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Spinal Exam

Assessing Thoracolumbar Movement

August 17th, 2019

Active Movement

  • How to Assess

  • Ask the patient to move the joint themselves. Assess the neutral position and the range of motion, and ask whether range of motion is limited by pain, weakness or stiffness.
  • Significance

  • Active movement is an indicator of the patient's ability to move the joint. It may be limited due to weakness, pain, mechanical stiffness or poor compliance.
  • Causes of Limited Active Movement

  • Joint pain / stiffness - see below
  • Upper motor neuron lesion - stroke, tumour, trauma, hypoxia, demyelination, deposition, inflammation
  • Lower motor neuron lesion - trauma, compression, demyelination, neuromuscular disorders, diabetes
  • Poor compliance

Extra Credit

  • Additional Causes of Limited Thoracic / Lumbar Spine Range of Motion

  • Fracture - compression, spinous process, vertebral body
  • Degenerative disc disease
  • Disc herniation
  • Spinal stenosis
  • Ankylosing spondylitis
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