TM
Dualer IQ
The Smarter InclinometerTM
Published by JTECH Medical
470 Lawndale Dr., Ste G
Salt Lake City, Utah 84115
801 478-0680
800 985-8324
www.jtechmedical.com
Copyright © 2005 JTECH Medical. All rights reserved.
Part # 18725-001
Table of Contents
Dualer IQ Specifications. . . . . . . . . . . . . . . . . . . . . . . i
Lumbosacral Lordosis . . . . . . . . . . . . . . . . . . . . . . 17
Register Your Dualer IQ . . . . . . . . . . . . . . . . . . . . . . 1
Lumbosacral Flexion/Extension . . . . . . . . . . . . . . . 17
Introduction to Dualer IQ . . . . . . . . . . . . . . . . . . . . . 2
Tightest Straight Leg Raise . . . . . . . . . . . . . . . . . . 18
Dualer IQ and Accessories. . . . . . . . . . . . . . . . . . . . . 2
Lumbosacral Rotation . . . . . . . . . . . . . . . . . . . . . . 18
Dualer IQ Operation
Dualer IQ Orientation During Use . . . . . . . . . . . . . . 3
Lumbosacral Lateral Flexion . . . . . . . . . . . . . . . . . 19
Additional Spine ROM Measurements
Connecting Primary and Secondary Inclinometers . . 5
Gross Combined Hip and Spinal Flex/Ext . . . . . . . 20
Turning Dualer IQ ON and Off . . . . . . . . . . . . . . . . 5
Gross Spinal Flexion/Extension . . . . . . . . . . . . . . . 20
The Dualer IQ Display. . . . . . . . . . . . . . . . . . . . . . . 6
Sacral Hip Flexion/Extension . . . . . . . . . . . . . . . . . 20
Dualer IQ Control Buttons . . . . . . . . . . . . . . . . . . . . 7
Scoliosis Measurements . . . . . . . . . . . . . . . . . . . . . 21
Clearing the Dualer IQ Memory. . . . . . . . . . . . . . . . 7
Extremity Protocols . . . . . . . . . . . . . . . . . . . . . . . . . 22
How the Control Buttons Function
Upper Extremities
Dynamic Testing Mode . . . . . . . . . . . . . . . . . . . . . . 7
Wrist Flexion/Extension . . . . . . . . . . . . . . . . . . . . . 22
Static Testing Mode . . . . . . . . . . . . . . . . . . . . . . . . . 8
Elbow Pronation/Supination. . . . . . . . . . . . . . . . . . 22
Reviewing Test Data . . . . . . . . . . . . . . . . . . . . . . . 10
Elbow Flexion/Extension . . . . . . . . . . . . . . . . . . . . 23
Advancing Display to Perform Another Test . . . . . 10
Shoulder Internal/External Rotation . . . . . . . . . . . . 24
Dualer IQ Accessories . . . . . . . . . . . . . . . . . . . . . . . 11
Shoulder Flexion/Extension . . . . . . . . . . . . . . . . . . 24
Dualer IQ Range of Motion Test Protocols
Number of Repetitions . . . . . . . . . . . . . . . . . . . . . . 12
Shoulder Adduction/Abduction . . . . . . . . . . . . . . . 25
Lower Extremities
Warmups . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Ankle Dorsiflexion/Plantar Flexion . . . . . . . . . . . . 26
About the Illustrations . . . . . . . . . . . . . . . . . . . . . . 12
Knee Flexion/Extension . . . . . . . . . . . . . . . . . . . . . 27
Cervical Spine Measurements
Cervical Flexion/Extension . . . . . . . . . . . . . . . . . . 12
Cervical Lateral Flexion. . . . . . . . . . . . . . . . . . . . . 13
Cervical Rotation . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Thoracic Spine Measurements . . . . . . . . . . . . . . . . 15
Thoracic Neutral Posture (Minimum Kyphosis) . . . 15
Thoracic Flexion . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Thoracic Lateral Flexion . . . . . . . . . . . . . . . . . . . . 15
Knee Extension Lag . . . . . . . . . . . . . . . . . . . . . . . . 27
Hip Forward Flexion . . . . . . . . . . . . . . . . . . . . . . . 27
Hip Extension . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
Hip Abduction/Adduction . . . . . . . . . . . . . . . . . . . 29
Hip Internal/External Rotation . . . . . . . . . . . . . . . . 30
Dualer IQ Worksheets . . . . . . . . . . . . . . . . . . . . . . . 31
Spine ROM Worksheet. . . . . . . . . . . . . . . . . . . . . . 32
Extremity ROM Worksheet . . . . . . . . . . . . . . . . . . 33
Thoracic Rotation. . . . . . . . . . . . . . . . . . . . . . . . . . 16
Dualer IQ Care and Maintenance . . . . . . . . . . . . . . 34
Lumbosacral Spine Measurements . . . . . . . . . . . . . 17
Dualer IQ Warranty . . . . . . . . . . . . . . . . . . . . . . . . 35
Dualer IQ Technical Specifications
Display
Sensors
Operation
Operation Modes
Data Displayed
Data Storage
Data Capture
Control Buttons
Accuracy
Repeatability
Operating Temperature
Storage Temperature
Dimensions
Weight
Rail Attachment
Housing
Internally Powered
Liquid crystal
Solid-state accelerometers
Dual or single inclinometry
Dynamic and Static measurement
Dual inclinometry: Total ROM, Primary value, Secondary value, test number, repetition,
mode symbol
Single inclinometry: ROM, test number, repetition, mode symbol
19 tests, 6 repetitions each
Dynamic automatic with change of direction, Static Start/Stop button
Start/Stop, Scroll, Dynamic/Static
+/- 1 degree
+/- 1 degree
40 - 95 degrees F, 10 - 40 degrees C
-40 - 158 degrees F, -40 to 70 degrees C
Primary: 3.6"L X 2.75" W X 1" D
Secondary: 2.1"L X 2.75" W X 1" D
Primary: Approx. 152g
Secondary: Approx. 94g
Magnetic
Machined aluminum
AAA alkaline battery
EN 60601-1 Specifications
Continuous Operation
Class II equipment
BF insulated equipment
IP20
Ingress rating
Equipment not suitable for use in the presence of flammable anesthetics.
i
Register Your Dualer IQ
Please take a moment to register your Dualer IQ with JTECH Medical. This will ensure you easy access to JTECH's
Customer Service and Technical Support and guarantee that you will be fully covered under your warranty.
To register your Dualer IQ please do one of the following:
Call customer service at 800 985-8324 or 801 478-0680.
Copy the form below and fax or mail to JTECH Medical, attention Customer Service.
Fax:
801 478-0673
Mail:
JTECH Customer Service
470 Lawndale Dr., Ste G
Salt Lake City, Utah 84115
Dualer IQ Registration Form
Name: __________________________________________________________________________________________
Company/Clinic Name: _____________________________________________________________________________
Street Address: ___________________________________________________________________________________
City: _________________________________________ State/Province: ____________ Zip/Postal Code: ___________
Phone Number: _____________________________________________
Fax Number: _______________________________________________
E-mail: ____________________________________________________
Date of Purchase: ____________________________________________
Purchased From: __________________________________________________________________________________
Serial Number: ______________________________________________
1
Introduction to Dualer IQ
The Dualer IQ was designed to make measuring spine and large extremity ranges of motion faster, easier and more accurate. The Dualer IQ allows you to measure spine ranges of motion using dual inclinometry, and to measure extremities
using either single or dual inclinometry. The Dualer IQ includes many special features that truly make it a “Smarter”
inclinometer.
Eliminates calculation, placement changes, and repeat procedures.
Provides Total Range of Motion, Upper Segment Extreme and Lower Segment Extreme for spine range of motion
measurements (vital data for AMA-based impairment rating).
Records up to six repetitions per test and up to 19 tests.
Features Dynamic and Static testing modes for the spine and extremities.
In Dynamic mode, Dualer IQ automatically records movement end-points so testing is more convenient.
