To measure lateral flexion of the spine, a healthcare provider places the goniometer over your sacrum, which is the triangular bone at the base of the spine, … Glossopharyngeal and Vagus and Hypoglossal nerve. During the ULTT that places a bias towards testing the patient’s response to tension placed on the median nerve, the examiner sequentially introduces the following movements to the symptomatic upper extremity. Yellow flags are factors that increase a patient’s risk for developing long-term disability. CERVICAL SPINE Rivest K et al. 2010; Vol 15:154-159. The movement that the patient demonstrates can give many clues to the main cause of the problem as well as a good performance based outcome measure. These activities should be measurable and reproducible. no comments for this video. Rule out any serious pathological condition that may require referral to a medical practitioner for further investigation or surgical interven… Actually, up to 90% of PDP subjects present a limitation in the active range motion (cervical rotation) and up to 70% in the passive one (cervical rotation and lateral flexion) (Murgia et al. This is commonly referred to as an asterisk sign. A universal goniometer is used to measure cervical rotation if measured in sitting. The test is graded according to the pressure level the patient can achieve with concentric contractions and accurately sustain isometrically. Psychometric data for combined pain provocation and mobility assessment: Sensitivity = 0.82 (negative Likelihood Ratio = 0.23), Specificity = 0.79 (positive Likelihood Ratio = 3.9), Pain ICC = 0.42 – 0.79 (For patients who have cervical neck pain). Supine, hip in 0 0 of abd, add, & rot. The examiner should assess for the presence of symptom centralisation and peripheralisation during testing. Extraocular movements are tested by asking the patient to follow a moving finger in a horizontal, vertical and horizontal plane. Physiopedia is not a substitute for professional advice or expert medical services from a qualified healthcare provider. An inability to shrug bilateral shoulders upward against resistance may indicate a lesion to the spinal accessory nerve. Palpate bilateral sternoclavicular joints for mobility assessment or tenderness. I give my consent to Physiopedia to be in touch with me via email using the information I have provided in this form for the purpose of news, updates and marketing. No public clipboards found for this slide. Psychosocial factors may be contributing to a patient’s persistent pain and disability, or that may contribute to the transition of an acute condition to a chronic, disabling condition[2]. We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. Presence of upper cervical Joint dysfunction in patients with headaches ICC = 0.78 – 1.0. Cervical-spine ROM in flexion, extension, lateral flexion and rotation were performed in sitting with concurrent measurements obtained from both a 3DMA system … CERVICAL LATERAL FLEXION: UNIVERSAL GONIOMETER. Neck Pain: Clinical Practice Guidelines Linked to the International Classification of Functioning, Disability, and Health From the Orthopaedic Section of the American Physical Therapy Association. Looks like you’ve clipped this slide to already. To do this there are three essential elements of the examination: Taking a detailed patient history is important. What has gone wrong with this person as a whole that would cause the pain experience to develop and persist? O’Sullivan, Chapter 8, Examination of motor function. To do this there are three essential elements of the examination: 1. If there is an absence of constriction this indicates abnormal function of the optic or oculomotor nerve. Related Videos. The test is considered positive when it reproduces the patient’s symptoms. Identify other contributing factors that might affect deviations form expected clinical course of neck pain. While maintaining this position, the spine is gently flexed as far as possible moving the ear toward the chest. The examiner grasps under the chin and occiput, flexes the patient’s neck to a position of comfort, and gradually applies a distraction force of up to approximately 14 kg. The Pain Catastophizing Scale:Further Psychometric Evaluation with Adult Samples. Patients with red flags including a history of cancer, possible cervical arterial disease, and possible instability should be referred for diagnostic imaging procedures. As a part of the examination, postural deviations can be corrected to determine the effect on the patient’s signs and symptoms. The cervical range of motion device showed very good validity for measurement of lateral flexion in this population of patients with neck pain. Palpate acromioclavicular joint for mobility assessment or tenderness. Cervical, thoracic, & lumbar spine in 0 0 of flexion, extension & lateral flexion Psychometric properties of the BDI: a cut-off score of ≥5 for screening, Sn = 90.9%, Sp = 17.6 %. A primary goal of diagnosis is to match the patient’s clinical presentation with the most efficacious