Spinal Measurements

Question 1

Why measure

Answer 1

1. Quantitative vs. qualitative data
2. Impairment based goals
3. Outcome measures
4. Disability ratings
5. Research

Question 2

Why not measure?

Answer 2

Not very functional - numbers in lumbar ROM don’t relate to function

Question 3

Tools to measure with

Answer 3

Vision
Tape measure
Goniometer
Inclinometer
Special tools (gravity assisted devices, BROM, radiographs)

Question 4

Visual Estimation

Answer 4

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

Question 5

Tape Measure

Answer 5

Inexpensive
Easy to use
Readily available

Question 6

Thoraco-Lumbar Flexion Tape Measure

Answer 6

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

Question 7

Thoracolumbar Flexion Cont. Measure from…

Answer 7

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

Question 8

Ankylosing Spondylitis

Answer 8

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

Question 9

Thoraco Lumbar Flexion Figure tip to floor method

Answer 9

Measurement of lumbar, thoracic, and hip ROM
Quickly performed
In flexion, measure from floor to fingertips
Norms = 0.1 - 2.2 cm

Question 10

Thing to consider with thoraco lumbar flexion figure tip to floor methog

Answer 10

Need to realize that it is not thoracolumbar flexion alone - hip flexion is involved, hamstring length too

Question 11

Lumbar spine - tape measure (flexion/extension)

Answer 11

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

Question 12

Lumbar spine - tape measure (flex/ext) - Modified Modified Schober (1973)

Answer 12

Line btw PSIS's
15 cm superior
Measure
Stabilize Pelvis
Flex forward
Measure
Calculate the difference

Question 13

Lumbar extension

Answer 13

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

Question 14

Lateral flexion - tape measure finger tip to thigh

Answer 14

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

Question 15

Lateral flexion - tape measure fingertip to floor

Answer 15

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

Question 16

Lumbar flexion and extension with goniometer

Answer 16

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

Question 17

Thoraco lumbar lateral flexion - gonio

Answer 17

Stationary arm = vertical to floor
Axis = spinous process S2
Moving arm - spinous process C7
Norms = 37 for 20 yp and 18 for 70 yo

Question 18

Thoraco lumbar rotation goni

Answer 18

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

Question 19

Inclinometers

Answer 19

american medial assoc guides to evaluation of permanent impairment use this for evals
System that awards workers depending on their injuries

Question 20

Thoraco lumbar flexion - double inclinometer

Answer 20

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

Question 21

Lumbar flex/ext inclinometer

Answer 21

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

Question 22

Thoracic/lumbar lateral flexion - inclinometer

Answer 22

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

Question 23

Back ROM - BROM

Answer 23

Used for lumbar motion
Requires magnetic yoke around the pelvis
Place at T12 and S1 vertebrae

Question 24

Flexible ruler

Answer 24

allows us to measure quantity of movement but does deal with quality

Question 25

Measuring motion in the lumbar spine before and after a stretching program is appropriate use of this evaluation tool - T or F

Answer 25

True

Question 26

The modified modified schober method was created to simplify measurement with tape measure - T or F

Answer 26

True

Question 27

Lumbar extension has ended when palpation of ASIS reveals anterior pelvic tilt - T or F

Answer 27

False

Question 28

A common compensation with lateral flexion of spine is concurrent flexion - T or F

Answer 28

True

Question 29

Comparing one tester over repeated trials is considered interrator reliability - T or F

Answer 29

False