Works as both dual and single inclinometer.
Upgrades to JTech computerized Range of Motion system without modification.
Dualer IQ and Accessories
Please check your new Dualer IQ to make sure everything is present with your order.
Three straps
Secondary Inclinometer
Primary Inclinometer
Connecting Cable
Protective Carrying
Case (not shown)
Two Alignment Rails
The two alignment rails are located in a small slit in the foam padding.
If any parts are missing from your order, please contact JTECH Customer Service at 800 985-8324 or 801 478-0680.
2
Dualer IQ Operation
Dualer IQ Orientation During Use
The Dualer IQ uses gravity (or the floor) as the reference point when measuring range of motion. Therefore, to ensure
proper orientation and accurate measurement, the narrow side of the Primary and Secondary inclinometers must always
be oriented as close to perpendicular to the floor as possible (shown below). They should never be tipped or rotated
more than 40 degrees off perpendicular, as that will result in inaccurate readings.
NOTE: The Secondary inclinometer functions the same as the Primary units shown below.
Axis of Rotation
The Dualer IQ Primary and Secondary inclinometers measure degrees of motion, up to 360 degrees, around the axis
shown on the right.
Incorrect Orientations
Correct Vertical Orientations
Correct Horizontal Orientations
(Narrow side perpendicular to floor)
Incorrect Vertical Orientations
Floor
Incorrect Horizontal Orientations
(Narrow side is not perpendicular to floor)
3
Dualer IQ Orientation, Continued
For dual inclinometry protocols, the side of Primary and Secondary inclinometers with the Dualer IQ label must both
face the same direction, as shown below. If the labels do not face the same direction when testing, inaccurate readings
can result.
Correct Orientation
(Logos face same way)
Incorrect Orientation
(Logos faces different directions)
Orientation for Different Types of Tests
Dualer IQ has an automatic “Zero” feature that makes placing the inclinometers and starting tests easier. When the inclinometers are positioned and you press the Start/Stop button (see Button Operation for more information), Dualer IQ
automatically zeros. Any movement from the zero point is measured. This innovative feature allows you to position the
inclinometers as shown below for different types of tests.
Important Note: The Primary inclinometer should always be positioned superior to the Secondary inclinometer. For
example, for cervical flexion/extension measurement, the Primary inclinometer should be positioned on the head since
that is where the primary motion occurs.
Basic Orientation
Inclinometers positioned
on patient to start test.
Starting position for tests such as
cervical flexion/extension.
Starting orientation for measuring
spine flexion and extension ranges
of motion.
Starting position for lateral bending
tests and abduction/adduction tests.
The following is an example of the flexibility automatic zeroing provides with the Dualer IQ.
In these illustrations the Dualer
IQ is being used to measure lateral bending. In both illustrations, automatic zeroing ensures
that the start point for both lateral bending movements is 0, even
though the Primary inclinometer
on the right is rotated 90 degrees
at the start.
4
Connecting Primary and Secondary Sensors
The Primary and Secondary sensors are only connected when used for dual inclinometer measurements, such as spine
ROM. Always make sure the Primary sensor is turned off when making the connection.
1. With the Primary sensor turned off, insert an end of the connecting cable into the phone jack (rs232) on top of the
Primary sensor. Make sure the cable locks (“snaps”) in place.
2. Insert the other end of the connecting cable into the phone jack on
the Secondary sensor, making sure it locks into place.
Note:
The Primary sensor functions as a stand-alone for single inclinometry procedures, while the Secondary unit only functions
when attached to the Primary sensor.
Primary Connection
Secondary Connection
Connected for Dual
Inclinometry
Disconnecting Cables
1. Press the release pin on the cable connector.
Cable Connector
Release Pin
2. Pull the cable end out of the Dualer IQ unit.
Turning Dualer IQ On and Off
The power toggle switch is located on top of the Primary sensor. This switch controls
power to both units when the Secondary sensor is attached to the Primary. The symbols
shown below, located on the front of the Primary sensor, indicate power ON and OFF positions.
"ON"
Power Switch (shown
in off position)
"OFF"
Important Note: When test data is stored in the Dualer IQ memory, turning the power off
does not erase that data from the memory. See Button Operation for information about
clearing the memory.
SLEEP MODE
Dualer IQ conserves battery life with an automatic “Sleep” mode. When Dualer IQ is turned on but no activity is detected for five minutes, the unit goes into Sleep mode. All data recorded before entering Sleep mode is stored in memory for
recall.
To rouse from Sleep mode, move the Power Switch to OFF
, wait a moment, then turn switch back to ON
.
Important Note: Even in Sleep mode, the Dualer IQ draws small amounts of power from the battery. Leaving the unit
in Sleep mode for extended periods will eventually drain the battery. Therefore, when not in use, JTech recommends that
you turn the Power Switch OFF
to extend the battery life. Even when the battery goes dead, Dualer IQ will retain
any data already stored in memory.
5
The Dualer IQ Display
The Dualer IQ LCD provides you with both measurement data and operation information. When the Dualer IQ Primary
sensor is turned on, the display will appear in one of the configurations shown below.
Initial display with Secondary sensor attached.
Test number
indicator
Primary and
Secondary
measurements
Initial display with Secondary sensor disconnected.
Dynamic testing indicator (default testing
mode)
Test number
indicator
Total Range of
Motion (Primary
minus Secondary
movement)
Dynamic testing
indicator (default
testing mode)
Range of Motion
(only movement
of Primary sensor
is displayed)
Display Symbols
The following list explains what the various symbols on the display represent:
Test Number - This box shows the number of the test for which you are reviewing or collecting data. Dualer IQ
stores data for up to 19 tests with up to six repetitions each.
Dynamic Testing Mode - Primarily used for measuring range of motion in pairs (ie. flexion/extension). In this
mode, a complete repetition is one flexion and one extension motion or vice versa. In Dynamic mode, Dualer
IQ automatically records the furthest end point (greatest range of motion) for each movement.
Static Testing Mode - Used for measuring a single motion. It is especially useful for kyphosis, ankylosis and
extremity testing. In this mode, a repetition is either one flexion or one extension movement. In Static mode,
endpoints are entered by pressing the Start/Stop button.
Low Battery - When this symbol is displayed the battery is low and should be replaced.
Degrees (angle) - Located next to ROM values to indicate measurements are in degrees.
Total ROM (or differential angle) - This symbol is only displayed for dual inclinometry. The Total ROM value
is the difference in angle between the Primary and Secondary inclinometers. It is produced by subtracting the
Secondary movement value from the Primary movement value.
Primary Inclinometer - Only displayed for dual inclinometry, the number to its right is the actual value measured by the Primary Inclinometer.
Secondary Inclinometer - Only displayed for dual inclinometry, the number to its right is the actual value measured by the Secondary Inclinometer.
Negative Movement - This symbol appears when motion of the Secondary Inclinometer is opposite that of the
Primary Inclinometer.
Repetitions - Shows repetitions performed for the test number displayed. In Dynamic mode, one half of the symbol represents the flexion and the other half the extension segment of the repetition. In Static mode, the symbol
remains whole since only one motion direction is measured for each repetition. Up to six repetitions are available per test.
6
Dualer IQ Control Buttons
Start/Stop Test
All Dualer IQ functions are controlled by three buttons: one
on the top, one on the left side and one on the right side.
Each button is associated with a symbol on the face of the
Primary sensor.
START/STOP - Starts and stops tests, and is used when
clearing the memory.
Scroll
Dynamic/Static
Modes
SCROLL - Scrolls through collected data, advances to
the next test, and is used when clearing memory.
DYNAMIC/STATIC - Switches between Dynamic and
Static testing modes. Dynamic mode is used when the
subject can move through ranges of motion. This makes
testing of movements, such as flexion/extension faster
and easier. Static mode collects data one measurement at
a time.
Clearing the Dualer IQ Memory
The Dualer IQ stores up to 19 tests with up to 6 repetitions each. You must clear the memory to erase data stored there.
