**10. Metrological engineering techniques**

Taking into account the above issues, the pursuit of professionalization in the measurement process gains extreme importance, which can be seen in the works of many authors, concerning the static features of the spine using the projection moire, axial spondylometry, as well as changes of these characteristics in various clinical conditions. Much attention was paid to the assessment of the motion range (SFTR), balance, and gait analysis carried out using contact and photogramometric methods. Joints are an area of particular interest—in clinical practice they are most often subjected to endoprosthetic surgery, i.e., knee, hip, shoulder joints, intervertebral discs or other elements of vertebroplasty, and even the joints of the fingers. An interesting combined research began, concerning the synergy of dynamometric tests, the range of foot movement and strength of lower limb muscles, and gnatosomal analyses. There are also attempts to model complex limb functions based on motion measurement data and EMG signals. Measurements using bioengineering techniques have a great impact on the development of clinical metrology. They have many advantages, such as (1) standardization of the measurement conditions (measurement track in particular), (2) repeatability of the body stimulation scaling parameters using electronic systems (3) repeatability of scaling of the measurement parameters, and (4) stability of the calculation and result-interpreting criteria. Noninvasive recording techniques, consist in resting or functional, but contactless monitoring of vital functions, based on registering parameters that are spontaneously emitted by the body, such as infrared radiation (pyrometry, thermography), electric field (electrography), or magnetic field (magnetography).

Contact recording techniques consist in applying a sensor to the skin surface, in order to establish physical contact (often galvanic as well). The skin surface changes a number of its properties depending on the symmetry and specificity of the processes taking place in the internal organs; hence, the registration of parameters at specific points of the marker will give clear information about the phenomena occurring in the internal organs (e.g., thermometry, ECG, EEG, EMG). The essence of measurement techniques is diverse, depending on the degree of invasiveness [93]:


**63**

therapy specifics.

*Biomechanics as an Element of the Motion Clinimetry System*

remain in physical contact or else operate contactlessly) while the evaluation takes place outside the sphere of the patient's consciousness, through the system of sensors registering involuntary vegetative reaction parameters.

6.*Invasive registering techniques (A)* that consist in making (in relation to the examined body) energetic extortion as well as recording and interpreting effects of this extortion in the form of (a) rays reflected off the surface (photography), (b) rays penetrating the object (X-ray, CT images), (c) the object being penetrated by the magnetic field (NMR), and (d) the object being penetrated

7.*Invasive registering techniques (B)* that consist in introducing into the body complex chemical compounds, which on one hand have affinity to specific body structures and, on the other, contain a substance that emits radiation that penetrates the coating (usually gamma)—this emission is recorded by the external recording system (scintigraphy, gammagraphy, single-photon emission computed tomography (SPECT)). Based on the above emission, a spatial reconstruction of the organ image is prepared (based on areas with isotope

A huge problem that is still present in movement studies and physiotherapies is the tendency to look at the multidimensional profile of the patient's suffering and dysfunction through the prism of a narrow specialization, causing multithreading and lack of synergy in procedures related to the diagnosis and treatment of a complex locomotor dysfunction. In this context, a complex biomechanical, psychophysical, and clinical problem begins to be seen as the sum of some separate sequences, which are diagnosed and treated fragmentarily in the narrow ranges of

It leads to an absurd situation, in which a pain and dysfunction problem is being taken care of by subsequent specialists in physio- and kinesiotherapy and finally in biomechanics. Based on their own experience and simple measurements, they assess the patient's condition and plan a simple treatment program, mainly in the aspect of symptoms and function, not having a full insight into the interpretation of the results of advanced diagnostic tests. Diagnostics, in turn, is carried out by a team of doctors, who have direct contact neither with a variety of procedures in applied physiotherapy nor with their effects. As for issues revolving around the experience of pain, especially against the background of the patient's individual psychophysical characteristics and predispositions, they are estimated by the psychologist, who is deprived of a broader knowledge of the details of diagnosis and

In this context, there was a need for a systemic change in quality, and thus also the effectiveness and image of modern physiotherapy, beginning from function in analogy to the principles of EBM presented above, as evidence-based physiotherapy (EBP). The trend initiated a few years ago was reflected in the literature, in the form of interesting publications, displaying various aspects of this issue. One of the first, conceptually well-structured works was a manual [96], then a collective work [97], which postulate that a physiotherapist performing direct, manual diagnostic and rehabilitation activities in a patient, should use the results of advanced clinical diagnostics to clarify any doubts arising from direct observation of the patient. In 2001, the World Confederation of Physical Therapy (WCPT) Expert Meeting on

*DOI: http://dx.doi.org/10.5772/intechopen.92757*

by the stream of ultrasounds (USG).

specializations of the successive therapists.

concentration).

**11. EBM**

5.*Bilaterally parametric test*, where the body is influenced by a reproducible, parametric stimulus generated by the technical device (which can either

remain in physical contact or else operate contactlessly) while the evaluation takes place outside the sphere of the patient's consciousness, through the system of sensors registering involuntary vegetative reaction parameters.

