Connor has a diagnosis of Diplegia - he was being harmed by his sleeping position and so needed to learn to lie in a symmetrical supported position. We used the Goldsmith Indices of Body Symmetry to measure the outcome.

1. Connor’s Story
©Simple Stuff Works Associates Ltd 2015

2. I used to lie in bed
like this – I didn’t
know this would add
to the difficulty I had
walking
I have a condition called
diplegia, I have had
difficulty controlling the
movement of my legs
since I was born
©Simple Stuff Works Associates Ltd 2015

3. So……. my shoulders were
pushed up and forwards
……….my chest was squashed
and my back was bent
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4. My pelvis was rotated… my knees were squashed together
My left hip was turned in
There were plans to perform a
de-rotation osteotomy to turn my left leg out
I kept my hips and knees bent
to feel comfortable and
relaxed
©Simple Stuff Works Associates Ltd 2015

5. Measurements of the Goldsmith Indices of Body
Symmetry show that on 8th June 2006 I had a
“Windswept Index”
of 20.25 degrees to the right
This means the way I have been lying has made my body
asymmetric
The explanation and results
are on the next slides
©Simple Stuff Works Associates Ltd 2015

6. These Measurements have been carefully designed, they are
standardised and have been shown to be reliable when carried out
properly by suitably skilled and qualified measurers
“Physiotherapy” April 1992, vol. 78, no 4, 235 – 242.
“Thus it appears that the measurements were mainly determined by
real differences between subjects and that there was negligible
systematic disagreement between the testers. It can be concluded
that the measurements obtained in this way consistently
differentiated among subjects even when made by different testers”
©Simple Stuff Works Associates Ltd 2015

7. Anticlockwise: (0.?)
Goldsmith Indices 0f Body Symmetry : Procedure 1.3
Measurements are taken from the xyphoid process to the
lateral border of the chest each side with the pelvis level
1 Clockwise: (1.?)
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8. Procedure 1.3 showed that the measures from my sternum to the
lateral border of my chest were 9.5 to my right and 10.5 to my left
My chest used to rotate anticlockwise
This is a Right/Left ratio of 0.9
9.5cm 10.5cm
©Simple Stuff Works Associates Ltd 2015

9. The Angle Between Legs and Pelvis
(ABLAP) was calculated
If my movement was symmetrical the
ABLAPs would be the same so the
INDEX would be zero
To measure Procedure 2 my knees
were gently taken from side to side
with my shoulders and feet fixed
A comparison was made between how
far my legs would go comfortably and
how my pelvis lifted as a result of the
leg movement
©Simple Stuff Works Associates Ltd 2015

10. Knees to Right = Leg angle 140 – pelvic angle 20 = ABLAP 120
Knees to Left = Leg angle 140 – pelvic angle 20 = ABLAP 120
ABLAP to right: 120 minus ABLAP to left: 120 = 0 = Symmetry
In real life there will be error in the measurements so they are repeated
4 times to reduce the standard error and provide a range of possible results
Leg Paddle Angle
140 degrees
Leg Paddle Angle
140 degrees
Pelvic Angle
20 degrees both sides
This is what a perfect measurement
of perfect symmetry would look like
©Simple Stuff Works Associates Ltd 2015

11. Mean
leg angle 145 146 147 147 146.25
pelvic angle 36 35 41 40 38
ABLAP 109 111 106 107 108.25
leg angle 150 151 152 150 150.75
pelvic angle 64 65 61 61 62.75
ABLAP 86 86 91 89 88
to R mean to L
25 20.25 -15
Knees to the Right
Knees to the Left
I had been sleeping in this position for 10
hours a night
By June 2006 my muscles were tight and
my pelvis rotated so it lifted to 62.75
degrees when my knees were taken to
the left. This asymmetry meant that the
ABLAPs were different by 20.25 degrees
The results also show a large range of
possible results because it was quite
difficult to take the measures
Windswept Index Results
©Simple Stuff Works Associates Ltd 2015

