Neurology Edited by Professor Emeritus Desire' Dubounet, IMUNE

Cervical Region-RotationBecause the technique stabilizes the shoulders in the supine position, formeasurement of rotation only a single inclinometer is needed. In effect,this is a simple, not a compound, joint mobility measurement.Measurement of cervical rotation1. Have the subject recline in the supine position on a flat examinationtable with shoulders exposed to permit direct observation of excessiveshoulder rotation. Stand at the head of the table and place theinclinometer in the coronal plane with the base near the back of the headapproximately in line with the cervico-occipital junction. Record theneutral "0" position with the subject's nose pointing to the ceiling (Figure89a).2. Ask the subject to rotate the head maximally to the right and recordthe cervical right rotation angle (Figure 89b).3. Ask the subject to rotate the head maximally to the left and recordthe cervical left rotation angle.4. Repeat the procedure three times. Only the right and left cervicalrotation angles need be consistently measured to within +/-10% or 5°,whichever is greater. The final measurement for impairment evaluation isthe greatest angle measured.5. Consult the Abnormal Motion Section of Table 53 to determine theimpairment of the whole person.Example: Left rotation is recorded at 15°, 35°, 40°, and 35°,respectively. The invalid initial measurement is thrown out, necessitating afourth measurement that meets validation criteria. The best measurementof 40° corresponds to an impairment rating due to abnormal left cervicalrotation of 2%.6. Add the impairment values contributed by left rotation and rightrotation. Their sum is the impairment of the whole person that iscontributed by abnormal rotation of the cervical region.Ankylosis1. Determine if the subject has no cervical axial motion whatsoever, oris simply unable to attain the neutral position. If the patient has somemotion, ask him or her to maintain the position closest to neutral.