Spinal Assessment ROM

Question 1

what are more reliable measurements in the neck? why?

Answer 1

full cycle versus half-cycle
neutral position for cervical spine is not well defined

Question 2

what are full-cycle vs half-cycle measurements

Answer 2

full = one end range to another
half = from neutral to end range

Question 3

what is the best position for cervical ROM testing

Answer 3

sitting is greater than standing

Question 4

what is the proportion of distance

Answer 4

difference of at-rest and end-range values
÷
at-rest value

Question 5

why is the proportion of distance important

Answer 5

when doing tape measure measurements, POD negates effects of different body sizes and measurements when comparing multiple patients

Question 6

mean ROM value of cervical flexion/extension

Answer 6

flex - 40
ext - 50

Question 7

testing position/motion for cervical flexion/extension

Answer 7

seated with spine supported and stabilized
cervical spine positioned in neutral rotation and lateral flexion
flex cervical spine forward while maintaining a tucked chin and guiding the head anteriorly

Question 8

end feel for flexion/extension

Answer 8

firm

Question 9

goniometer placement cervical flexion/extension

Answer 9

axis - over external auditory meatus
SA - perpendicular to the ground
MA - along the base of the nares

Question 10

what can be used to better align the goniometer?

Answer 10

tongue depressor between teeth
moving arm parallel to depressor

Question 11

mean cervical spine lateral flexion ROM

Answer 11

22° to each side

Question 12

testing position for CS lateral flexion

Answer 12

patient seated with spine supported and stabilized with neutral cervical flex/ext and rotation
say were going to the right
lateral flex by grasping left side and pulling to the side

Question 13

normal end feel of cervical lateral flexion

Answer 13

Firm

Question 14

goniometer placement for cervical spine lateral flexion

Answer 14

axis - C7 spinous process
SA - perpendicular to the ground
MA - along dorsal midline of head with occipital protuberance being point of reference

Question 15

how would a tongue depressor be used during lateral flexion ROM

Answer 15

between teeth
axis centered near one end of tongue depressors
stationary arm is perpendicular to the floor
moving arm is aligned with tongue depressor

Question 16

cervical spine rotation average ROM

Answer 16

50-80°

Question 17

CS rotation testing position/movement

Answer 17

seated with spine supported, cervical spine should be in neutral
pull chin and head toward the shoulder

Question 18

cervical spine rotation goniometer position

Answer 18

axis - over center of cranium
SA - perpendicular to an imaginary line between acromion processes
MA - aimed at tip of nose

Question 19

tape measure method for cervical spine flex/extend

Answer 19

distance between tip of chin and lower edge of sternal notch

mouth closed

Question 20

tape measure method for cervical spine lateral flexion

Answer 20

measure distance between mastoid process and lateral tip of the acromion process

Question 21

tape measure method for cervical spine rotation

Answer 21

measure distance between the tip of the chin and acromion process

Question 22

cervical flexion/extension inclinometer placement

Answer 22

one inclinometer over C7 spinous process and adjusted to 0°

one inclinometer is on posterior aspect of head and adjusted to 0°

Question 23

what is important to keep in mind when doing cervical measurements of inclinometry

Answer 23

might need to move the C7 inclinometer to the side to not impede extension

if there is a deviation from 0 at C7, subtract that from the one on dorsal aspect of head.

Question 24

cervical spine lateral flexion inclinometer placement

Answer 24

one inclinometer placed over C7 spinous process

one inclinometer placed on top of subject’s head and adjusted to 0°

Question 25

cervical spine rotation inclinometer placement

Answer 25

patient in supine position one inclinometer on center of subject's forehead and adjusted to 0° asked to roll head into rotation

Question 26

generally which portion of the spine is the most flexible? why?

Answer 26

cervical > thoracic > lumbar structural differences, specifically spinous processes found in thoracic spine tighter joint capsule of thoracic spine/rib cage

Question 27

the lumbar spine is oriented in a way to allow for ____&_____, rather than _____&_______

Answer 27

flexion and extension lateral flexion and rotation

Question 28

how is the lumbar spine oriented?