Note: The memory can be cleared regardless of whether or not the Secondary sensor is attached.
1. Make sure Primary sensor is turned on.
2. Simultaneously press and hold both the Start/Stop
and Scroll
buttons until CLr is displayed.
3. When cleared, the Dualer IQ resets to begin testing in Dynamic mode at test 1 repetition 1.
How the Control Buttons Function
Dynamic Testing Mode
Using dual inclinometry in Dynamic testing mode is the preferred method for measuring most spine ranges of motion.
Dynamic mode measures movement pairs, such as cervical flexion/extension or left and right cervical lateral flexion.
Dynamic is the default testing mode, so the Dualer IQ automatically begins operation in Dynamic testing mode.
Dynamic tests can be performed using dual or single inclinometry. For dual inclinometry, the display provides three
measurements: movement of both sensors and Total Range of Motion. For single inclinometry, the display only shows
the Primary sensor’s movement. Dynamic Testing for dual or single inclinometry is essentially the same.
Basic Operation for Dynamic Testing
1. For dual inclinometry tests, attach the Secondary sensor. Turn the Primary sensor on.
2. With the patient in neutral position, place the Dualer IQ on the patient according to the test protocol (see Test
Protocols Section for more information).
3. Press the Start/Stop
button to automatically establish 0 and begin collecting test data.
4. Have the patient move in one direction, stop briefly at the farthest point, then move in the opposite direction to the
furthest possible point. Continue doing the movements until the patient completes the requisite number of repetitions
(up to six). To end the test, press the Start/Stop
button.
NOTE: Dualer IQ automatically records the farthest point the patient is able to reach in each direction, so you do not
need to press a button to capture the end range of motion data.
7
2. Patient flexes forward to
maximum range of motion.
1. With inclinometers in place,
press the Start/Stop
button to
zero and begin collecting data.
When test begins
all values are set
to 0 and half of
the repetition
symbol flashes.
When patient
stops and begins
extension, Dualer
IQ records the
end-point and calculates Total
Range of Motion.
3. Patient extends backward to
maximum range of motion.
4. To end the test, have patient move
back toward neutral and press the
Start/Stop
button.
As patient
extends, right half
of repetition symbol flashes. End
points and Total
ROM are recorded
when patient
begins flexion.
Solid repetition
symbols indicate
completed repetitions.
Static Testing Mode
Static testing can be performed using either single or dual inclinometry protocols. Static testing means the patient’s
range of motion is measured in a static position. In Static mode, ROM is also only measured for a single joint movement, such as single inclinometry elbow flexion or dual inclinometry thoracic kyphosis. Dynamic is the default testing
mode, so to perform static tests you must change into Static Testing mode.
1. With the Primary sensor on, press the Dynamic/Static
button to display the Static symbol.
2. Dualer IQ will remain in Static mode until changed back to Dynamic mode or until the Primary unit is turned off.
Basic Static Single Inclinometry Testing
NOTE: In Static testing mode the Dualer IQ does not automatically record the end-point value for range of motion. End
point values are entered using the Start/Stop
button.
1. With the Secondary unit detached, turn the Primary sensor on.
2. Press the Dynamic/Static
button to change into Static mode.
3. Position the Primary sensor at the reference point according to the test protocols and press the Start/Stop
to establish 0.
button
4. According to the protocol, either move the Primary sensor or have the patient move with the inclinometer to the second position and press the Start/Stop
button to record the ROM.
5. Repeat steps 3 and 4 for additional measurements or press the Scroll
8
button to advance to the next test.
This is an example of a static straight leg raise.
Static symbol
1. With Dualer IQ in Static mode and positioned
on the patient, press Start/Stop
to establish 0.
When Start/Stop
is pressed
the first time, the display is
set at 0.
Repetition symbol flashes.
When Start/Stop
is pressed
the second time, the ROM is
recorded.
2. Move patient to the
end-point of the range
of motion and press
Start/Stop
to record
range of motion.
NOTE: The display will continue to change, even though
the ROM was recorded.
Repetition symbol turns solid.
3. Repeat steps for more repetitions or press the Scroll
button to advance to the next test or to review test data.
Basic Operation for Static Dual Inclinometry Testing
Kyphosis and ankylosis measurements are just some of the special uses of Static dual inclinometry. In many of these tests,
a flat surface, such as a table or wall, is used to establish the 0 point.
1. With the Secondary unit attached, turn the Primary sensor on.
2. Press the Dynamic/Static
button to display the Static symbol.
3. Place the inclinometers on a flat surface, such as a wall, or on the patient according to the test protocol and press the
Start/Stop
button to establish 0.
4. According to the protocol, position the inclinometers on the patient or have the patient move to maximum ROM and
press the Start/Stop
button to record the angle.
5. Repeat steps 3 and 4 for additional measurements or use the Scroll
test data.
In Static mode, place inclinometers on flat surface,
such as a wall and press the
Start/Stop
button to
establish zero.
button to advance to the next test or to review
Place the inclinometers on
the patient and press the
Start/Stop
button to
record the angle.
These illustrations are for measuring thoracic kyphosis with static
dual inclinometry.
9
Reviewing Test Data
After at least one test with one repetition is completed, you can use the Scroll
Dualer IQ memory.
1. To begin reviewing stored data, press the Scroll
ond press displays test 1 repetition 1.)
button to review data stored in the
button twice. (The first press advances to the next test, the sec-
2. Continue pressing the Scroll
button to advance through all completed tests and repetitions. Scrolling past the last
stored repetition advances to the next available test. Pressing the button again goes back to test 1 rep 1.
NOTE: You cannot back up or skip tests as you scroll through data. You can only advance through each test and repetition as they were performed.
Advancing Display to Perform Another Test
1. Make sure that none of the repetition symbols is flashing. If one is flashing, you are still in Testing mode and cannot
advance to the next test. (To exit Testing mode, press the Start/Stop
button.)
2. Press the Scroll
button once.
The test number in the display’s
upper left-hand advances to the
next test number. Values for the
Primary and Secondary sensors
are not displayed until you begin
the next test by pressing the
Start/Stop
button.
10
Dualer IQ Accessories
Dualer IQ comes with several accessories that can be used to measure ranges of motion more accurately.
Using Attachment Straps
Velcro straps are provided for attaching Dualer IQ sensors to the body. Using the straps may increase examination time
slightly more than holding sensors in place by hand, but the result is greater accuracy because the straps reduce slippage
of sensors during joint movement.
For spinal range of motion exams, some of the procedures do not require straps. Careful holding of the sensors to the
body by hand is adequate to avoid slippage.
The large strap that comes with the Dualer IQ is recommended for use on the head. This strap can be used with lateral
flexion and rotational movement.
The two shorter straps are used on the extremities. The straps are especially important when performing passive range of
motion tests, as they free the clinician's hands to work with patient. Straps can also be used in special situations, such as
swelling or large muscle mass, that may interfere with sensor placement.
Note: When using straps with extremity procedures, be sure to zero the sensor after it is
attached to the strap and when the subject is in neutral. Dualer IQ measures ROM from
when the Start/Stop
button is pressed, and if neutral was not achieved, the final reading
will be incorrect. If neutral cannot be reached, then alternate procedures for ankylosis
should be used.
Attaching straps to extremities and head
To affix straps, select the proper strap size, place the non-fuzzy side of the strap against the skin, wrap around the body
part stretching the material as you wrap, and affix with the Velcro end.
Place Velcro on backside of sensor flat against the strap in the proper orientation. Wiggle the sensor against the strap to
achieve better contact of the loop material of the strap against the hook material of the sensor.
Using Alignment Rails
Dualer IQ comes with two metal rails that are used to help align the inclinometers when testing. The “feet,” or bottom,
of both the Primary and Secondary inclinometers are magnetized specifically for attaching the alignment rails. See Test
Protocols section for application of the rails.
Dualer IQ sensors have magnetic bottoms to
hold alignment rails in place during testing.
