Multi-Trial ROM works similarly to Single-Trial, but you must repeat each test at least three times. The software will show which trial that you are on. At the end of the third trial for each test, it will calculate the variance in the results for each test. If the results vary too much, myINSiGHT™ will prompt you for a fourth trial. The process is repeated, and you might be prompted for a fifth and sixth trial. If, after six trials the results still vary by too much, the result is considered Invalid and is recorded that way. You can choose to accept the results or to cancel and restart the test at the first trial.
For a motion in a ROM test to be considered Valid, the following must be true:
1. Three consecutive trials of this motion must produce results that are within 5 degrees or 10% of each other (10% if the average is >50 degrees).
2. Results of the three consecutive trials are averaged to produce the final result for a test.
3. There can be no more than six trials of a motion – if there is not a valid result after six trials, the motion is considered invalid for use in evaluating impairment.
An additional rule is that Multi-Trial ROM testing is by spinal region. You must complete all tests within a region (cervical, thoracic, lumbo-sacral). This contrasts with the Single-Trial ROM, in which you can choose to do any or all tests from any or all regions. You will notice that the test settings in multi-trial ROM do not allow you to select individual tests, only spinal regions.
To start a Multi-Trial Scan, first click on Multi-Trial (Note that this scan setting is not available during a scan so you must do this before you start the scan). Then select which of the three spinal regions you would like to be part of the scan. You should see a screen that looks like this:
Notice that the trial number (1) appears above the picture.
First take the neutral reading for the first test, as instructed. Then have the patient execute the motions while the system records the maximums. After ending the test, the system will prompt for the neutral reading for the same test, and indicate that this is the second trial. Then again, the system will prompt you for a third time.
Using the criteria discussed above, the software may prompt for a fourth, fifth and sixth test.
When you have completed all the tests, the software will again show the Scan Summary. The results in the Scan Summary are the averaged results of the last three values recorded for each test. If the variance between these three results is more than 5 degrees or 10% as explained above, the result is considered Invalid, and will appear in red in the Scan Summary.
Whether you perform a Multi-Trial or Single-Trial ROM scan, the default views (ROM Table and ROM Graph) show the same results for all tests in the scan. In a Multi-Trial Scan, the averaged results of the trials for each test are displayed, if a Single-Trial, there is one result for each test.