Spine Practical
TL lateral flexion w/ goni
S2 and perp to floor and moving arm is pointing towards spinous process of c7. Normal is 35-38°
TL Rotation tape measure
pt sits on plinth w/ arms crossed at chest. pt hold tape measure at lateral acromion process and wraps around to posterior side of greater trochanter. reading is the difference between 2 landmarks. Therapist stabilizes pelvis. Cheat- rotating the pelvis
Trunk flexion and rotation MMT
Muscles- external and internal oblique Supine must maintain chin tuck and clear inferior angle of scap Grade 2 gravity eliminated- seated cheat- hip flexors increase LS lordosis
CS rotation w/ goni
Axis- top of head SA- imaginary line connecting the 2 acromion processes MA- aligned w/ nose Normal- 80
TL Flexion/Extension w/ tape measure
C7 and S2 difference between start and end position. Cheat- bending the knees Normal- 10cm for flxn
TL flexion&Extension w/ inclinometer
C7 and S2, difference between readings. normal Flexion is 60° normal Extension is 25° (hands behind hips) Cheat- bending knees
TL lateral flexion w/ inclinometer
T1 and S2 (frontal plane) Normal is 25°
CS Flex/Ext tape measure
Tip of mandible to suprasternal notch normal flexion- 1-4cm normal extension- 20cm cheat- opening mouth
CS flexion/extension with goni
axis- external auditory meatus SA- perp to floor MA- parallel to base of nares normal Flexion ROM- 45 normal Extension ROM- 60
CS lateral flexion w/ goni
axis- spinous process of C7 SA- perp to floor MA- posterior midline of skull Normal- 45 cheat- shoulder shrug
CS lat flexion tape measure
mastoid process and lateral tip of acromion normal- 13cm cheat- shrugging shoulder or rotating
TL lateral flexion tape measure
measure distance between 3rd digit and floor (normal- 22cm) or difference between starting and end position of 3rd digit. Cheat- trunk flexion
TL Extension alternate position tape measure
measure from plinth to suprasternal notch, strap around sacrum. Hands flat under shoulders and pt pushes up. Cheat- pelvis lifting up
Cervical rotation and lateral flexion
muscles- SCM position- supine with arms at 90, rotates head to one side and maintains chin tuck cheat- not keeping chin tucked?
Trunk Extension MMT
muscles- erector spinae, multifidus, semispinalis, thoracis, quadratus, lumborum stabilize- strap of sacrum to stabilize pelvis sternum and xiphoid process must clear cheat- hip extension 5- hands behind head, 4- hands behind back, 3- hands at side
Cervical Extension MMT
muscles- erector spinae, obliquus capitis superior, rectus capitis posterior Position- prone with arms at 90 cheat- bias to one side, using arms?
Cervical Flexion MMT
muscles- longus capitis, longus colli, rectus capitis anterior, anterior scalenese, SCM Position- supine with arms at 90° of flexion, pt tucks chin and lifts head Cheat- not maintaining chin tuck or leading with chin
Trunk flexion MMT
muscles- rectus abdominus stabilize- PPT and chin tuck 5- hands on head, 4- hands cross chest, 3- hands by side inferior angle of scapula must clear cheat- hip flexors increase LS lordosis
Trunk flexion (lower bias) MMT
muscles- rectus abdominus, internal and external oblique stabilize- PPT, head and shoulders down Cheat- APT, increase LS lordosis Grades- 3=75-90, 3+=60-74, 4-=45-59, 4=30-44, 4+=15-29, 5= 14-0
CS Flexion/Extension ROM Inclinometer
sitting in chair- Vertex of skull and T1 normal rom for flexion- 50° normal rom for extension- 60°
CS lateral flexion ROM inclinometer
sitting in chair- vertex of skull and T1 (frontal plane) normal rom- 45° cheat- rotating
CS rotation ROM with inclinometer
supine with head off edge of table- base of forehead normal ROM- 80° Stabilize- one hand to prevent side bending cheat- side bend (lat flexion)
CS rotation with tape measure
tip of mandible and lateral tip of acromion normal- 11cm cheat- shrugging shoulder, protrusion of shoulder girdle, trunk rotation