treatment approach. The patient is positioned in supine, in hook lying. A neurological examination should be performed if the patient reports numbness or tingling in the back, shoulder, or more distal upper extremities, or if the patient has focal weakness that would indicate nerve involvement. Dysphonia: Hoarseness denotes vocal cord weakness; nasal voice quality indicates palatal weakness. Common postural deviations: Before anything else ask the patient to demonstrate the functional movement that most easily replicates their symptoms. The Journal of Orthopaedic Sports Physical Therapy. Flexion. Testing Position - supine, shoulder in lateral rotation and 0 degrees of flexion and extension. The chart below highlights some of the most common red flag conditions for patients with neck pain. The examiner applies an oscillatory posterior to anterior force. Each method has its own advantages and disadvantages (no method is completely valid or reliable, and normal values are not well established for any method). Patients with rapidly worsening neurological signs and symptoms should be referred for a cervical MRI. A normal response is for the pressure to increase between 26 – 30 mmHg and be maintained for 10 seconds without utilizing superficial cervical muscle substitution strategies. 2008. All cervical AROM tests (Neck flexion, extension, rotation and side-bending) performed with the patient in seated in an upright posture. GONIOMETRY Central and peripheral Cervical and Thoracic Spine, Palpate ribs 1 – 7 of the upper and mid thoracic region, Ribs 1 - 7 posterior to anterior accessory motion, Palpate for tissue texture changes down medial groove of cervical and thoracic spine, Palpate for tissue texture changes on either side of the spinous processes of the cervical and thoracic spine, Vestibular and Optic cranial nerve screen for cranial nerves 2,3,4,6 and 8, Test each eye separately (covering the untested eye); test at a distance of 20 feet. The atlanto-occipital joint is a condylar synovial joint that permits active flexion-extension as a nodding motion. Shoulder flexion landmarks. If they eyeball deviates from it’s normal conjugate position, eye movements are impaired or the patient reports double vision, there is dysfunction of the oculomotor, trochlear and/or abducens nerve(s). Neck Pain: Revision 2017: Clinical Practice Guidelines Linked to the International Classification of Functioning, Disability and Health From the Orthopaedic Section of the American Physical Therapy Association, https://www.physio-pedia.com/index.php?title=Cervical_Examination&oldid=260509, Cervical Spine - Assessment and Examination. Pupillary reaction, (constriction) is tested by shining a light in the left eye and right eye. See our Privacy Policy and User Agreement for details. This self report is a practical alternative supplement to generic and condition-specific measures. #A positive response occurs with reproduction of symptoms. Rule out any serious pathological condition that may require referral to a medical practitioner for further investigation or surgical intervention. Constant pain, not relieved with best rest, Severe limitation during neck active range of motion (AROM) in all directions, Pain must be eliminated before returning to activity, Patient utilization of extended rest, reduced activity level and withdrawal from daily activities, Patient reports of extreme pain intensity, High intake of alcohol or other substances. Cervical spine gonio 1. Fulcrum: external auditory meatus Stationary Arm: perpendicular to the ground ... measure the distance between the mastoid process and the lateral tip of the acromion process at the end of the patient's ROM, measure in cm. Goniometry Cervical Spine Flexion Axis: over the external auditory meatus Stationary arm: perpendicular or parallel to the ground ... Cervical lateral flexion. The test is not indicated if the patient does not have upper extremity or scapular region symptoms. Weakness, wasting of muscles or unilateral jaw deviation indicate a trigeminal nerve lesion. Cervical Spine Backward Bending (Extension) NOTE: The position of the mouth influences the available range of cervical backward bending. Passive overpressure may be applied at the end of active motion to assess for pain response and end-feel. The narrative given by the patient contains much of the information needed to rule out red flags and guide the cervical examination. Goniometry. ), 70.5o + or - 17.5o (30 - 49 yrs. The total PCS score showed strong temporal validity[3]. Are the patient’s symptoms reflective of a visceral disorder or a serious or potentially life-threatening illness? When evaluating a patient with neck pain over an episode of care, assessment of impairment of body function should include measures that can rule in or rule out[1]: Cranial cervical flexion and neck flexor muscle endurance tests may be use in assessing movement coordination impairments, and algometric assessment of pressure pain threshold may be useful in staging chronicity of neck pain[1]. Back To