Measuring waist circumference in disabled adults
Open accessAbstract
To date, it is unknown whether waist circumference can be measured validly and reliably when a subject is in a supine position. This issue is relevant when international standards for healthy participants are applied to persons with severe intellectual, sensory, and motor disabilities. Thus, the aims of our study were (1) to determine the validity of waist circumference measurements obtained in a supine position, (2) to formulate an equation that predicts standing waist circumference from measurements obtained in a supine position, and (3) to determine the reliability of measuring waist circumference in persons with severe intellectual, sensory, and motor disabilities. First, we performed a validity study in 160 healthy participants, in which we compared waist circumference obtained in standing and supine positions. We also conducted a test-retest study in 43 participants with severe intellectual, sensory, and motor disabilities, in which we measured the waist circumference with participants in the supine position. Validity was assessed with paired t-test and Wilcoxon signed rank test. A prediction equation was estimated with multiple regression analysis. Reliability was assessed by Wilcoxon signed rank test, limits of agreement (LOA), and intraclass correlation coefficients (ICC). Paired t-test and Wilcoxon signed rank test revealed significant differences between standing and supine waist circumference measurements. We formulated an equation to predict waist circumference (R(2)=0.964, p<0.001). There were no significant differences between test and retest waist circumference values in disabled participants (p=0.208; Wilcoxon signed rank test). The LOA was 6.36 cm, indicating a considerable natural variation at the individual level. ICC was .98 (p<0.001). We found that the validity of supine waist circumference is biased towards higher values (1.5 cm) of standing waist circumference. However, standing waist circumference can be predicted from supine measurements using a simple prediction equation. This equation allows the comparison of supine measurements of disabled persons with the international standards. Supine waist circumference can be reliably measured in participants with severe intellectual, sensory, and motor disabilities.
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The systematic difference between CT-measured waist circumference and manually-measured waist circumference can be explained by differences in patient position, breath control, and measurement principle.
“This discrepancy can be explained by differences in patient position (supine versus standing), breath control (expiration versus inspiration), and the measurement principle (perimeter including skin surface irregularities versus tape measurement).”
From Fully automated waist circumference measurement on abdominal CT: Comparison with manual measurements and potential value for identifying overweight and obesity as an adjunct output of CT scan (2021) · cites this paper as [20]
The Discussion reports a systematic difference between standing and supine waist measurements, supporting patient position as a relevant distinction. The Measurements sections say the study used a tape measure and averaged readings taken during inhalation and exhalation. The paper does not compare CT with manual measurements or explain a discrepancy through breath control or skin-surface irregularities. (LLM, conf=0.86)
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References 28 · Cited by 33
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- Authors
- Waninge, A., Ligthart, K. A. M., Kramer, J., Hoeve, S., van der Schans, C. P., & Haisma, H. H.
- Affiliations
- Hanze University of Applied Sciences (NL)
- Visio (NL)
- University of Groningen (NL)
- Corresponding author
- Waninge, A.
- Venue
- Research in Developmental Disabilities
- Publisher
- Elsevier BV
- Published
- 2010-05
- Volume
- 31
- Issue
- 3
- Pages
- 839-847
- ISSN
- 0891-4222 (ISSN-L)
- OpenAlex
- W2134861319
- Cited by
- 33
- References
- 28
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 1 · 2023: 4 · 2022: 2 · 2021: 6 · 2020: 2 · 2019: 1 · 2018: 2 · 2017: 1 · 2015: 2 · 2014: 2 · 2013: 3 · 2012: 2
- FWCI
- 1.52
- Type
- journal article
- Language
- en
- Open access
- green
- research.rug.nl
- Licence
- Locations
- Research in Developmental Disabilities (publishedVersion)
- PubMed (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- Funders
- Rijksuniversiteit Groningen
- Topics
- Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Down syndrome and intellectual disability research
- Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Reliability and Agreement in Measurement
- Keywords
- waist circumference, measurement validity, measurement reliability, prediction equations, test-retest reliability, limits of agreement, intellectual disability, sensory disabilities, motor impairment, adults with disabilities, international health standards
- MeSH terms
- Adult, Aged, Anthropometry, Body Composition, Female, Persons with Disabilities, Disabled Persons, Humans, Male, Intellectual Disability, Middle Aged, Posture, Reproducibility of Results, Linear Models, Supine Position, Waist Circumference, Young Adult
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