title: Comparing measurement techniques of accommodative amplitudes.
abstract: OBJECTIVE
  This study was designed to compare four standard procedures, for determining the monocular accommodative amplitudes.
  
  
  METHODS
  Fifty-two students participated in this analytical-descriptive study. Accommodative amplitudes were measured using four common clinical techniques, namely: Push-up, push-down, minus lens, and modified push-up.
  
  
  RESULTS
  The highest amplitude was obtained using the push-up method (11.21 ± 1.85 D), while the minus lens technique gave the lowest finding (9.31 ± 1.61 D). A repeated-measures Analysis of Variance (ANOVA) showed a significant difference between these methods (P < 0.05), further analysis showed that this difference was only between the minus lens and other the three methods (the push-up (P < 0.001), the push-down (P < 0.001) and the modified push-up (P < 0.001)). The highest and the lowest mean difference was related to the push-up with the minus lens, and the push-down with the modified push-up, while the highest and the lowest 95% limits of agreement were related to the push-up with the modified push-up and the push-up with the push-down methods. There was almost a perfect agreement between the push-up and the push-down method, whereas, a poor agreement was present between the modified push-up and the minus lens technique, and a fair agreement existed between the other pairs.
  
  
  CONCLUSIONS
  The quick and easy assessment of the amplitude using the push-up and the push-down methods compared to other methods, and the obtained perfect agreement between these two methods can further emphasize their use as a routine procedure in the clinic, especially if a combination of the two techniques is used to offset their slight over- and underestimation.
authors.affiliation: Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran.
authors.forename: Hamed
authors.initials: H
authors.lastname: Momeni-Moghaddam
authors.forename: James
authors.initials: J
authors.lastname: Kundart
authors.forename: Farshad
authors.initials: F
authors.lastname: Askarizadeh
mesh_terms: D000065:Accommodation, Ocular / Q000502:physiology*; D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007908:Lens, Crystalline / Q000502:physiology*; D008297:Male; D009907:Optometry / Q000379:methods*; D012372:ROC Curve; D014792:Visual Acuity; D055815:Young Adult