NECK FLEXIONStarting & ending positionSitting 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 FLEXIONPrecautionPrevent trunk flexion. Prevent neck rotation and lateral flexion.Factors limiting ROMTension 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 ExtensionStarting & ending positionJust as for flexionAxis – external auditor
meatus Stationary arm – vertical Moving arm – aligned with
nostrils ROM From 45 – 0 for
extensionFrom o- 45 for hyper
extension
NECK ExtensionPrecautionJust as for flexionFactors limiting ROMTension of flexors muscles of neck ( ventral
neck muscles)Approximation of spinous process.
Starting & ending positionJust as for flexion& extensionAxis : 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.
ROMFrom 0 – 60-75 degrees in each
direction.The distance is approximately 5
in to each side as measured by tape.
CERVICAL ROTATION
CERVICAL ROTATION
precautionPrevent trunk rotationPrevent 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 positionSitting 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)PrecautionPrevent trunk lateral flexion to the test side.Tape measurementBetween mastoid process of the temporal
bone and the acromion process of the scapula..
Trunk FlexionStarting 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 HyperextensionThe tape alignment is just the
same as for trunk flexionROM 2 inchesPrecautionsPrevent hip extension.Prevent trunk rotation.Factors Limiting ROMTension of anterior abdominal
muscles ( muscles of trunk flexion)
Contact of spinous processes.Tension of longitudinal ligament
of spine.
Thoracic and lumbar lateral flexionPosition Standing erect.Axis - S1 spinous process Stationary arm - vertical Moving arm - C7 spinous
process Stabilization The pelvis is stabilized.
Thoracic and lumbar lateral flexionMeasuring tapeStarting 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 ROMContact 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.