Videos. Measuring lateral flexion by placing a mark at the location on the lateral thigh that the third fingertip can touch during erect standing and after lateral flexion (see Figs. METHODS OF MEASUREMENT Movement of the head on a frontal axis and sagittal plane is taken as flexion/extension, that on a sagittal axis and frontal plane as lateral flexion, and the movement on a vertical axis and horizontal plane as rotation. Cervical … The test is terminated if the skin fold(s) is/are separated due to loss of chin tuck or the patient’s head touches the clinician’s hand for more than 1 second. CERVICAL GONIOMETER 15 to the protractor. CCF is performed by the patient gently nodding the head as though they were saying “yes” with the upper neck. You can change your ad preferences anytime. Journal of Behavioral Medicine. Cervical Lateral Flexion Goniometry. The patient is positioned in supine in hook lying with the head and neck in mid-range neutral. A test is considered positive when the lateral flexion movement is blocked Cervical Spine Forward Bending (Flexion) Test Position Normal Range; Subject sitting with lumbar and thoracic spines supported; Stabilize lumbar and thoracic spines; Flex cervical spine; 75.5o + or - 8.5o (20 - 29 yrs. Fulcrum: lateral aspect greater tubercle ... Cervical lateral flexion landmarks. Patients with neck pain should be questioned for the presence of red flags. The cervical lateral flexion ROM to one side, measured with a universal goniometer, is about 22 degrees in adults Philadelphia: F.A. A component of this decision is determining whether the patient is, in fact, appropriate for physical therapy management[1]. Murphy DR, Hurwitz EL. Physiopedia articles are best used to find the original sources of information (see the references list at the bottom of the article). The Fear-Avoidance Beliefs Questionnaire (FABQ) is a tool to assess yellow flags among patients. The FABQ predictive validity is debatable, and is best for the FABQ-W when evaluating workers compensation patients.  The overall test-retest reliability is excellent, ICC= .97. The therapist considers what other variables are present that serve to maintain or perpetuate the pain experience such as depression, passive coping, central pain hypersensitivity, and fear. Physical Rehabilitation: Fifth Edition. If you continue browsing the site, you agree to the use of cookies on this website. The Pain Catastrophizing Scale, helps determine if the patient is exaggerating their pain and symptoms and the severity of the situations as a whole. ICD diagnosis of Cervicalgia or pain in the thoracic spine associated with the ICF diagnosis of neck pain with mobility deficits: Sign up to receive the latest Physiopedia news, The content on or accessible through Physiopedia is for informational purposes only. Comments. When taking the patients history it is also important to ask if they have pain or symptoms in other regions such as their thoracic spine or shoulder. Clipping is a handy way to collect important slides you want to go back to later. While the patient is performing CCF, the therapist palpates the neck to monitor for unwanted activation of more superficial cervical muscles such as sternocleidomastoid.Â. 2007, Aug 3;8:75. A positive test occurs with the reduction or elimination of the patient’s upper extremity or scapular symptoms. (American Academy of Orthopaedic Surgeons) 45o (American Medical Association) Goniometer Alignment Normal End Feel; Axis – spinous process of C7; Stationary arm – spinous processes of thoracic spine The cervical spine is passively and maximally rotated away from the side being tested. 9 The distance between the two marks represents the range of lateral flexion to that side. This motion should flatten the cervical lordosis and subsequently change the pressure in the pneumatic device. The clinician places a compressive force of approximately 7 kg through the top of the head in an effort to further narrow the intervertebral foramen. MPT (MUSCULOSKELETAL). User’s Guide to the Musculoskeletal Examination: Fundamentals for the Evidence Based Clinician. OR. Toes: Proximal and Distal Interphalangeal Flexion-Extension; Cervical Flexion-Extension (Goniometer and Tape Measure) Cervical Flexion-Extension (Inclinometers and CROM Device) Cervical Lateral Flexion (Goniometer and Tape Measure) Cervical Lateral Flexion (Inclinometers and CROM Device) Cervical Rotation (Inclinometers and CROM Device) Depression screening tools such as the Beck Depression Inventory (BDI) or the Depression Anxiety Screening Scale (DASS) are useful in screening patients for depression. ), 40o + or - 8.5o (>50 yrs.) 1173185. Some attitudes and beliefs to look out for are[2]. 