11
Dualer IQ Range of Motion Test Protocols
The following section describes protocols used to measure spine and extremity ranges of motion. Each protocol will tell
you whether it is for dual or single inclinometry. Many of the protocols can be performed in Dynamic or Static testing
mode. Illustrations are included to help you understand inclinometer placement for each protocol.
Number of Repetitions
Three repetitions are usually performed for spine range of motion measurements. When performing an AMA impairment
rating three consecutive measurements must be within 5 degrees or 10 percent (whichever is greater) of the mean (average). If validity is not reached within six repetitions, the test is invalid for impairment rating. For more information see
the Guides to the Evaluation of Permanent Impairment published by the American Medical Association.
One repetition is usually performed for extremity measurements. However, when performing a straight leg raise for
impairment rating, the 5 degree or 10 percent rule applies.
Warm-ups
When performing an impairment evaluation, the Guides 5th Edition recommends that warm-up range of motion movements be performed before the evaluation: two flexion/extension, two left and right rotation, two left and right lateral
bending followed by one additional flexion/extension. Warmups do not need to be repeated before additional measurements on the same spinal region.
About the Illustrations
For clarity, illustrations omit examiner hand placement and the cord connecting the two sensors. Most of the illustrations
are shown from the right side of the patient. The examiner should stand in a position that allows the sensors to be held
firmly to the body through the entire movement.
Cervical Spine Measurements
Some of the cervical protocols include alternate methods for measuring range of motion with the Dualer IQ. Use the one
most comfortable for you.
Head Strap
Some of the illustrations show the sensors used with a strap. Simply affix the sensors as shown. If straps are not used,
place the sensors in the same locations, but use caution to ensure the sensors do not slip during movement.
Cervical Flexion/Extension
Dual inclinometry in Dynamic or Static modes
With the subject seated and cervical spine in neutral, place the Secondary sensor in the sagittal plane at T1 and the
Primary sensor in the sagittal plane on the calvarium. Make sure the sensors do not slip during flexion and extension. If
slippage occurs the Primary sensor can be positioned above the ear using the strap. The subject can reach out and hold a
solid object, such as a table, to prevent shoulder sway during the test. Have subject flex and extend cervical spine.
Note: To avoid the patient bumping the Secondary unit in extension, move the Secondary unit slightly to the left or right
before pressing the Start/Stop
button to begin the test.
In neutral an imaginary line from
the corner of the eye to the ear
should be parallel to the floor.
12
Cervical Flexion/Extension Cont.
Cervical flexion/extension with strap
Ankylosis
Single inclinometry in Static mode.
If some movement is observed, have subject try to reach neutral. If movement to neutral is achieved, evaluate per previous Cervical Flexion/Extension protocol.
Have patient attempt to reach neutral and hold maximum position. Place the Primary sensor at T1 and press the
Start/Stop
button to establish 0. Move the sensor to the upper aspect of the cervical spine and press the Start/Stop
button to record the angle.
With patient as close to neutral
as possible, zero Primary at T1.
While patient maintains position, place
the Primary at upper aspect of cervical
spine and record the angle.
T1
Cervical Lateral Flexion
Dual inclinometry in Dynamic or Static mode
For best accuracy, draw a line at right angles to spine at T1.
With subject in seated position and cervical spine in neutral, place the Secondary sensor in the coronal plane over T1 and
place the Primary sensor over the calvarium. If slippage occurs with the Primary sensor, it can be attached at the back of
the head with a strap. Have subject laterally flex right and left.
Secondary sensor held at T1 and Primary
sensor held on the calvarium.
Cervical lateral flexion/extension
with strap.
Ankylosis
Dual inclinometry in Static mode
Draw a line over the T1 spinous process and attach alignment rails to both sensors.
Place both sensors on a table and press the Start/Stop
button to establish 0. With
subject seated and ankylosis minimized, place the Primary sensor in the coronal
plane at the upper edge of the cervical spine perpendicular to the spine. Place the
Secondary sensor at T1 with the base parallel to the skin mark.
Measuring cervical lateral ankylosis using alignment
rails on the Primary and Secondary sensors.
13
Cervical Rotation
Single inclinometry in Dynamic or Static mode
With the subject supine on a table and head in neutral rotation (nose pointing at the ceiling), place and hold the Primary
sensor in the transverse plane securely on the forehead. If unable to hold the sensor securely, attach it to the top of the
head over the calvarium using a strap. Note: When using the strap, attaching the rail to the sensor and aligning it with
the back of the ears may improve accuracy.
Make sure the inclinometer does not slip as the
patient rolls head from side to side without lifting
head from the table during the test.
Cervical rotation with strap
Alternate Cervical Rotation
Inclinometers are perpendicular
to the floor when testing.
Dual inclinometry in Dynamic or Static mode
Note: This procedure should not be used for impairment rating.
Have subject standing or sitting, bent forward at the waist at least 45 degrees. With the cervical spine in neutral rotation, place the Primary sensor on the back of the head and the
Secondary sensor over T1.
Ankylosis
Single inclinometry in Static Mode
Attach the alignment rail to the Primary sensor, then place the sensor on a table and press the Start/Stop
button to
establish 0. With the subject in a supine position with the head rotated as close to neutral as possible, place the Primary
sensor over the calvarium and align the rail with the back of the ears, and record the angle.
Position sensor over calvarium and
align rails with back of the ears.
14
Thoracic Spine Measurements
For thoracic measurements, the sensors are held at the ends of the region by the examiner. Stand to the side of the patient
with your thumb and middle fingers on opposite sides of the sensor near the base, allowing easy access to the Start/Stop
button. Start tests when the subject is in neutral.
Thoracic Neutral Posture (Minimum Kyphosis)
Dual inclinometry in Static mode
With subject either standing or sitting in a neutral “military brace” position, place the sensors on a
wall and press the Start/Stop
button to establish 0. Place the Primary sensor at T1 and the
Secondary sensor at T12 and record the angle.
In static mode, place inclinometers on a wall, and
press the Start/Stop
button to establish 0.
Position inclinometers and
press the Start/Stop
button
to measure kyphosis.
Thoracic Flexion
Dual inclinometry in Static mode
With subject standing or sitting in neutral “military brace position,” place the Primary sensor in the sagittal plane at T1
and the Secondary sensor at T12. Press the Start/Stop
button to establish 0. Have subject fully flex the thoracic spine
(bending at the waist is permitted) and record the angle.
Position inclinometers at T1 and T12. Press
the Start/Stop
button to establish 0.
Make sure narrow side of inclinometers is
oriented parallel to the spine.
Hip movement is automatically
subtracted from Total ROM.
Thoracic Lateral Flexion
Dual inclinometry in Dynamic or Static mode
Note: This measurement is not needed for AMA impairment ratings.
For best accuracy, place a line at right angles to the spine at T1 and T12. With subject standing or seated with thoracic
spine in neutral, place Primary sensor at T1 and the Secondary sensor at T12 in the coronal plane. Have subject bend laterally to the left and right.
Primary at T1 and
Secondary at T12
Right lateral flexion
15
Left lateral flexion
Thoracic Lateral Flexion Cont.
Ankylosis
Dual inclinometry in Static mode
Draw lines over the T1 and T12 spinal processes and attach alignment rails to both inclinometers. Place both sensors on
a table and press the Start/Stop
button to establish 0. With subject minimizing the lateral flexion ankylosis, place the
Primary sensor at T1 and the Secondary sensor T12 in the coronal plane with alignment rails positioned over the skin
lines and record the angle.
In Static mode, place inclinometers on a table and press
the Start/Stop
button to
establish 0.
Place inclinometers at T1 and
T12 in alignment with the
skin marks you drew and
record the angle.
Thoracic Rotation
Dual inclinometry in Dynamic or Static mode
Place skin marks over the T1 and T12 spinal processes. With subject seated or standing, have the subject flex forward
until the spine is horizontal with the floor. Place the Primary sensor at T1 and the Secondary sensor at T12 in the transverse plane. Make sure both sensors are perpendicular to the floor. Have subject rotate maximally left and right.
