Goniometer-Cervical Flexion and Extension
- The fulcrum is placed over the external auditory meatus
- The proximal arm is placed either perpendicular or parallel to the ground
- Distal arm lines with the base of the nares or if a tongue depressor is used, align the arm of the goniometer parallel to the longitudinal axis of the tongue depressor.
Cervical Flexion and Extension using a Tape Measure
Cervical flexion can also be measured using a tape measure. The examiner uses a tape measure to determine the distance from the tip of the chin to the sternal notch.
Goniometer- CERVICAL LATERAL FLEXION
- Fulcrum at C7 spinous process
- Proximal arm with the spinous processes of the thoracic vertebra so that the arm is perpendicular to the ground
- Distal arm with the dorsal midline of the head, using the occipital protuberance for reference
Cervical Lateral Flexion using a Tape Measure
The examiner uses a tape measure to measure the distance from the tip of the ear to the acromion process.
Goniometer- CERVICAL ROTATION
- Fulcrum is over the center of the cranial aspect of the head
- Proximal arm to an imaginary line between the two acromial processes
- Distal arm with the tip of the nose
Goniometer-Thoracic and Lumbar Lateral Flexion
- Subject is standing with the feet shoulder with apart and the cervical thoracic, and lumbar spine in 0 degreed of flexion, extension and rotation.
- Stabilize the pelvis to prevent lateral tilting.
- The subject bends to one side while keeping the arm in a relaxed position at the side of the body. Keep both feet flat on the floor. The end of the motion occurs when the heel begins to rise on the foot opposite the side of the motion or the pelvis begins to tilt laterally.
- Mark the spinous processes of C7 and S2.
- Fulcrum over the posterior aspect of the spinous process of S2
- Proximal arm is perpendicular to the ground
- Distal arm points to the posterior aspect of the C7 spinous process
Thoracic and Lumbar Lateral Flexion using a Tape Measure
Thoracic and Lumbar Lateral Flexion using a Tape Measure
Have the subject stand with feet shoulder width apart and arms hanging freely at the sides. Ask the subject to bend to the side as far as possible while keeping both feet flat on the ground with knees extended. At the end of the ROM, mark the leg level witi
h the tip of the middle finger and use a tape measure or ruler to measure the distance between the mark on the leg and the floor.
Key Concepts for Spinal Goniometry
Transitions from sitting to standing require an average of 35 degrees lumbar flexion.1,2
- Donning socks/shoes requires an average of 56 degrees lumbar flexion.1
- Deep squatting to retrieve an object on the floor requires and average of 60 degrees of lumbar flexion.1
- Use caution when assessing lumbar motion for treatment goals as low correlations exist between ROM measures and impairment/disability in studies by Sullivan, Shoaf, Riddle and Nattrass.1,3,4,5
