Kines Final

Practical
Spine

Cervical Flexion
Axis of Rotation : Earhole , External Auditory
Meatus
Moving Arm : Align with base of nose
Stationary Arm : Perpendicular to ceiling or floor
pt position : Sitting, PT to the side
Cues: can you look down for me? Bring chin to
chest
Normal Values : 0- 40 Deg
Documentation : CSpine AROM Flexion 0-58Deg
Notes
Avoid awkard bends, look for consistent/even
flexion. No protrusions / retractions.

Cervical
Extension
Axis of Rotation : Earhole , External Auditory
Meatus
Moving Arm : Align with base of nose
Stationary Arm : Parallel to ceiling or floor
pt position : Sitting, PT to the side
Cues: Let your head drop back and look at the
ceiling for me
Normal Values : 0 -50
Documentation : CSpine AROM Extension 0-68Deg
Notes
May be painful, be quick. Be mindful for Vertebral
artery test.

Cervical Lateral Flexion

Axis of Rotation : C7 Spinous Process/
Protuberance
Moving Arm : Bisect the head
Stationary Arm : Perpendicular to the ground
pt position : sitting
Cues: can you bring your right ear to your right
shoulder
Normal Values : 0 20 Deg
Documentation : Cspine AROM R/L Lat Flexion 038Deg
Notes
confirm you are on C7, look for pure cervical

Cervical
Rotation

Axis of Rotation : Center of Cranium

Moving Arm : Line that aligns with base of nose
Stationary Arm : Line that connects acomions
pt position : sitting, PT above head

Cues: can you turn and look over R/L shoulder?

Normal Values : 0- 90deg
Documentation : Cspine AROM R/L Rotation 077Deg
Notes
Look for pure rotation, avoid flexion, extension.

ThoracoLumbar
Rotation
Axis of Rotation : Straight through cranium
superior to inferior
Moving Arm : line between acromions
Stationary Arm : line between iliac crests
pt position : sitting in pelvic neutral, good
posture for zero
Cues: place arms across chest, turn body to R/L
Normal Values : 0 40degrees
Documentation : AROM R/L ThoracoLumbar
Rotation 0-35deg
Notes:
Make sure its a transverse motion, avoid flexion,

ThoracoLumbar
Flexion
Axis of Rotation : Line across T12
Inclinometer Position : Base right above T12 line
pt position : Standing, Pelvis Blocked
Cues: lean down and try to touch your toes
Normal Values : 0-100 Deg
Documentation : AROM T/L Flexion 0-84deg
iPhone App
Notes
may need someone to help block or take
inclinometer reading
ZERO inclinometer

ThoracoLumbar
Extension
Axis of Rotation : Line across T12
Inclinometer Position : Base right above T12 line
pt position : Standing, Pelvis Blocked
Cues: Try and lean back for me, as far as you can
go
Normal Values : 0-25 Deg
Documentation : AROM T/L Flexion 0-90deg
iPhone App
Notes
may need someone to help block or take
inclinometer reading
ZERO inclinometer

Lumbar Flexion
Axis of Rotation : Line across S2
Inclinometer Position : Base right above PSIS line
pt position : Standing, Pelvis Blocked
Cues: lean down and try to touch your toes
Normal Values : 0-50 Deg
Documentation : AROM L Flexion 0-14deg iPhone
App
Take T/L measurement and subtract what you get for
L Flexion

Notes
may need someone to help block or take
inclinometer reading
ZERO inclinometer

Lumbar Extension
Axis of Rotation : Line across S2
Inclinometer Position : Base right above PSIS line
pt position : Standing, Pelvis Blocked
Cues: Lean back all the way for me as far as you
can
Normal Values : 0-20 Deg
Documentation : AROM L Extension 0-14deg
iPhone App
Take T/L measurement and subtract what you get for
L extension

Notes
may need someone to help block or take
inclinometer reading

ThoracoLumbar
Lateral Flexion
Axis of Rotation : Line across T12
Inclinometer Position : Flat against pt spine, base T12
pt position : Standing, Pelvis Blocked
Cues: slide your R/L arm down R/L leg as far as you
can
Normal Values : 0-30 Deg
Documentation : AROM T/L SideBend R/L 0-14deg
iPhone App
Notes
Pure side-bending, avoid tri-planar motion. Look for
symmetrical movements and angulations. Differences
bi-laterally. Avoid pelvis shifting/hip hiking.

