Neck & Trunk ROM Measurement

NECK FLEXION Starting & ending position Sitting with trunk well supported , neck in the anatomical position , hand placed on the lap. &shoulder joints are relaxed. Axis – external auditory meatus Stationary arm – vertical Moving arm – aligned with nostrils ROM From 0 – 45 degrees

NECK FLEXION Precaution Prevent trunk flexion. Prevent neck rotation and lateral flexion. Factors limiting ROM Tension of the extensor muscles of neck (posterior muscles of neck) . Tension of the ligaments Longitudinal ligament. Interspinal & supraspinal ligaments.   Bony blockage: contact of lower lips of vertebral bodies with surface of subjacent vertebrae anteriorly.

NECK Extension Axis – external auditor meatus Starting & ending position Just as for flexion Axis – external auditor meatus Stationary arm – vertical Moving arm – aligned with nostrils ROM From 45 – 0 for extension From o- 45 for hyper extension

NECK Extension Precaution Just as for flexion Factors limiting ROM Tension of flexors muscles of neck ( ventral neck muscles) Approximation of spinous process.

CERVICAL ROTATION Just as for flexion& extension Starting & ending position Just as for flexion& extension Axis : placed over the center of the top of the head. Stationary arm: placed in the line with the acromion process of the side being measured. Moving arm placed in the line with the tip of the nose. ROM From 0 – 60-75 degrees in each direction. The distance is approximately 5 in to each side as measured by tape.

CERVICAL ROTATION precaution Prevent trunk rotation Prevent scapular elevation. Tape measurement Place measuring tape on the mid-line of the chin and the acromion process, measure the difference between the starting and ending position The difference in the measurement is the amount of range of motion.

CERVICAL lateral flexion ( side flexion) Starting & ending position Sitting with trunk well supported , neck in the anatomical position , hand placed on the lap. &shoulder joints are relaxed. Axis : placed over the spinous process of C7 . Stationary arm: placed along the thoracic spinous processes. Moving arm placed over the external occipital protuberance of the occipital bone. ROM From 0 – 45-60 degrees in each direction. The distance is approximately 5 in to each side as measured by tape.

CERVICAL lateral flexion ( side flexion) Precaution Prevent trunk lateral flexion to the test side. Tape measurement Between mastoid process of the temporal bone and the acromion process of the scapula..

Trunk Flexion Starting position: the tape is placed proximally on the spinous process of C7 and distally to S1. Ending position: following flexion of the vertebrae using the same land mark. Calculate the difference in distance between starting and ending positions. ROM Approximately 4 in. The difference between starting and ending positions.

Trunk Flexion Precaution The pelvis and hip joints are stabilized. Factors limiting motion  Tension of spinal extensor muscles. Contact of last ribes with abdomin. Bony blockage: contact of lips of vertebral bodies with subjacent vertebrae anterriorly. Tension of ligaments: Posterior longitudinal Inter spinal ligament. Supra spinal ligament.

Trunk Hyperextension The tape alignment is just the same as for trunk flexion ROM 2 inches Precautions Prevent hip extension. Prevent trunk rotation. Factors Limiting ROM Tension of anterior abdominal muscles ( muscles of trunk flexion) Contact of spinous processes. Tension of longitudinal ligament of spine.

Thoracic and lumbar lateral flexion Position Standing erect. Axis - S1 spinous process Stationary arm - vertical Moving arm - C7 spinous process Stabilization The pelvis is stabilized.

Thoracic and lumbar lateral flexion Measuring tape Starting position: place one end of measuring tape on the tip of the middle finger and other on the tip of the lateral malleolus. Measure the difference in inches following the lateral flexion motion Precautions Avoid trunk flexion, extension and rotation Prevent lateral tilting of the pelvis. Factors limiting normal ROM Contact of lips pf vertebral bodies with subjacent vertebrae laterally.

Trunk Rotation Position Sitting without back support, feet flat on the floor.  Axis - center of superior aspect of head Stationary arm - aligned with anterior superior iliac spines Moving arm - aligned with acromion processes Normal Range 45o Stabilization The pelvis is stabilized.

Trunk Rotation Precautions Prevent pelvis rotation. Avoid trunk flexion, extension and lateral flexion. Factors limiting normal RON Tension of oblique abdominal muscle of opposite side being tested. In thoracic area: tension of costovertebral ligament. In lumbar area: interlocking of articular facets.