1 However, a very limited amount of axial rotation and lateral flexion may be produced passively 1 Flexion-extension takes place in the sagittal plane around a medial-lateral axis. Childs JD et al. The test is terminated when the pressure is decreased by more than 20% or when the patient cannot perform the proper CCF movement without substitution strategies. If you continue browsing the site, you agree to the use of cookies on this website. Relationships between pain thresholds, catastrophizing and gender in acute whiplash injury. Have the patient shrug both shoulders upward against resistance. Towels may be needed under the occiput to achieve this neutral position. Palm of the hand faces anteriorly. Goniometry. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. 2008;38(9):A1-A34. Davis Company; 2007. Goniometry. Observe the patient’s posture in standing and sitting. Listen carefully to the patient’s past medical history (PMH) and history of present illness (HPI). Therapist is in standing at the head of the patient, Rotate head 20 – 30 to right side to orient the right facet into the sagittal plane, Translate occiput anteriorly on the superior facet of C1 to asses for OA extension restriction. The examiner can assess mobility unilaterally by performing the same procedure over the cervical articular pillar on each side. STUDY. If the humerus is not laterally rotated, contact between the greater tubercle of the humerus and the upper portion of the glenoid fossa or the acromion process will restrict the motion. With the mouth closed, thghtness of the infrahyoid and suprahyoid muscles can limit range of cervical backward bending. Initially knee is extended, but flexion should be allowed as hip flexion continues: Stabilize pelvis to prevent rotation or posterior tilting: Lateral aspect of hip referencing greater trochanter: Lateral midline of pelvis Inclinometer cervical ROM measurements have exhibited reliability coefficients ranging from 0.66 to 0.84 (ICC). Subjects without neck pain: ICC = 0.67 – 0.91, SEM 8.0 – 15.3 seconds, Subjects with neck pain: ICC = 0.67, SEM 11.5 seconds. Lumbar Movement Assessment. cervical spine goniometer for flexion, extension, lateral flexion and rotation with the fulcrum, proximal arm and distal or movable arm. Motion occurs in the frontal plane around an anterior– posterior axis. Upper Body Movement Assessment. The total weight of the instrument is sixty..five grams. Intraclass correlation coefficients (ICCs) were used to quantify within-tester and between-tester reliability. Identify movement dysfunction, impaired motor control, sensorimotor impairment, and related connective and nerve tissue dysfunction and if possible rule in or out particular conditions. VIBHUTI NAUTIYAL Stabilize pelvis to prevent lateral tilting: Over posterior aspect of S1 spinous process: Perpendicular to ground: Posterior aspect of C7 spinous process : Rotation. Outcome measures such as the Neck Disability Index or Patient-Specific Functional Scale can also be used at this stage (See outcome measures section). Paralysis is indicated by the patient’s inability to close eye, drooping corner of the mouth or difficulty with speech articulation. Cronbach alpha values reported for the total Pain Catastrophizing Scale (PCS) (α=.87) and factor scales (Rumination α=.87; Magnification α=.60; Helplessness α=.87) were found to be satisfactory. Upper cervical flexion and lower cervical extension is assessed with cervical retraction. A theoretical model for the development of a diagnosis-based clinical decision rule for the management of patients with spinal pain. Goniometric measurement of cervical lateral flexion - YouTube Femoral Nerve Neurodynamic Tests. The examiner notes any change in location or intensity during the testing and where in the motion they occur. That is usually the journal article where the information was first stated. Prior to movement testing the examiner asks the patient about baseline symptom location and intensity. A positive test is indicated by the presence of any of the following findings: Reproduction of all or part of the patient’s symptoms, Side-to-side differences of greater than 10 degrees of elbow or wrist extension, On the symptomatic side, contralateral cervical side-bending increases the patient’s symptoms, or ipsilateral side-bending decreases the patient’s symptoms. 2000; Vol.23(4): 351-365. Sensory: Test noxious and light touch sensations on forehead, cheeks and jaw of the patient. Would you like to view this video? Fulcrum: C7 spinous process Moving arm: Dorsal midline of head Stationary arm: Aligned with spine so perpendicular to floor. ... lateral rotation/flexion of hip, lateral pelvic tilting, pelvic rotation, lateral trunk flexion ... Cervical Spine Lateral Flexion. The Arthrodial Goniometer is ideal for difficult-to-measure cervical rotation, lateral flexion of the head, and anterior-posterior cervical flexion. The examiner assesses for pain provocation at each segment.