Side view of inclinometer positioning
Shown in standing
positioning
Right Rotation
Neutral Position
16
Left Rotation
Lumbosacral Spine Measurements
For most lumbosacral measurements, the sensors are held at the ends of the region by the examiner. Stand to the side of
the patient with your thumb and middle fingers on opposite sides of the sensor near the base, allowing easy access to the
Start/Stop
button. Start tests when the subject is in neutral.
Included in the Lumbosacral Section is the “straight leg raise.” This protocol is described in the AMA Guides to the
Evaluation of Permanent Impairment as a validity check for lumbosacral flexion/extension.
Lumbosacral Lordosis
Dual inclinometry in Static mode
Place both sensors on a wall and press the Start/Stop
button to establish
0. With subject standing in neutral, knees straight and weight equally on
both feet, place at Primary sensor at T12 and the Secondary sensor over the
sacral midpoint in the sagittal plane and record angle.
T12
Sacral
Midpoint
Zero sensors on a wall
Lumbosacral Flexion/Extension
Dual inclinometry in Dynamic or Static modes
Important Note: The Dualer IQ provides all the necessary data for complete
lumbosacral flexion/extension impairment evaluation without additional
inclinometer placements. When the Dualer IQ sensors are placed as
described below, the display provides T12 ROM (Primary sensor), Sacral
ROM (Secondary sensor) and Total ROM with each flexion/extension
movement.
Total ROM Value
Sacral ROM Value
T12 ROM Value
Note: The AMA Guides requires three consecutive flexion and three consecutive extension repetitions to be within 5
degrees or 10 percent, which ever is greater, of the average for valid impairment rating. Validity does not necessarily
mean they must be the same flexion/extension pair. For example, if the first three flexion movements are valid, but
extension is not, continue the test until also reaching valid extension, up to six repetitions. You would then use the
first three consecutive flexion values and the three consecutive extension values.
Have subject stand with spine in neutral position, knees straight, weight equally on both feet and hands on hips. Place
the Primary sensor at T12 and the Secondary sensor over the sacral midpoint in the sagittal plane. Have subject flex forward maximally, then extend maximally.
Dualer IQ simultaneously measures and displays
T12, sacral hip and total ROM values for lumbosacral flexion and extension.
Primary at
T12
Secondary
center over
sacral
midpoint
Extension
Flexion
17
Lumbosacral Spine Measurements
For most lumbosacral measurements, the sensors are held at the ends of the region by the examiner. Stand to the side of
the patient with your thumb and middle fingers on opposite sides of the sensor near the base, allowing easy access to the
Start/Stop
button. Start tests when the subject is in neutral.
Included in the Lumbosacral Section is the “straight leg raise.” This protocol is described in the AMA Guides to the
Evaluation of Permanent Impairment as a validity check for lumbosacral flexion/extension.
Lumbosacral Lordosis
Dual inclinometry in Static mode
Place both sensors on a wall and press the Start/Stop
button to establish
0. With subject standing in neutral, knees straight and weight equally on
both feet, place at Primary sensor at T12 and the Secondary sensor over the
sacral midpoint in the sagittal plane and record angle.
T12
Sacral
Midpoint
Zero sensors on a wall
Lumbosacral Flexion/Extension
Dual inclinometry in Dynamic or Static modes
Important Note: The Dualer IQ provides all the necessary data for complete
lumbosacral flexion/extension impairment evaluation without additional
inclinometer placements. When the Dualer IQ sensors are placed as
described below, the display provides T12 ROM (Primary sensor), Sacral
ROM (Secondary sensor) and Total ROM with each flexion/extension
movement.
Total ROM Value
Sacral ROM Value
T12 ROM Value
Note: The AMA Guides requires three consecutive flexion and three consecutive extension repetitions to be within 5
degrees or 10 percent, which ever is greater, of the average for valid impairment rating. Validity does not necessarily
mean they must be the same flexion/extension pair. For example, if the first three flexion movements are valid, but
extension is not, continue the test until also reaching valid extension, up to six repetitions. You would then use the
first three consecutive flexion values and the three consecutive extension values.
Have subject stand with spine in neutral position, knees straight, weight equally on both feet and hands on hips. Place
the Primary sensor at T12 and the Secondary sensor over the sacral midpoint in the sagittal plane. Have subject flex forward maximally, then extend maximally.
Dualer IQ simultaneously measures and displays
T12, sacral hip and total ROM values for lumbosacral flexion and extension.
Primary at
T12
Secondary
center over
sacral
midpoint
Extension
Flexion
17
Lumbosacral Rotation Cont.
Ankylosis
Dual inclinometry in Static mode
Place both sensors on a table and press the Start/Stop
button to establish 0. With the subject either sitting or standing,
flexed forward, and spine as close to horizontal and neutral rotation as possible, place the Primary sensor at T12 and
Secondary over the sacral midpoint and record the angle. (See previous lumbosacral rotation illustrations for inclinometer placement.)
Lumbosacral Lateral Flexion
Dual inclinometry in Dynamic or Static mode
For best accuracy, place a line at right angles to the spine at T12 and sacral midpoint. With subject standing in neutral
with the knees straight, place the Primary sensor at T12 and the Secondary over sacral midpoint. Make sure bases of the
sensors remain over the lines drawn on the skin throughout the movement.
Note: If the sensors can be firmly held on the body without slippage, then alignment marks on the body and rails are not
needed.
T12
Sacral Midpoint
Ankylosis
Dual inclinometry in Static mode
For best accuracy, place a line at right angles to the spine at the sacral midpoint and T12. Place both sensors on a table
and press the Start/Stop
button to establish 0. With the subject minimizing the ankylosis, place the Primary sensor at
T12 and the Secondary sensor over the sacral midpoint and press the Start/Stop
button to record the angle.
Position the sensors and
press the Start/Stop
button to record the angle.
Place both sensors on a table and press
the Start/Stop
button to establish 0.
19
Additional Spine ROM Measurements
Gross Combined Hip and Spinal Flexion/Extension
Dual inclinometry in Dynamic or Static mode
Note: This measurement is not used for AMA impairment rating.
Primary at T1
Attach the Secondary sensor to the thigh with a strap and hold the
Primary sensor at T1. With the subject standing upright in a neutral
position, press the Start/Stop
button to establish 0. Have subject
flex forward maximally, then extend maximally.
Secondary attached
to thigh.
Flexion
Extension
Gross Spinal Flexion/Extension
Dual inclinometry in Dynamic or Static modes
Note: This measurement is not used for AMA impairment ratings.
Primary at T1.
With the subject standing upright in a neutral position, place the
Primary sensor at T1 and the Secondary sensor over the sacral midpoint. Have the subject flex maximally and extend maximally.
Secondary over the
sacral midpoint.
Flexion
Extension
Sacral Hip Flexion/Extension
Dual inclinometry in Dynamic and Static modes
Note: Dualer IQ automatically shows sacral hip motion when performing lumbosacral flexion/extension measurements.
With the subject standing in neutral, attach the Secondary sensor
to the thigh with a strap and hold the Primary sensor over the
sacral midpoint. Have the subject flex maximally and extend
maximally.
Primary held over
the sacral midpoint.
Secondary attached
or held on the thigh.
Extension
Flexion
20
Scoliosis Measurements
Several methods can be used to determine the degree of scoliosis from x-ray. Two methods are described below.
Ferguson's Method
Single inclinometry in Static mode
See Roentgen Diagnosis of Extremities and Spine: 1949.
1. Attach a rail to the Primary sensor. Set the inclinometer to Static mode.
2. Place the x-ray film vertically in a view box. Mark the apical vertebrae of the curvature and the two points at the
ends of the curve.
3. Span the middle and outer point defined above with the sensor and press the Start/Stop
4. Span the middle point and the other outer point and press the Start/Stop
button to establish 0.
button to record the angle.
Position inclinometer over
the upper vertebra and press
the Start/Stop
button.
Position inclinometer over
the lower vertebra and press
the Start/Stop
button to
record the angle.
