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Spinal Exam

Assessing Thoracolumbar Movement


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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