Spinal Measurements Flashcards
Why measure
- Quantitative vs. qualitative data
- Impairment based goals
- Outcome measures
- Disability ratings
- Research
Why not measure?
Not very functional - numbers in lumbar ROM don’t relate to function
Tools to measure with
Vision Tape measure Goniometer Inclinometer Special tools (gravity assisted devices, BROM, radiographs)
Visual Estimation
Commonly used by clinicians
Poor reliability
Clinicians are looking at intersegmental mobility and quality of the movement - most clinicians couldnt tell you normative number for norms
Tape Measure
Inexpensive
Easy to use
Readily available
Thoraco-Lumbar Flexion Tape Measure
Subject standing - stabilize pelvis
Mark C7 and S2 (line btw PSIS)
Align tape measure btw 2 processes
Let tape measure taunt - dont flatten it along the spine
When you feel ASIS tilt forward - thats where the thoraco-lumbar flexion is
Thoracolumbar Flexion Cont. Measure from…
C7 to S2
Have subject perform flexion ROM
Stabilize the pelvis to prevent anterior tilting
Record distance at end of ROM - subtract differences
Norm is 4 inches
Ankylosing Spondylitis
arthritis of the spine that can lead to the vertebrae fusing together
Technique of measuring with tape measure would be appropriate for them because need to track ROM over time
Thoraco Lumbar Flexion Figure tip to floor method
Measurement of lumbar, thoracic, and hip ROM
Quickly performed
In flexion, measure from floor to fingertips
Norms = 0.1 - 2.2 cm
Thing to consider with thoraco lumbar flexion figure tip to floor methog
Need to realize that it is not thoracolumbar flexion alone - hip flexion is involved, hamstring length too
Lumbar spine - tape measure (flexion/extension)
Schober method - 1937
Two points marked, lumbosacral junction, 10 cm superior to first mark
Modified schober - 1969
Three points used, lumbosacral junction, 10cm superior to first mark, 5cm inferior to first mark
Lumbar spine - tape measure (flex/ext) - Modified Modified Schober (1973)
Line btw PSIS's 15 cm superior Measure Stabilize Pelvis Flex forward Measure Calculate the difference
Lumbar extension
Measure same as modified modified schober technique
Have patient extend spine until you feel the beginning of post pelvic tilting
Measure, calculate difference
Norm = 4.21cm in male teen to 3.41cm in male 65 yo
Lateral flexion - tape measure finger tip to thigh
Mark middle finger level on thigh
Have subject go through ROM - make sure no compensatory rotation of flexion occurs
Mark on leg where the middle finger has touched
Measure the difference
Avg.ROM 21.6cm in adults
Lateral flexion - tape measure fingertip to floor
Tip of middle finger to floor after performing ROM
Mark leg where hand touches
Measure to floor
Norms F with age 53= 15.9cm R and 16.9 L
Lumbar flexion and extension with goniometer
Stationary arm = vertical to floor
Axis - midaxillary line immediately below ribs
Moving arm = along midaxillary line (mid trunk)
Flexion norms = none
Extension norms = 41 for 20 yo and 16 for 70 yo
Thoraco lumbar lateral flexion - gonio
Stationary arm = vertical to floor
Axis = spinous process S2
Moving arm - spinous process C7
Norms = 37 for 20 yp and 18 for 70 yo
Thoraco lumbar rotation goni
Subject is sitting thereby stabilizing pelvis, feet on floor
Subject rotated till pelvis begins to rotate
Axis - over patients head
Stationary arm - imaginary line btw iliac crests
Movable arm - imaginary line over acromial processes
45 deg is norm
Hard to do and hard to see
Inclinometers
american medial assoc guides to evaluation of permanent impairment use this for evals
System that awards workers depending on their injuries
Thoraco lumbar flexion - double inclinometer
Mark mid sacrum and C7 spinous process
Align inclinometer and zero device
Have patient move and make sure pelvis is stabilized
Read both inclin and diff btw two is the ROM
Lumbar flex/ext inclinometer
Normal ROM is 60 deg flex, 25 degrees ext
Mark S2 and T12 spinous processes
Place inclinometer over marks
Zero both inclinometers and have subject flex or extend
Calc by subtracting degrees from sacral from those on thoracic
Thoracic/lumbar lateral flexion - inclinometer
Mark at S2 and T1 for thoraco lumbar and S2 and T12 for lumbar
Place inclinometers at landmarks - zero
Have patient move
Read angles on both devices
Subtract sacral measurement from thoracic measurement
AMA - lumbar ROM is 25 degrees
Back ROM - BROM
Used for lumbar motion
Requires magnetic yoke around the pelvis
Place at T12 and S1 vertebrae
Flexible ruler
allows us to measure quantity of movement but does deal with quality
Measuring motion in the lumbar spine before and after a stretching program is appropriate use of this evaluation tool - T or F
True
The modified modified schober method was created to simplify measurement with tape measure - T or F
True
Lumbar extension has ended when palpation of ASIS reveals anterior pelvic tilt - T or F
False
A common compensation with lateral flexion of spine is concurrent flexion - T or F
True
Comparing one tester over repeated trials is considered interrator reliability - T or F
False
