Neck and trunk ROM, MMT and special tests

Trunk lateral flexion (lumbar spine) ROM with goni ROM norm

35 degrees

Neck flexion (cervical spine) ROM with TM starting landmark

Tip of the chin

Neck flexion (cervical spine) ROM with TM ending landmark

Suprasternal notch

Neck flexion (cervical spine) ROM with TM ROM norm

3 cm

Neck extension (cervical spine) ROM with TM ending landmark

Suprasternal notch

Neck lateral flexion (cervical spine) ROM with TM ending landmark

acromion process

Trunk Flexion (thoracolumbar) ROM with TM starting landmark

C7

Trunk Flexion (thoracolumbar) ROM with TM ending landmark

S2

Trunk Flexion (thoracolumbar) ROM with TM ROM norm

6-7 cm

Trunk Extension (thoracolumbar) ROM with TM starting landmark

C7

Trunk Lateral Flexion (Thoracolumbar) ROM with TM starting landmark

Draw a line where the tip of the middle finger falls on the lateral surface of the leg while standing

Trunk Lateral Flexion (Thoracolumbar) ROM with TM ROM norm

22 CM

Trunk rotation (Thoracolumbar) ROM with TM position

Seated

Trunk rotation (Thoracolumbar) ROM with TM ROM norm

Compare

GR Trunk flexion position

supine

GR Trunk flexion stabiliaztion

Do not stabilize the feet

GR Trunk Extension position

Prone (feet over the edge of mat)

GR Trunk Extension stabilaztion

Strap is placed over the pelvis with therapist stabilizing just proximal to the ankles. If no pelvic strap is available, therapist stabilizes at pelvis asking patient to keep dorsum feet on mat when performing

GR Trunk Extension palpation

Erector Spinae

GR Trunk Flexion & Rotation position

Supine

GR Trunk Flexion & Rotation stabilization

Do not stabilize the feet

GR Trunk Flexion & Rotation palpation

External and internal obliques

GE Trunk rotation position

Seated

GE Trunk rotation stabilization

Pelvis stabilized by pt's body weight

Neck flexion MMT position

Supine

Neck flexion MMT stabilization

None

Neck flexion MMT resistance location

Forehead

Anterolateral Neck flexion MMT position

supine

Anterolateral Neck flexion MMT stabilization

No stabilization

Anterolateral Neck flexion MMT resistance

Temporal region of the head

Neck extension MMT position

Prone

Neck extension MMT stabilization

Grasps end of the mat

Neck extension MMT resistance

Just proximal to the occiput

Vertebral Artery Test

Slowly extend, rotate, and laterally flex the cervical spine to each side and hold for 30 seconds. Positive shows that Pt has dizziness, blurred vision, nystagmus, slurred speech, loss of consciousness. Cause is compression of the vertebral artery

Spurling (Compression) Test

Apply downward compression force with palms of both hands on top of the pt's head while the pt laterally flexes to the opposite side. Positive indicated by c/o pain into the UE on the same side of the laterally flexed head. Cause is compression of nerve root with movement

Distraction Test

Upward force with hands under chin and occiput to slowly distract head from trunk. Also performed in supine, with both hands hooking the occiput. Positive caused by c/o decreased pain. Cause is shows that the nerve root is compressed at rest and improves with distraction force

Straight Leg Raise Test (Hoover test)

Tests for lack of effort from a patient/malingering

Slump test

Pt is in seated with hands folded behind back with slumped posture. You passively flexed the pt's head into full cervical flexion and have the pt extend the knee with DF. PTA passively brings ankle into DF while maintaining passive cervical flexion. Positive is indicated by c/o of shooting pain, numbness or burning into the LE. Cause is herniated disc or nerve root entrapment