Cobb's Method
Single inclinometry in Static mode
See Cobb: American Academy of Orthopedic Surgery, 1948.
1. Attach a rail to the Primary sensor and set it to Static mode.
2. Place the x-ray film vertically in a view box. Determine an end vertebra of the curvature, place the sensor rail along
the long axis of the segment, and press the Start/Stop
button to establish 0..
3. Determine the vertebra at the other end of the curve, place the sensor rail along the long axis of the segment, and
press the Start/Stop
button to record the angle.
Position inclinometer over the
long axis of the vertebra at the
top of the curve and press the
Start/Stop
button.
Position inclinometer over the vertebra at the
lower end of the curve and press the
Start/Stop
button to record the angle.
21
Extremity Protocols
Dual and single inclinometer methods for measuring range of motion of each joint are illustrated. Choose the one most
comfortable for you to use. Protocols for measuring ankylosed joints are also included.
Simulated Goniometer
Dualer IQ can be used to simulate a goniometer, both in dual and single inclinometry modes, when measuring extremity
ranges of motion. While the individual angles of the Primary and Secondary units are displayed for dual inclinometry,
only the Total Range of Motion value is typically required for extremity range of motion. The Dualer IQ is very accurate
for measuring extremity ranges of motion because it effectively eliminates goniometer alignment errors and substantially
increases inter- and intra-rater repeatability.
Upper Extremities
Wrist Flexion/Extension
Dual inclinometry in Dynamic or Static mode
Support the arm with the patient’s wrist in neutral. Hold the Primary sensor on the dorsal
aspect of the hand and the Secondary sensor on top of the forearm. Have subject flex and
extend the wrist.
Wrist
Extension
Note: If either sensor does not parallel the longitudinal axis of the segment due to swelling,
use static single inclinometry with alignment rails described below.
Wrist Flexion
Single inclinometry in Static mode
Note: If swelling is present, attach the alignment rail and align the Primary sensor
along the axis of each segment instead of placing it on top of the forearm and
hand.
Start test with
Primary on top
of the forearm
With the arm supported, have subject flex wrist maximally. Place the Primary sensor
on the top of the forearm and press the Start/Stop
button to establish 0. While
subject maintains wrist flexion, place the Primary sensor on the back of the hand and
press the Start/Stop
button to record the angle.
Have subject extend the wrist and repeat the above procedure.
Elbow Pronation/Supination
Dual inclinometry in Dynamic or Static mode
Wrist Flexion
Wrist Extension
Note the offset rotation of the Primary and Secondary sensors in the neutral
position. The sensors can be placed this way because of Dualer IQ’s automatic zero feature.
Note: For better accuracy attach the Secondary sensor to the upper arm with a strap.
Have subject seated, elbow flexed to 90 degrees and
the forearm in the neutral position. Strap or hold the
Secondary sensor to the upper arm and place the
Primary unit on the dorsal side of the wrist. Have
subject pronate and supinate the elbow.
Elbow at 90 degrees and
wrist in neutral position.
22
Pronation
Supination
Elbow Pronation/Supination Cont.
Ankylosis
Single inclinometry in Static mode
Note: Use this procedure if the subject cannot reach neutral for elbow pronation or supination.
Have the subject seated, elbow flexed at 90 degrees, and forearm as close to neutral as possible. Place the Primary sensor on a wall and press the Start/Stop
button to establish 0. Place the Primary sensor on the wrist and press the
Start/Stop
button to record the angle.
In Static mode, place the Primary
sensor on a wall and press the
Start/Stop
button to establish 0.
With subject as close to neutral as possible, place the
Primary sensor on the wrist
and record the angle.
Elbow Flexion/Extension
Dual or Single inclinometry in Dynamic mode
Note: For best accuracy, attach sensors with straps and support the upper arm on a flat table.
For dual inclinometry, attach the Primary sensor to the forearm and the Secondary sensor to the upper arm. For single
inclinometry, attach the Primary sensor to the forearm with a strap. Begin the test with the subject’s shoulder flexed to
90 degrees and elbow at neutral. Have subject flex the elbow, then extend the elbow.
Helpful Hint: If the sensors touch during dual inclinometry flexion, move one closer to the elbow and the other away
from the elbow.
Dual Inclinometry
Elbow Flexion
Single Inclinometry
Elbow Flexion
Single inclinometry in Static mode
Note: Use this procedure for ankylosis measurement.
Attach the alignment rail to the Primary sensor. Have subject’s shoulder flexed to 90 degrees and elbow flexed maximally. Place the Primary sensor’s alignment rail along the long axis of the upper arm and press the Start/Stop
button to
establish 0. Without moving the upper arm, rotate the Primary sensor to the long axis of the forearm and press the
Start/Stop
button to record the angle.
23
Shoulder Internal/External Rotation
Single inclinometry in Dynamic or Static mode
Attach the Primary sensor to the forearm with a strap. Have subject stand or sit with shoulder abducted to 90 degrees,
elbow flexed to 90 degrees, and upper arm in neutral rotation. If torso sway is a problem, the Secondary sensor can be
attached and positioned over the sternum. Have subject externally and internally rotate the shoulder.
Note: This test can also be performed in a prone or supine position with the upper arm supported.
Arm in Neutral
Externally Rotated
Internally Rotated
Shoulder Flexion/Extension
Single inclinometry in Dynamic or Static mode
Attach the Primary sensor to the upper arm with a strap. Have subject stand with arm down and shoulder in neutral position. Have subject flex and extend the shoulder maximally.
Note: For motion between the humerus and scapula, attach the Secondary sensor and hold it firmly against the scapula
during motion. If torso sway affects the test, attach and hold the Secondary unit against the sternum.
Secondary unit can be
attached for scapular
motion.
shoulder in
Neutral
Shoulder Flexed
To eliminate
effects of sway,
attach Secondary
unit and place it
on the sternum.
Shoulder Extended
Ankylosis
Single inclinometry in Static mode
Attach an alignment rail to the Primary sensor. Place the Primary sensor on a wall and press the Start/Stop
button to
establish 0. Align the rail of the primary sensor along the axis of the upper arm and press the Start/Stop
button to
record the angle.
Note: If movement is possible, have subject flex or extend as far as possible and record the angles.
24
Shoulder Flexion/Extension Cont.
Shoulder Extension
Ankylosis
Shoulder Flexion
Ankylosis
Establish 0 on a wall in
this orientation for shoulder extension ankylosis.
Establish 0 on a wall in
this orientation for shoulder flexion ankylosis.
Shoulder Adduction/Abduction
Single inclinometry in Dynamic or Static modes
Attach the Primary sensor to upper arm with a strap. Place subject in a standing position with arm down in neutral and
hand supinated. Have subject adduct and abduct the shoulder maximally.
Note: If torso sway affects the test, attach and hold the Secondary unit against the sternum.
Secondary unit attached
to compensate for sway
during movement.
Arm in Neutral
Shoulder Abduction
Shoulder Adduction
Ankylosis
Single inclinometry in Static mode
Place an alignment rail on the Primary sensor and have subject stand with arm down as close to neutral as possible and
hand supinated. Place the Primary sensor on a wall and press the Start/Stop
button to establish 0. Place the Primary
sensor’s rail along the axis of the upper arm and record the angle.
Primary sensor aligned
with upper arm.
Establish 0 on a wall.
25
Lower Extremities
Ankle Dorsiflexion/Plantar Flexion
Single inclinometry in Static mode
Place the subject on a horizontal surface with the foot in neutral position. Attach an alignment rail to the Primary sensor
and place on the sole of the foot. Have subject dorsiflex and record the angle, then plantar flex and record the angle.
Ankle in Neutral
Dorsiflexion
Plantar Flexion
Single inclinometry in Static mode for impairment rating
Verify that the wall used for zeroing the sensor is 90 degrees to the surface on which the patient is placed. Place the
Primary sensor on the wall, press the Start/Stop
button to establish 0, then place it on the surface.
Step 1.