MANUAL MUSCLE TESTING

For All :
Grade 0 = No contraction or
Motion

Capital Extension
Muscles used : Rectus Capitus Posterior Min/Maj,
Sup/Inf Oblique
Position: Prone for 3,4,5 Supine for 1,2 *Use towel
on forehead for comfort or pop out face piece
Grade 5: Prone, Can you tilt your head back? Max
resist
Grade 4:Prone, Can you tilt your head back? Mod
resist
Grade 3:Prone, Can you tilt your head back? No
Resist, Full ROM
Grade 2: Supine, Can you tilt your head back ?
Movement
Grade 1: Supine, Can you tilt your head back ?

Cervical Extension
Muscles used : Splenius cervicis & capitis, Semispinalis
cervicis
Position: Prone for 3,4,5 Supine for 1,2
Grade 5: Prone, Can you move your whole head
towards the ceiling without looking up ? Max Resist
Grade 4:Prone, Can you move your whole head
towards the ceiling without looking up ? Mod Resist
Grade 3:Prone, Can you move your whole head
towards the ceiling without looking up ? Full ROM, no
resist
Grade 2: Supine, Push head into table, any motion
Grade 1: Supine, Push head into table, any
contraction

Capital Flexion
Muscles used : Rectus Capitus Ant/Lat ,Longus
Capitus
Position: Supine
Grade 5: Supine, Nod, Head on neck, max resist
on side of head
Grade 4: Supine, Nod, Head on neck, min resist
on side of head
Grade 3:Supine, Nod, Head on neck, full ROM
Grade 2: Supine, Nod, Partial ROM
Grade 1: Supine, Nod, Contraction

Cervical Flexion
Muscles used : SCM, Longus Colli, Ant Scalene
Position: Supine
Grade 5: Supine, Bring head straight up, keep
looking straight, Max Resist
Grade 4:Supine, Bring head straight up, keep
looking straight, Mod Resist
Grade 3:Supine, Bring head straight up, keep
looking straight, Full ROM
Grade 2: Supine, Ask for cervical rotation side to
side
Grade 1: Trace, Ask for cervical rotation, Check
Opp. SCM

Cervical Rotation
Muscles used : SCM, Levator Scap, Upper Trap, Scalenes
Position: Supine; PT should guard against gravity rotating
Grade 5: Supine, Max Resist against rotation to left and
right
Grade 4: Supine, Mod Resist against rotation to left and
right
Grade 3: Supine rotated to one side, Rotate head all the
way to the other side, keep looking straight, Full ROM
Grade 2: Supine, Rotation, Partial ROM or Gravity
Rotating
Grade 2: Sitting, Rotation, Full ROM
Grade 1: Trace; Contralateral SCM, scalenes,

Lumbar Extension
Muscles used : Erector Spinae
Position: Prone; Ankles stabilized
Grade 5: Prone, Lift trunk off table, Belly button
clears table with no difficulty
Grade 4:Prone, Lift trunk off table, Belly button
clears table with little time or difficulty
Grade 3:Prone, Lift trunk off table, Belly button
clears table but cant hold
Grade 2: Prone, Lift trunk off table, Belly button
doesnt clear
Grade 1: Trace

Thoracic Extension
Muscles used : Erector Spinae
Position: Prone; Nipple line to base of table, Ankle
Stabilized
Grade 5: Prone, Comes to horizontal immediately
Grade 4:Prone, Comes to horizontal with little
difficulty
Grade 3:Prone, Comes to horizontal but cant hold
Grade 2: Prone, Come to horizontal, partial ROM
Grade 1: Trace

Trunk Flexion
Muscles used : Rectus Abdomis, Ext Oblique, Int Oblique
Position: Supine; Arm placement varies
Grade
Scap
Grade
Scap
Grade
Grade

5: Arms behind head, Lift up, Clears Inf. Angle of

4: Arms across chest, Lift up, Clears Inf. Angle of
3: Arms on side, Lift up, Clears Inf. Angle of Scap
2: Sequence (Arms to side)

Head Raise : Lift head off table, Scap comes off = Grade 2
Assisted Fwd Lean : PT cradle head & shoulder, can you lean
forward depression of rib cage = Grade 2
No depression but contraction of Rectus Abdominis = Grade 1

Cough : Head and Shoulder cradled, cough = Grade 2

Cant cough but contracts Rectus = Grade 1

Trunk Rotation
Muscles used : Contralateral External Oblique,
Internal Oblique
Position: Supine, Looking for Scapula to clear
Grade 5: Supine, Arms behind head, Try to bring
elbow to opposite hip, Smooth motion
Grade 4: Supine, Arms across chest, Try to bring
elbow to opposite hip, Smooth motion
Grade 3: Supine, Arms on side, Try to bring elbow
to opposite hip, Smooth motion
Grade 2: Supine, Arms on side, Try to bring elbow
to head, Partial ROM
Grade 1: Assist and ask for movement, Trace