Neck Flexion (Cervical Spine) ROM with Goni position

seated

Neck Flexion (Cervical Spine) ROM with Goni stationary arm

Perpendicular to the floor

Neck Flexion (Cervical Spine) ROM with Goni axis

ear lobe

Neck Flexion (Cervical Spine) ROM with Goni moving arm

Parallel to base of nose

Neck Flexion (Cervical Spine) ROM with Goni ROM norm

45 degrees

Neck Extension (Cervical Spine) ROM with Goni position

seated

Neck Extension (Cervical Spine) ROM with Goni stationary arm

Perpendicular to floor

Neck Extension (Cervical Spine) ROM with Goni axis

ear lobe

Neck Extension (Cervical Spine) ROM with Goni moving arm

Parallel to base of nose

Neck Extension (Cervical Spine) ROM with Goni ROM norm

45 degrees

Neck lateral flexion (Cervical Spine) ROM with Goni position

Seated

Neck lateral flexion (Cervical Spine) ROM with Goni stationary arm

Along spine, perpendicular to floor

Neck lateral flexion (Cervical Spine) ROM with Goni axis

C7

Neck lateral flexion (Cervical Spine) ROM with Goni moving arm

Midpoint of the posterior aspect of the head

Neck lateral flexion (Cervical Spine) ROM with Goni ROM norm

45 degrees

Neck rotation (Cervical Spine) ROM with Goni position

Seated

Neck rotation (Cervical Spine) ROM with Goni stationary arm

Parallel to an imaginary line that runs between the acromion processes

Neck rotation (Cervical Spine) ROM with Goni axis

Midpoint of the top of the head

Neck rotation (Cervical Spine) ROM with Goni moving arm

Aligned with the tip of the nose

Neck rotation (Cervical Spine) ROM with Goni ROM norm

60 degrees

Trunk lateral flexion (lumbar spine) ROM with goni position

Standing

Trunk lateral flexion (lumbar spine) ROM with goni stationary arm

Perpendicular to the floor

Trunk lateral flexion (lumbar spine) ROM with goni axis

S2

Trunk lateral flexion (lumbar spine) ROM with goni moving arm

Points toward C7 along the spine

Neck flexion (cervical spine) ROM with TM position

Seated

Neck extension (cervical spine) ROM with TM position

Seated

Neck extension (cervical spine) ROM with TM starting landmark

Tip of the chin

Neck extension (cervical spine) ROM with TM ROM norm

20 cm

Neck lateral flexion (cervical spine) ROM with TM position

Seated

Neck lateral flexion (cervical spine) ROM with TM starting landmark

mastoid process

Neck lateral flexion (cervical spine) ROM with TM ROM norm

13 cm

Neck rotation (cervical spine) ROM with TM position

Seated

Neck rotation (cervical spine) ROM with TM starting landmark

Tip of chin

Neck rotation (cervical spine) ROM with TM ending landmark

Acromion process

Neck rotation (cervical spine) ROM with TM ROM norm

11 cm

Trunk Flexion (thoracolumbar) ROM with TM position

Standing

Trunk Extension (thoracolumbar) ROM with TM position

Standing

Trunk Extension (thoracolumbar) ROM with TM ending landmark

S2

Trunk Extension (thoracolumbar) ROM with TM ROM norm

Compare

Trunk flexion (lumbar spine) ROM with TM position

Standing

Trunk flexion (lumbar spine) ROM with TM starting landmark

S2

Trunk flexion (lumbar spine) ROM with TM ending landmark

Draw a line 15 cm above S2

Trunk flexion (lumbar spine) ROM with TM ROM norm

Compare

Trunk Extension (lumbar spine) ROM with TM position

Standing

Trunk Extension (lumbar spine) ROM with TM starting landmark

S2

Trunk Extension (lumbar spine) ROM with TM ending landmark

Draw a line 15 cm above S2

Trunk Extension (lumbar spine) ROM with TM ROM norm

Compare

Trunk Lateral Flexion (Thoracolumbar) ROM with TM position

standing

Trunk Lateral Flexion (Thoracolumbar) ROM with TM ending landmark

Draw a line where the tip of the middle finger falls on the lateral surface of the leg during lateral flexion

Trunk rotation (Thoracolumbar) ROM with TM starting landmark

Lateral aspect of the acromion

Trunk rotation (Thoracolumbar) ROM with TM ending landmark

Contralateral greater trochanter OR upper point of iliac crest

GR Trunk flexion palpation

Rectus abdominis

GE Trunk rotation palpation

external and internal obliques

Neck flexion MMT palpation

Sternoclediomastoid

Anterolateral Neck flexion MMT palpation

SCM

Neck extension MMT palpation

Splenius capitis and cervicis

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