Place the subject supine on a horizontal surface with the tibia parallel to the surface and the ankle in neutral position.
With an alignment rail attached, place the Primary sensor on the wall and press the Start/Stop
button to establish 0.
Place the Primary sensor on the sole, and measure the dorsiflexion angle. Rezero the sensor on the wall and measure
plantar flexion.
Step 2
Flex the subject’s knee to 45 degrees and align the sensor along the tibia and press the Start/Stop
button to establish
0. Dorsiflex the foot, place the Primary sensor on the sole, and record the angle. Repeat for plantar flexion.
Subtract 90 degrees from the dorsiflexion value for the true dorsiflexion angle and subtract the plantar flexion value
from 90 degrees for true plantar flexion.
Step 3
Average the results of both sets of measurements and use to calculate the impairment.
Establish 0 on a wall ...
Establish 0 on a wall ...
then measure dorsiflexion.
With knee flexed at 45
degrees, align Primary sensor
with tibia.
then measure plantar flexion.
Measure dorsiflexion and subtract 90 degrees.
26
Realign with tibia, measure plantar
flexion and subtract the results from
90 degrees.
Knee Flexion/Extension
Dual inclinometry in Dynamic mode
Helpful Hint: If the sensors touch during flexion, move one closer to the knee and the other away from the knee.
Attach one sensor to the lower leg and one to the thigh with straps. Have the subject lying on a horizontal surface with
the knee neutral. Have the subject flex the knee maximally, then extend the knee.
Single inclinometry in Static mode
Attach a rail to the Primary sensor. With the subject supine on a horizontal surface and the knee flexed maximally, place
the sensor's rail along the femur and press the Start/Stop
button to establish 0. Place the Primary sensor’s rail along
the tibia and press the Start/Stop
button to record the angle. If the subject cannot reach neutral, this value represents
extension lag.
Place the Primary sensor
along the femur and press
the Start/Stop
button to
establish 0.
Align the Primary sensor
along the tibia and record
the angle.
Knee Extension Lag
Dual inclinometry in Static mode
Note: Use the procedure if subject cannot reach neutral knee position.
Attach rails to the sensors and zero on a table. With the subject supine on a horizontal surface and the knee as close to
neutral as possible, place one sensor's rail along the femur and the other along the tibia and record the angle.
Establish 0 on a table.
Subject supine on table, sensors on femur and tibia.
Hip Forward Flexion
Single inclinometry in Static mode
Attach the Primary sensor to the thigh with a strap. With the subject supine on a table, place the hip to be evaluated in
neutral position and extend the knee in neutral position. Have the subject flex the opposite hip and knee and hold them
in position. Press the Start/Stop
button to establish 0, then have subject flex hip until the iliac spine begins to move
and record the angle.
Hip for evaluation in neutral, opposite hip
flexed and held.
Hip for evaluation is raised to maximum flexion
and the angle is recorded.
27
Hip Flexion Cont.
Ankylosis
Single inclinometry in Static mode
Attach an alignment rail to the Primary sensor, place the sensor on a table and establish 0. With the subject supine, have
the subject flex both hips and hold the opposite hip. Place the sensor rail along the femur and record the angle.
With hip flexed maximally, place the
Primary along the femur and press
Start/Stop
to record the angle.
Place the sensor on a table and press the
Start/Stop
button to establish 0.
Hip Extension
Single inclinometry in Static mode
Attach the primary sensor to the thigh with a strap. Place the subject prone on a horizontal surface with hip and knee in
neutral position. Press the Start/Stop
button to establish 0. Have subject extend hip maximally and record the angle.
Hip in Neutral Position
Record angle with hip extended.
Ankylosis
Single inclinometry in Static mode
Note: If subject can reach neutral hip position, the previous hip extension protocol should be used.
Attach an alignment rail to the Primary sensor. Place the sensor on a table and press the Start/Stop
button to establish
0. Place the subject supine on a horizontal surface with the hip as close to neutral as possible. Place the Primary sensor’s
alignment rail along the femur and record the angle.
Place the sensor on a table and press the
Start/Stop
button to establish 0.
Hip unable to reach neutral for
extension (ankylosed).
28
Hip Abduction/Adduction
Single inclinometry in Dynamic or Static mode
Attach the Primary sensor to the front of the thigh with a strap. Place the subject on the edge of a table with leg hanging
downward off the table and the hip in neutral position. The opposite hip and knee are flexed and held to lock the pelvis.
Subject abducts the hip maximally, then adducts the hip maximally.
Hip in neutral position
with the leg hanging down
off the end of the table.
Hip abducted
Hip adducted
Ankylosis
Single inclinometry in Static mode
Attach the alignment rail to the Primary sensor, place the sensor on a wall and press the Start/Stop
button to establish
0. Place the subject on the edge of a table with leg hanging downward off the table and the hip as close to neutral as possible. The opposite hip and knee are flexed and held to lock the pelvis. Place the edge of the Primary sensor’s rail along
the front of the femur so the back of the sensor rests on the thigh and record the angle.
Place the sensor on a wall and
press the Start/Stop
button
to establish 0.
With leg hanging off table and hip
as close to neutral as possible,
place the Primary sensor on front
of thigh in line with the femur.
29
Hip Internal/External Rotation
Single inclinometry in Dynamic or Static mode
With the subject prone on a table, knee flexed 90 degrees and hip in neutral position, attach the Primary sensor to the
tibia with a strap. Have subject internally rotate the hip maximally, then externally rotate the hip.
Ankylosis
Single inclinometry in Static mode
Place subject prone on a table, knee flexed at 90 degrees and hip as close to neutral as possible. Attach an alignment rail
to the Primary sensor, place the sensor on a wall and press the Start/Stop
button to establish 0. Align the Primary sensor’s rail along the middle of tibia and record the angle of ankylosis.
Align with tibia and press
the Start/Stop
button to
record the angle.
With the Primary sensor placed on a wall,
press the Start/Stop
button to establish 0.
30
Dualer IQ Worksheet Templates
The worksheet templates provided on the following two pages can be used to record test data from your Dualer IQ.
Simply photocopy the worksheet templates as you need them and record the data from your Dualer IQ exams onto the
copied forms.
For progress reports, place maximum ROM in the column under the date. For impairment ratings, use the columns for
each repetition in the exam.
On spinal exam worksheet, ankylosis should be indicated with an “A.” For extremity exams indicate ankylosis with a “-”
symbol.
Computerized Reporting
For more professional looking reports and computerized data management, JTECH Medical offers our Easy Doc Plus
program. Easy Docs Plus allows you to enter all your data into the software using your keyboard. You can then print
computerized reports in both narrative and data formats.
For easier impairment rating, Easy Docs Plus has an optional AMA licensed Impairment Module. The Impairment
Module automatically calculates test validity and impairments to the whole-person level based on your test data.
For more information on Easy Docs Plus, contact the JTECH Sales Department at 800 985-8324 or 801478-0680.
