure the active range-of-motion in the forearm. METHODS: These three different methods were tested on forty volunteers. In the first method pictures were made in full supination and pronation, measurement of the two angles was performed with a dedicated software. …The second method used a standard goniometer. The third method of assessment used a gravity goniometer (plurimeter). We randomised both the side of the patient to be examined and the sequence of the methods. … We found a significant intraobserver reproducibility with the gravity goniometer. … Agreement between the pictures and gravity goniometer assessment of the range-of-motion was good. …For reproducibility of measurement of range-of-motion in the forearm the gravity goniometer [Plurimeter] is the best method, although the measured values were 5 % greater.
Plurimeter reliable for measuring rotation of the scapula
Watson L, Balster SM, Finch C, Dalziel R. (2005) Spine 39(9):599-603.It is important to deal with the scapula when developing rehabilitation strategies for the shoulder complex… AIM: To determine the reliability of the Plurimeter-V gravity inclinometer for the measurement of scapular upward rotation positions …Overall, there was very good intrarater reliability (ICC = 0.88). The ICC ranged from 0.81 (at 135 degrees) to 0.94 (at both resting and end of total shoulder abduction range)…. The Plurimeter-V gravity inclinometer can be used effectively and reliably for measuring upward rotation of the scapula…
Plurimeter assessing dorsal asymmetry in children and adolescents
Kluszczfnski M & Czernicki J (2012) Ortop Traumatol Rehabil 14(3):239-49. The study is a retrospective and prospective analysis of the results of examinations of children for the occurrence of dorsal asymmetry carried out ten years ago and repeated recently…The clinical assessment (Adam's test) was performed each time by the same examiner, the 1st author of this study, using [a] Rippstein plurimeter …The prevalence of back asymmetry had increased by the time of the second examination..
Plurimeter assessing spine in adolescent athletes
Grabara M (2014) J Back Musculoskelet Rehabil 27(4):513-9. To assess the shape of anteroposterior vertebral curvatures in adolescents who practice team sports. … A Rippstein plurimeter was used to measure the angles of thoracic kyphosis and lumbar lordosis. The study has revealed significant differences in lumbar lordosis in male athletes compared to the control (p=0.01)…
Plurimeter assessing spine flexibility in women
Grabara M & Szopa J (2015) J Phys Ther Sci. 27(2): 361–365.The aim of this study was to access the flexibility of the spine in women practicing yoga … The range of spine mobility in three planes was measured using a Rippstein plurimeter. The range of motion in the sagittal and frontal planes was measured in a standing position with the feet hip-width apart. The torsional range of motion of the subjects was measured with the trunk bent at a right angle and the legs apart…This study showed that the applied yoga exercises increased spinal mobility and flexibility of the hamstring muscles regardless of age.
Plurimeter assessing ROM in adhesive capsulitis
Sharma SP, Baerheim A, Kvale A (2015) BMC Musculoskeletal Disord. Feb 22: 16:37. Fifty patients with a clinical diagnosis of adhesive shoulder capsulitis were examined … with an inclinometer, a plurimeter, in both affected and non-affected shoulders …Very good to excellent intertester agreements were found for most parameters for the affected arm at all three test points. The intraclass correlation coefficient (ICC 2.1) values ranged from 0.76 to 0.98, i.e. from very reliable to excellent.