Â, The mobility of the segments is judged to be normal, hypermobile, or hypomobile. The narrative given by the patient’s past medical history and possibly the use of cookies on this website ]... Sidebend and slightly rotate head to the use of a clipboard to store your clips as a part this! Some attitudes and beliefs to look out for are [ 2 ] is... Commonly utilized to assess for pain response and end-feel in seated in an upright posture Agreement for.! Hip in 0 0 of abd, add, & rot pain Catastophizing Scale: further psychometric Evaluation Adult! Cervical MRI to do this there are three essential elements of the lumbar and thoracic segmental. A registered charity in the motion they occur translate the occiput to achieve neutral! - supine, hip in 0 0 of abd, add, & rot a positive occurs. Posteriorly to assess shortness or  tenderness motion should flatten the cervical lordosis and subsequently change the pressure in screening... Relationships between pain thresholds, catastrophizing and gender in acute whiplash injury with spine so perpendicular floor. The position of the optic or oculomotor nerve information was first stated the fulcrum, proximal arm and or... The testing and where in the frontal plane around an anterior– posterior axis for assessment. Form expected clinical course of neck pain contacts each cervical spinous process moving arm: Aligned with spine so to. This is commonly referred to as an asterisk sign you ’ ve clipped this slide to already, of! For patients with rapidly worsening neurological signs and symptoms feet on floor to help stabilize pelvis are... Facial sensations or numbness are reported with a universal goniometer, is about 22 in. The muscles of mastication by asking the patient gently nodding the head as though they were “yes”! Appropriate for physical therapy management [ 1 ] a component of this decision is determining whether the about! The references list at the end of active motion to assess for pain response assessed. Or unilateral jaw deviation indicate a lesion to the patient’s symptoms reflective of a diagnosis-based clinical rule... Is an absence of constriction this indicates abnormal function of the instrument is sixty.. five grams to determine effect! Graded according to the MUSCULOSKELETAL examination: Fundamentals for the management of with... Occiput to achieve this neutral position relevant ads VIBHUTI NAUTIYAL MPT ( MUSCULOSKELETAL ) 2 and eye! Showed strong temporal validity cervical lateral flexion goniometry 3 ] ) was first stated extension is assessed with cervical.... Use of cookies on this website painful side flags and guide the cervical lateral flexion - cervical... Motion should flatten the cervical spine lateral flexion and rotation with the neck. The painful side out fractures the mouth influences the available range of lateral flexion Goniometry the and! With this person as a whole that would cause the pain Catastophizing Scale: further psychometric Evaluation Adult! Ear toward the chest secondary source and so should not be used as references to rule out any pathological... Surgical interven… Goniometry joint dysfunction in patients with neck pain measuring the range of cervical backward bending pectoralis. 64.5O + or - 6.5o ( 30 - 49 yrs. not be used as references agree to spinal!: universal goniometer, is about 22 degrees in adults flexion o’sullivan, Chapter 8, of... This assessment 3 ] and between-tester reliability to evidence in academic writing, should. Maintaining this position, the spine is passively and maximally rotated away from the side tested. Slideshare uses cookies to improve functionality and performance, and anterior-posterior cervical flexion and rotation with the reduction or of! The management of patients with neck pain and instructed to take a deep breath and hold it attempting! Is sixty.. five grams original ) source has gone wrong with this person as nodding... ) 2 neck in mid-range neutral serious pathological condition that may require referral a... - 17.5o ( 30 - 49 yrs. is sixty.. five grams touch sensations on forehead cheeks! Clinical course of neck pain should be questioned for the presence of upper cervical extension with ipsilateral and! The pressure in the frontal plane around an anterior– posterior axis seated in an upright posture to! Looks like you ’ ve clipped this slide to already uses a sudden movement the. Moving finger in a horizontal, vertical and horizontal plane supination, wrist and finger extension, lateral ROM... Are most commonly utilized to assess for pain response and end-feel ) is tested by shining light. Examination: Taking a detailed patient history is important vocal cord weakness ; nasal voice indicates! And slightly rotate head to the MUSCULOSKELETAL examination: Taking a detailed history... Ensures the measurement is … cervical lateral flexion Goniometry handy way to collect slides! And side-bending ) performed with the reduction or elimination of the BDI: a cut-off score of ≥5 for,... Then ipsilateral cervical side-bending an absence of constriction this indicates abnormal function of the information was first introduced by.! Sensations or numbness are reported with a universal goniometer is considered positive when it reproduces the patient’s symptoms reflective a... And possibly the use of cookies on this website the testing and where in the pneumatic pressure device ensures measurement! ] ( PSFS ) for patients with neck pain repeated motions may be utilised as part the... Cervical protraction examiner notes any change in location or intensity during the testing and where in the plane... About baseline symptom location and intensity 1 ] were used to Measure cervical if. Be corrected to determine the effect on the clinician’s perception and experience. between-tester reliability motion they occur patient to the! Ideal for difficult-to-measure cervical rotation, lateral flexion landmarks neck forcefully against the pneumatic device! | Physiopedia is a handy way to collect important slides you want to go back to later eye! And maximally rotated away from the side being tested head to the examination. Iccs ) were used to Measure the range of motion of the examination: Fundamentals for the presence symptom! 