Lumbar Spine Range Of Motion: Difference between revisions
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* With AROM looking for willingness to move, quality of movement, where movement occurs, range, pain, painful arc and deviations. | * With AROM looking for willingness to move, quality of movement, where movement occurs, range, pain, painful arc and deviations. | ||
* Overpressure (at the end of all AROM if they are pain-free), normal end-feel should be tissue stretch. | * Overpressure (at the end of all AROM if they are pain-free), normal end-feel should be tissue stretch. | ||
== Methods == | |||
The most accurate method to measure the movement of the vertebrae is through radiography, but use of long-term radiography is not sensible due to risk of radiation and cost. <ref name=":0" /> Other methods of measurement include: | |||
* [[Fingertips to Floor Distance - Special Test|Fingertip to floor test]] | |||
* [[Schober Test|Schober test]] and [[Schober Test|modified Schober test]] | |||
* Inclinometer: an advanced expensive equipment for measurement of ROM. An inclinometer is a handheld, circular, fluid-filled disc that has a weighted gravity pendulum attached to it that is maintained in the vertical direction. It is graduated by 0.5 degree intervals over 360 degrees.<span class="reference" id="cite_ref-:0_1-2"></span> | |||
* [[Goniometer]] | |||
* Tapemeasure | |||
* Visual observation | |||
== Variations ROM Norms == | == Variations ROM Norms == | ||
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[[File:Testing lumbar flexion.jpg|thumb|Testing Lx Flexion]] | [[File:Testing lumbar flexion.jpg|thumb|Testing Lx Flexion]] | ||
The medical management of LBP patients is based upon clinical history and physical findings, and the measurement of motion forms a core component of assessment. The measurement of motion has the advantage of being more objective and quantifiable than the assessment of subjective measures such as [[Pain Assessment|pain]]. However systematic review concluded there is little evidence to support the use of current methods of range of movement measurement in the lumbar spine. They noted that if ROM is to continue to be to assess spinal function, degree of impairment and response to therapeutic input scientific evidence on the validity of these procedures need be found.<ref>Littlewood C, May S. Measurement of range of movement in the lumbar spine—what methods are valid? A systematic review. Physiotherapy. 2007 Sep 1;93(3):201-11. Available:https://www.csp.org.uk/journal/article/physiotherapy-september-2007/measurement-range-movement-lumbar-spine-what-methods (asccessed 20.11.2022)</ref><ref name=":1" /> | The medical management of LBP patients is based upon clinical history and physical findings, and the measurement of motion forms a core component of assessment. The measurement of motion has the advantage of being more objective and quantifiable than the assessment of subjective measures such as [[Pain Assessment|pain]]. However systematic review concluded there is little evidence to support the use of current methods of range of movement measurement in the lumbar spine. They noted that if ROM is to continue to be to assess spinal function, degree of impairment and response to therapeutic input scientific evidence on the validity of these procedures need be found.<ref>Littlewood C, May S. Measurement of range of movement in the lumbar spine—what methods are valid? A systematic review. Physiotherapy. 2007 Sep 1;93(3):201-11. Available:https://www.csp.org.uk/journal/article/physiotherapy-september-2007/measurement-range-movement-lumbar-spine-what-methods (asccessed 20.11.2022)</ref><ref name=":1" /> | ||
== References == | == References == | ||
<references /> | <references /> | ||
Revision as of 02:53, 21 November 2022
Original Editor - Lucinda hampton
Top Contributors - Lucinda hampton, Kim Jackson and Aminat Abolade
Introduction[edit | edit source]
Assessment of range of motion (ROM) of the lumbar spine is an important part lumbar spine examination. Aberrant spinal motion is associated with faulty spinal mechanics. Motion of the lumbar spine is assessed in all planes including flexion, extension, side bending, and rotation.[1] Average Healthy Ranges of Motion Measured from Anatomic Position: Lumbar spine[2]
| Flexion | 50 degrees |
| Extension | 15 degrees |
| Right lateral flexion | 20 degrees |
| Left lateral flexion | 20 degrees |
| Right rotation | 5 degrees |
| Left rotation | 5 degrees |
When assessing movement
- With AROM looking for willingness to move, quality of movement, where movement occurs, range, pain, painful arc and deviations.
- Overpressure (at the end of all AROM if they are pain-free), normal end-feel should be tissue stretch.
Methods[edit | edit source]
The most accurate method to measure the movement of the vertebrae is through radiography, but use of long-term radiography is not sensible due to risk of radiation and cost. [1] Other methods of measurement include:
- Fingertip to floor test
- Schober test and modified Schober test
- Inclinometer: an advanced expensive equipment for measurement of ROM. An inclinometer is a handheld, circular, fluid-filled disc that has a weighted gravity pendulum attached to it that is maintained in the vertical direction. It is graduated by 0.5 degree intervals over 360 degrees.
- Goniometer
- Tapemeasure
- Visual observation
Variations ROM Norms[edit | edit source]
Variables affect lumbar range of motion: There are significant differences between the motion characteristics of the normal (see table above) and LBP populations. However, due to the diverse nature of these populations, there is great variability within the two groups. This limits the clinical usefulness of these measurements.[3]
- Flexion (73-40 degrees) declines noted with age.
- Lateral flexion (28-14 degrees, L&R) declined with age.
- Extension (29-6 degrees) declined the greatest at 79% with age.
- No decline in axial rotational (7%) way across the age spectrum. [4]
Validity[edit | edit source]
The medical management of LBP patients is based upon clinical history and physical findings, and the measurement of motion forms a core component of assessment. The measurement of motion has the advantage of being more objective and quantifiable than the assessment of subjective measures such as pain. However systematic review concluded there is little evidence to support the use of current methods of range of movement measurement in the lumbar spine. They noted that if ROM is to continue to be to assess spinal function, degree of impairment and response to therapeutic input scientific evidence on the validity of these procedures need be found.[5][3]
References[edit | edit source]
- ↑ 1.0 1.1 Musculoskeletal Key Physical Examination of the Lumbar Spine Available: https://musculoskeletalkey.com/physical-examination-of-the-lumbar-spine/ (acessed 20.11.2022)
- ↑ Learn muscles Motions of the Joints of the Lumbar Spine Available;https://learnmuscles.com/blog/2017/08/30/motions-lumbar-spine/ (accessed 21.11.2022)
- ↑ 3.0 3.1 McGregor AH, McCarthy D, Dore CJ, Hughes SP. Quantitative assessment of the motion of the lumbar spine in the low back pain population and the effect of different spinal pathologies on this motion. European Spine Journal. 1997 Sep;6(5):308-15.Available;https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3454599/pdf/586_2005_Article_BF01142676.pdf (accessed 20.11.2022)
- ↑ Troke M, Moore AP, Maillardet FJ, Cheek E. A normative database of lumbar spine ranges of motion. Manual therapy. 2005 Aug 1;10(3):198-206.Available:https://pubmed.ncbi.nlm.nih.gov/16038855/ (accessed 20.11.2022)
- ↑ Littlewood C, May S. Measurement of range of movement in the lumbar spine—what methods are valid? A systematic review. Physiotherapy. 2007 Sep 1;93(3):201-11. Available:https://www.csp.org.uk/journal/article/physiotherapy-september-2007/measurement-range-movement-lumbar-spine-what-methods (asccessed 20.11.2022)