31
Dualer IQ Spinal Range of Motion Worksheet
Patient Name: ___________________________________________________________ ID #: __________________
Date of Birth: _________________________________ Social Security #: __________________________________
Occupation: ___________________________________ Employer: ________________________________________
Date of First OV: ______________________________ Date of Injury: ____________________________________
Reason for Exam: ________________________________________________________________________________
Date (Progress Report) __________
__________
__________
__________
__________
__________
Cervical Region
Flexion
__________
__________
__________
__________
__________
__________
Extension
__________
__________
__________
__________
__________
__________
Right Lateral
__________
__________
__________
__________
__________
__________
Left Lateral
__________
__________
__________
__________
__________
__________
Right Rotation
__________
__________
__________
__________
__________
__________
Left Rotation
__________
__________
__________
__________
__________
__________
Minimum Kyphosis
__________
__________
__________
__________
__________
__________
Flexion
__________
__________
__________
__________
__________
__________
Extension
__________
__________
__________
__________
__________
__________
Right Lateral
__________
__________
__________
__________
__________
__________
Thoracic Region
Left Lateral
__________
__________
__________
__________
__________
__________
Right Rotation
__________
__________
__________
__________
__________
__________
Left Rotation
__________
__________
__________
__________
__________
__________
Lumbosacral Region
Lordosis at Neutral
__________
__________
__________
__________
__________
__________
Right Lateral
__________
__________
__________
__________
__________
__________
Left Lateral
__________
__________
__________
__________
__________
__________
Right Rotation
__________
__________
__________
__________
__________
__________
Left Rotation
__________
__________
__________
__________
__________
__________
Flexion
__________
__________
__________
__________
__________
__________
Sacral Hip Flexion
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
Total Sacral Hip (Flex+Ext) __________
__________
__________
__________
__________
__________
Right Straight Leg Raise __________
__________
__________
__________
__________
__________
Left Straight Leg Raise
__________
__________
__________
__________
__________
Extension
Sacral Hip Extension
__________
Straight Leg Raise Mean
Right Side ___________
Lumbar Flexion/Extension Validity:
__________
SLR
-
Left Side _____________
_________
=
_________
(Use smallest)
(Less than or equal to 15º for validity)
Total Sacral Hip (Flex+Ext)
Examiner’s Name: ______________________________________________________________________________
Examiner’s Signature: __________________________________________________________________________
Inability to reach neutral is indicated with an “A.”
This chart may be reproduced for the purpose of examination with the Dualer IQ only. Any other use is strictly prohibited.
Copyright © ZEVEX International. All rights reserved.
Dualer IQ Extremity Range of Motion Worksheet
Patient Name: ___________________________________________________________ ID #: __________________
Date of Birth: _________________________________ Social Security #: __________________________________
Occupation: ___________________________________ Employer: ________________________________________
Date of First OV: _____________ Date of Injury: __________________ Affected Side: Right
Left
Reason for Exam: ________________________________________________________________________________
Date (Progress Report) _________
_________
________
________
_________
_________
Non affected
side (max)
Upper Extremity
Wrist Flexion
_________
_________
________
________
_________
_________
________
Wrist Extension
_________
_________
________
________
_________
_________
________
Elbow Pronation
_________
_________
________
________
_________
_________
________
Elbow Supination
_________
_________
________
________
_________
_________
________
Elbow Flexion
_________
_________
________
________
_________
_________
________
Elbow Extension
_________
_________
________
________
_________
_________
________
Shoulder Internal Rot.
_________
_________
________
________
_________
_________
________
Shoulder External Rot. _________
_________
________
________
_________
_________
________
Shoulder Flexion
_________
_________
________
________
_________
_________
________
Shoulder Extension
_________
_________
________
________
_________
_________
________
Shoulder Abduction
_________
_________
________
________
_________
_________
________
Shoulder Adduction
_________
_________
________
________
_________
_________
________
Ankle Dorsiflexion
_________
_________
________
________
_________
_________
________
Ankle Plantar Flexion
_________
_________
________
________
_________
_________
________
Knee Flexion
_________
_________
________
________
_________
_________
________
Knee Extension
_________
_________
________
________
_________
_________
________
Hip Flexion
_________
_________
________
________
_________
_________
________
Hip Extension
_________
_________
________
________
_________
_________
________
Hip Abduction
_________
_________
________
________
_________
_________
________
Hip Adduction
_________
_________
________
________
_________
_________
________
Hip External Rotation
_________
_________
________
________
_________
_________
________
Hip Internal Rotation
_________
_________
________
________
_________
_________
________
Lower Extremity
Examiner’s Name: ______________________________________________________________________________
Examiner’s Signature: __________________________________________________________________________
For progress reports, place maximum ROM in column for the date. For impairment ratings, use the columns for each repetition in the exam.
Inability to reach neutral is indicated with a “-” sign.
This chart may be reproduced for the purpose of examination with the Dualer IQ only. Any other use is strictly prohibited.
Copyright © JTECH Medical. All rights reserved.
Dualer IQ Care and Maintenance
Dualer IQ is a precision instrument and should be handled with care. Avoid dropping or banging the inclinometers as
repeated abuse may void your warranty. Keep the instruments clean, but do not immerse them or the cables in water. Do
not use an autoclave. When not in use, make sure the Primary sensor is turned off to conserve battery life. Always store
the Primary and Secondary sensors in their protective carrying case.
Clean the exterior housings of the sensors with a non-scratching, slightly damp (not wet) cloth. Use only mild soap
and water.
Do not use alcohol, harsh cleaners, disinfectant or solvents as they may damage the LCD cover.
Battery Life and Installation
Dualer IQ is powered by a single AAA battery, which should provide 30 hours of continuous operation. A battery symbol appears on the LCD when the battery has approximately three hours of continuous use left. Dualer IQ will shut down
soon after the symbol appears to prevent spurious operation. Replace the battery when this symbol appears.
Low Battery Symbol - When this symbol is displayed the battery is low and should be replaced.
The Dualer IQ has a “Sleep” feature to help conserve battery life. When no movement is detected for five minutes the
Dualer IQ automatically goes into Sleep mode. In this state Dualer IQ will not record or display data. To rouse from
Sleep mode, turn the Primary sensor off, wait a few seconds and turn the sensor back on.
Note: Even in Sleep mode the Dualer IQ will draw small amounts of power from the battery, therefore Dualer IQ should
always be turned off when not in use.
Installing a New Battery
The Dualer IQ battery is located inside the Primary sensor housing.
1. Remove cover screws from Primary sensor using a Phillips screwdriver and carefully lift off the cover.
2. Momentarily ground yourself against a metal object to discharge any static charge. A STATIC ELECTRIC SHOCK
TO THE CIRCUIT BOARD CAN PERMANENTLY DAMAGE YOUR INSTRUMENT.
3. Remove the old battery from the battery clip.
4. Install a new AAA alkaline battery, making sure the battery polarity is correct.
5. Replace the cover and tighten screws till just snug. Over tightening can strip the threads in the housing.
6. Test operation before using the instruments with a patient.
34
Dualer IQ Warranty
One-year Limited Warranty
The Dualer IQ is designed to perform reliably and to meet specifications. In spite of care exercised in manufacture, it is
impossible to eliminate malfunctions due to random and component failure. Therefore, JTECH will, at its option, repair
or replace the product with a new or reconditioned unit at no charge for a period of one year from the date of purchase.
In view of the varied conditions in which the unit will be used, it is sold "as is" and JTECH's responsibility does not go
beyond the terms set forth above. JTECH will not be responsible for medical expenses or any direct, incidental, or consequential damages arising from the use of this product.
THIS WARRANTY IS MADE EXPRESSLY IN LIEU OF ANY OTHER WARRANTY, EXPRESSED OR IMPLIED,
INCLUDING AN IMPLIED WARRANTY OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE. UNDER NO CIRCUMSTANCES SHALL JTECH BE LIABLE FOR ANY DIRECT, INCIDENTAL, OR CONSEQUENTIAL DAMAGES. THE REMEDIES SET FORTH IN THIS WARRANTY SHALL BE THE ONLY REMEDIES AVAILABLE, EXCEPT AS SPECIFICALLY PROVIDED BY STATE LAW. NO PERSON HAS ANY AUTHORITY TO BIND JTECH TO ANY REPRESENTATION OR WARRANTY EXCEPT AS SPECIFICALLY SET FORTH
HEREIN.
To Have Your Dualer IQ Repaired
1. Contact JTECH Customer Service (800 985-8324 or 801 478-0680) to describe the problem and receive an RMA
number. No returns will be accepted without an RMA number. Return the Dualer IQ in its case with all accessories
using a prepaid, insured, trackable shipping method to JTech Medical Industries. JTECH IS NOT RESPONSIBLE
FOR DAMAGES OR LOSSES INCURRED DURING RETURN SHIPMENT.
2. Submit original date and proof of purchase.
3. Include a brief description of the problem.
35
470 Lawndale Dr., Ste G
Salt Lake City, UT 84115 800 985-8324
www.jtechmedical.com
801 478-0680