12. Knees to Right = Leg angle 146.25 – pelvic angle 38 = ABLAP 108.25
Knees to Left = Leg angle 150.75 – pelvic angle 62.75 = ABLAP 88
ABLAP to right: 108.25 minus ABLAP to left 88 = Windswept Index 20.25
The range of possible results is calculated by comparing the
highest Right ABLAP with the lowest Left (25 degrees) and then
the highest Left ABLAP with the lowest Right (-15 degrees)
Leg Paddle Angle
150.75 degrees
Leg Paddle Angle
146.25 degrees
This is what my measurements
looked like in June 2006
Pelvic Angle
62.75 degreesPelvic Angle
38 degrees
108.25 88
©Simple Stuff Works Associates Ltd 2015

13. Comparing my ABLAPs with normative data shows my results are
below the norm, 108.25 when my knees are taken to the right and
88 degrees when taking my knees to the left
This is because my body is tight and my pelvis is rotated from
lying scrunched up on my side
©Simple Stuff Works Associates Ltd 2015

14. Then I began to lie straight in bed on
my back with support
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15. My chest used to rotate
anticlockwise
With support this
could be corrected
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16. My knees used to turn in
With this support my
knees are relaxed outwards
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17. Sam and Carl can help me
to straighten
my pelvis
My right side back
left side forward
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18. I worked hard to change
the way I slept and by
15th
September 2006
my measurements showed
that I had succeeded in
straightening my body
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19. June 2006
My shoulders were hunched with
sleeping on my side
Right/Left ratio of o.9
9.5cm 10.5cm
11.5cm 11.5cm
September 2006
My shoulders have relaxed with
sleeping on my back
Right/Left ratio of 1
©Simple Stuff Works Associates Ltd 2015

20. Knees to the Right
Knees to the Left
Windswept Index Results
Mean
leg angle 142 141 136 140 139.75
pelvic angle 21 19 16 19 18.75
ABLAP 121 122 120 121 121
leg angle 144 142 139 138 140.750
pelvic angle 28 24 21 19 23
ABLAP 116 118 118 119 117.75
Windswept Index to R mean to L
6 3.25 -1
By sleeping symmetrically on my
back for 3 months my body has
straightened and relaxed
Some people might be surprised
but this provides…
10 hours therapy a night
70 hours a week
280 hours a month
840 hours in 3 months
…when the body is most
susceptible to restoration
The band of possible results was
smaller because I was more relaxed
and it was easier to take the
measures
©Simple Stuff Works Associates Ltd 2015

21. Knees to Right = Leg angle 139.75 – pelvic angle 18.75 = ABLAP 121
Knees to Left = Leg angle 140.75 – pelvic angle 23 = ABLAP 117.75
ABLAP to right: 121 minus ABLAP to left 117.75 = Windswept Index 3.25
The range of possible results is calculated by comparing the
highest Right ABLAP with the lowest Left (6) and then
the Highest Left ABLAP with the lowest right (-1)
Leg Paddle Angle
140.75 degrees
Leg Paddle Angle
139.75 degrees
This is what my measurements
looked like in September 2006
Pelvic Angle
23 degreesPelvic Angle
18.75degrees
121 117.75
©Simple Stuff Works Associates Ltd 2015

22. Comparing my ABLAPs with normative data shows that once I have been
lying on my back for 3 months my results are within the norm
121 to the right and 117.75 to the left
This is because my body is relaxed and rotation of my pelvis has reduced
©Simple Stuff Works Associates Ltd 2015

23. The Summary Result sheet can show progress towards symmetry….
Here are my Results!
Goldsmith Indices of Body Symmetry Results: Summary Procedure 2
Name Date of Birth Measurer
25 24 23 22 21 20 19 18 17 16 15 14 13 12 11 10 9 8 7 6 5 4 3 2 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
Date
20 10 0 10 20
Connor **** ****
08/06/06
15/09/06
When the body is symmetrical results will span the midline because measurement error will occur randomly
so measurements of a symmetrical body look something like this
A tighter band of possible results indicates more confidence in the result and that the measurements were easier to take
Symmetry
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24. This is Good News!
I am off the list for surgery
I can run and ride a bike more easily
Once I am grown and in the habit of lying straight I can use
less equipment
This will help me to do things I want to do…
Catch me on YouTube
“Connor’s Success Story”
©Simple Stuff Works Associates Ltd 2015