Answer 28

primarily in sagittal plane

Question 29

_____ is more limited than _____ in the lumbar spine

Answer 29

flexion extension

Question 30

where does the greatest mobility of flexion and extension occur between

Answer 30

L4-L5

Question 31

where does the greatest amount of flexion occur

Answer 31

L5-S1

Question 32

what portion of the lumbar spine allows for more lateral flexion / rotation

Answer 32

upper lumbar

Question 33

in general, what plane/axis does flexion and extension occur in (for all spinal sections)

Answer 33

sagittal medial-lateral

Question 34

in general, what plane/axis does lateral flexion occur in (for all spinal sections)

Answer 34

frontal anterior-posterior axis

Question 35

what is the mean lateral flexion range for thoracic/lumbar spine

Answer 35

35°

Question 36

testing position/motion of lateral flexion in lumbar/thoracic spine

Answer 36

standing with spine in neutral asked to bend trunk to one side both feet flat with knees extended do not allow for any flexion/ext/rotation of spine

Question 37

end feel for thoracic/lumbar lateral flexion

Answer 37

firm

Question 38

goniometer placement for thoracic/lumbar spine lateral flexion

Answer 38

axis - posterior aspect of S1 SA - perpendicular to ground MA - aligned with posterior aspect of C7 spinous process

Question 39

in general, what axis/plane does rotation occur on (for all segments of the spine)

Answer 39

transverse vertical axis

Question 40

what is the mean ROM for thoracic/lumbar spine rotation

Answer 40

45°

Question 41

testing position for thoracic/lumbar rotation

Answer 41

patient is sitting spine in neutral asked to twist their body to one side keeping trunk erect and feel flat on the supporting surface

Question 42

end feel for thoracic/lumbar spine rotation

Answer 42

firm

Question 43

goniometer placement for T/L spine rotation

Answer 43

axis - center of cranial aspect of subjects head SA - perpendicular to an imaginary line between two tubercles on the iliac crests MA - perpendicular to an imaginary line between the two acromion processes

Question 44

tape measure method for T/L Spine flexion ROM

Answer 44

Spinous process of C7 and S1 are marked distance between the two are measured in starting position (neutral spine, erect posture) patient is asked to flex forward and distance between points is measured difference between two is the final measurement

Question 45

average T/L spine flexion using tape measure method

Answer 45

4 inches

Question 46

tape measure method for Lumbar Flexion ROM

Answer 46

Modified-Modified Schober Test mark made over spine midway between two PSIS with a second mark made 15cm above patient asked to bend forward while keeping feet flat and knees extended. distance between 15cm and second measurement is range of motion for lumbar flexion.

Question 47

how does the original Schober test differ from the modified?

Answer 47

OG - made at lumbrosacral junction and second mark is made 10 cm above first mark

Question 48

T/L spine extension ROM tape measure method

Answer 48

same as flexion, but just extend go until pelvis tilts posteriorly difference between two second and first measurements is range of extension

Question 49

Lumbar Spine extension ROM tape measure method

Answer 49

same as flexion but in extension

Question 50

what is the fingertip to floor ROM measurement (T/L Spine Flexion)

Answer 50

standing position patient is asked to bend forward as far as possible while keeping feet flat on floor and knees extended difference between middle finger tip and ground is measured

Question 51

is the fingertip-to-floor measurement recommended? what is it good for?

Answer 51

no, because hip flexion is included and spinal flexion cannot be isolated. overall flexibility testing

Question 52

Fingertip-to-Floor method for T/L spine lateral flexion

Answer 52

standing position asked to bend to the side as far as possible with feet flat and knees extended be sure patient maintains neutral spine at end range, mark where tip of middle finger reaches to difference between this point and floor is the range of motion

Question 53

what is the alternative measuring process for a fingertip to floor measurement of T/L spine lateral flexion

Answer 53

difference between finger tip positions marking where tip of middle finger is during starting position (erect, neutral posture) doing normal test, then taking difference between fingertip positioning at the start and end on the leg.

Question 54

inclinometer test for flexion (T/L spine)

Answer 54

inclinometer placed on spinous process of C7, adjusted to 0° second inclinometer placed on midsacrum, adjusted to 0° end range is recorded and difference between two is taken from the measurement

Question 55

inclinometer placement for lumbar spine flexion

Answer 55

one inclinometer over spinous process of T12 and adjusted to 0° another inclinometer placed over midsacrum, adjusted to 0° patient is to flex to end range of motion, measurement is taken midsacrum inclinometer subtracted from that on T12

Question 56

for inclinometry measurement of lumbar flexion, what do numbers on the midsacral inclinometer represent

Answer 56

hip flexion range of motion

Question 57

T/L Spine lateral flexion inclinometer measurements

Answer 57

standing position one inclinometer on spinous process of T1, adjusted to 0° one inclinometer placed on spinous process of S1, adjusted to 0° asked to laterally flex subtract reading on sacral inclinometer from that of the thoracic at end range

Question 58

T/L spine rotation inclinometer measurement

Answer 58

standing position, patient asked to flex forward so that back is parallel to ground one inclinometer on C7 spinous process, adjusted to 0° one inclinometer on spinous process of S1, adjusted to 0° sacral # - cervical = rotation ROM