Neck & trunk rom measurement

2. 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

3. 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.

4. NECK Extension
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

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

6. 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

7. 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.

8. 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.

9. 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..

10. 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.

11. 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.

12. 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.

13. 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.

14. 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.

15. 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 45
o

Stabilization
The pelvis is stabilized.

16. 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.