Cervical and lumbar Range of Motion

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Presentation transcript:

Cervical and lumbar Range of Motion Arcon, Inc www.fcesoftware.com (734) 904-1895

The Cervical ROM protocol brackets the portion of the spine between the cranium and the T1 spinous process. To perform this test, select ROM Cervical Range of Motion from the protocol list, then click the Test button. Note that the illustrations below show the ROM sensor on the outside of the wrap material so that the position of the sensor can be seen. In practice, the first layer of wrap material is applied to the subject, then the sensor is placed and the wrap material is applied OVER the sensor to hold it firmly in position. If the sensor cannot be held firmly with wrap, it is advised that the evaluator hold both sensors. When holding a moving sensor, be sure to allow the sensor to move freely to faithfully follow the subject's movements.

Cervical Flexion / Extension

With the patient seated in a relaxed but erect fashion, attach the secondary sensor (also called sensor #1) to the patient’s head in the sagital plane using an elastic wrap such as Nylatex . The sensor should be situated just above the patient’s ear. Hold the primary sensor (also called sensor #2) in the sagital plane against the T1 spinous process (Note: Make sure the labels on both sensors face in the same direction). Have the patient assume a neutral posture. Now press the ROM switch to start the test. Have the patient slowly move into flexion. Press the switch when the patient reaches maximum flexion. Now have the patient slowly move into extension until they reach their maximum then press the switch again. Repeat this process until validity is achieved (please see page 7-5 for an explanation of ROM validity). Make sure the patient has reached their maximum range of motion before pressing the switch. You can actually press the switch any time after they reach maximum, but before they return to the neutral position.

Cervical Lateral Flexion

With the patient seated in a relaxed but erect fashion, attach the secondary sensor (also called sensor #1) to the patient’s head in the coronal plane at the occiput using an elastic wrap such as Nylatex . Hold the primary sensor (also called sensor #2) flat against the patient’s T1 spinous process (Note: Make sure that the labels on both sensors are facing you). Have the patient assume a neutral position then press the ROM switch to start the test. Have the patient move their head slowly to the left until they reach their maximum lateral flexion then press the switch to record the motion. Now have them move their head back to the right, through neutral, until they reach maximum lateral flexion on that side. Press the ROM switch again to record the motion. Repeat this process until you achieve validity for both sides.

Cervical Rotation

With the patient lying in a supine position with shoulders exposed for direct observation, align and attach the secondary sensor (also called sensor #1) in the coronal plane on the forehead of the patient using an elastic wrap such as Nylatex . The primary sensor (also called sensor #2) is not used for this test (except for the ROM switch). Have the patient assume a neutral position and press the ROM switch. Have the patient rotate their head slowly to the left until they reach maximal rotation and press the switch. Now have the patient rotate their head slowly to the right until they reach maximal rotation and press the switch. Repeat this process until you reach validity for both sides.

The Thoracic ROM protocol brackets the portion of the spine between T1 and T12. To perform this test, select ROM Thoracic Range of Motion from the protocol list, then click the Test button. Note that one illustration below shows the ROM sensor on the outside of the wrap material so that the position of the sensor can be seen. In practice, the first layer of wrap material is applied to the subject, then the sensor is placed and the wrap material is applied OVER the sensor to hold it firmly in position. If the sensor cannot be held firmly with wrap, it is advised that the evaluator hold both sensors. When holding a moving sensor, be sure to allow the sensor to move freely to faithfully follow the subject's movements

Thoracic Flexion

The thoracic flexion test begins with a measurement of the angle of minimum kyphosis. Attach the secondary sensor (also called sensor #1) to T12 in the sagital plane using an elastic wrap such as Nylatex (the best attachment is achieved by placing the sensor in between the body and the wrap material). With the patient standing in a neutral position, press the ROM button to start the test. Now place the primary sensor (also called sensor #2) edge-to-edge with the other sensor (stacked like blocks, extending out from the spine), and with both labels facing to the right. Press the ROM switch to set the zero point. Now move the primary sensor (#2) up and place it over T1, placing the same edge against the spine as was against the lower sensor. Press the ROM switch to record the angle of minimum kyphosis (see picture above). Now with the sensors in this position, have the patient move slowly into maximum thoracic flexion (roll the shoulders and head forward to stretch the thoracic spine - it is not necessary to bend at the waist) then press the ROM switch to record the value. Have the patient move back to neutral and then repeat the flexion measurement until validity is achieved.

Thoracic Rotation

Attach the secondary sensor (also called sensor #1) in the axial and vertical planes at T12. With the patient in a standing forward flexed position hold the primary sensor (also called sensor #2) in the axial and vertical planes at T1. Have the patient assume a neutral “military brace” position with their arms crossed over their chest and press the ROM switch to start the test. Have the patient slowly twist their arms and shoulders to maximal left rotation and press the switch. Now have the patient rotate to the right until they reach maximal rotation and press the switch again. Continue until validity is achieved.

The Lumbar ROM protocol brackets the portion of the spine between T12 and the Sacral midpoint. To perform this test, select ROM Lumbar Range of Motion from the protocol list, then click the Test button. Note that one illustration below shows the ROM sensor on the outside of the wrap material so that the position of the sensor can be seen. In practice, the first layer of wrap material is applied to the subject, then the sensor is placed and the wrap material is applied OVER the sensor to hold it firmly in position. If the sensor cannot be held firmly with wrap, it is advised that the evaluator hold both sensors. When holding a moving sensor, be sure to allow the sensor to move freely to faithfully follow the subject's movements.

Lumbar Flexion/ Extension

Attach the secondary sensor (also called sensor #1) to T12 in the sagital plane using an elastic wrap such as Nylatex. With the patient standing hold the primary sensor (also called sensor #2) against the sacrum at S1, (Note: Make sure the labels on both sensors face in the same direction). Have the patient assume a neutral position and press the ROM switch to start the test. Have the patient slowly bend forward into flexion (instruct them to try to touch their toes) until they reach their maximum range of motion then press the switch. Now have the patient move back through the neutral position and continue bending back into extension until they reach their maximum range of motion then press the switch again. Be sure to follow the full sacral movement with the sensor you are holding to insure accurate results. Continue until validity is achieved.

Lumbar Lateral Flexion

Attach the secondary sensor (also called sensor #1) at T12 in the coronal plane. Hold the primary sensor (also called sensor #2) at the sacral mid-point with the labels on both sensors facing you. Have the patient assume a neutral position then press the ROM switch to start the test. Have the patient bend slowly to the left (instruct the patient to slide their hand down their leg toward their knee) until they reach their maximum range of motion then press the switch. Now have the patient bend to their right, back through the neutral position, until they reach their maximum range of motion then press the switch again. Repeat this process until validity is achieved.

Straight Leg Raise

With the patient in a supine position attach the secondary sensor (also called sensor #1) in the sagital plane to the right ankle using an elastic wrap such as Nylatex. The other sensor is not used in this test (other than the ROM switch). Have the patient assume a neutral position (leg flat on the table) and press the switch. With your hand placed under the ankle, passively lift the patient’s leg only until you start to feel resistance from the hamstring, then press the control switch. Lower the leg and repeat process until validity is achieved. Switch sensor to the left leg and repeat the straight leg raise test.