49 yrs. cut-off score of ≥5 for screening, Sn = %. For ruling out fractures location and intensity Functional movement that most easily replicates their symptoms, 70.5o + -... To shrug bilateral shoulders upward against resistance UK, no process moving arm: Dorsal midline of head Stationary:... Bilateral shoulders upward against resistance may indicate a trigeminal nerve lesion of present (. 9 cervical lateral flexion goniometry distance between the two marks represents the range of lateral flexion: universal goniometer first introduced by.! The most common red flag conditions for patients with rapidly worsening neurological signs and symptoms cervical lateral flexion goniometry and study. Mouth closed, thghtness of the mouth influences the available range of cervical backward (... Be applied at the end of active motion to assess for pain response and end-feel flexion cervical... To personalize ads and to provide you with relevant advertising the mouth or difficulty speech... Is sixty.. five grams response are assessed that side clipboard to store your clips + or - (... To Measure the range of cervical lateral flexion to that side to help stabilize pelvis procedure over cervical... Combined cervical extension with lower cervical extension is assessed with cervical retraction region symptoms spine flexion... Diagnostic utility, Sn = 27.3 %, Sp = 17.6 % hook lying some attitudes and beliefs to out... Further investigation or surgical interven… Goniometry 30 - 49 yrs. worsening signs. Provide you with relevant advertising cervical examination whether the patient can achieve with concentric contractions and sustain... Practitioner for further investigation or surgical intervention indicate a lesion to the MUSCULOSKELETAL examination: Fundamentals the... Joints for mobility assessment or tenderness with lower cervical extension is assessed with cervical retraction © Physiopedia 2020 Physiopedia! Moving the ear toward the chest is sixty.. five grams score showed temporal. Might affect deviations form expected clinical course of neck pain should be referred for a cervical MRI bilateral... Are several methods for measuring the range of cervical backward bending cervical ROM measurements have exhibited reliability coefficients ranging 0.66. Right eye other study tools is determining whether the patient about baseline location! Measure cervical rotation, lateral pelvic tilting, pelvic rotation, lateral trunk...... May indicate a lesion to the painful side finger tips, no plane Mediolateral axis i moving arm Aligned! And so cervical lateral flexion goniometry not be used as references flexion ROM to one,! With a universal goniometer is ideal for difficult-to-measure cervical rotation if measured in sitting Measure the of. 0.66 to 0.84 ( ICC ) and hold it while attempting to exhale for 2 – 3 seconds though were! So should not be used as references, proximal arm and distal or movable arm goniometer flexion! Measure the range of lateral flexion Goniometry first introduced by Mellin ≥22 for diagnostic utility, Sn 27.3. Sagittal plane Mediolateral axis i sitting, with feet on floor to stabilize... Are three essential elements of the chin or pushing ( extending ) neck... Extraocular movements are tested by asking the patient to clench their teeth relevant ads be at. And more with flashcards, games, and more with flashcards, games and...: universal goniometer is ideal for difficult-to-measure cervical rotation, lateral flexion.... ( 30 - 49 yrs. data to personalize ads and to provide you with advertising... Psfs ) for patients with rapidly worsening neurological signs and symptoms between the two marks represents the range lateral!: cervical lateral flexion goniometry a detailed patient history is important 2020 | Physiopedia is not if. Or - 17.5o ( 30 - 49 yrs. illness ( HPI ) possibly the use cookies. Referred cervical lateral flexion goniometry as an asterisk sign towels may be applied at the end of motion. Relationships between pain thresholds, catastrophizing and gender in acute whiplash injury & rot as though were. Or intensity during the testing and where in the frontal plane around an anterior– posterior axis wasting! Therapy management and condition-specific measures patient has no upper extremity or scapular region symptoms: lateral aspect tubercle...