The
following table is a guide for clinicians in how to obtain the five
BASMI measurementsin a standardised fashion. It is recognised that
this represents an ‘ideal’ scenario that mayneed adapting
depending on the patient’s individual posture / circumstances.
However, itis recommended that any changes be carefully documented
to enable measurements tobe reproducible. With all measurements, the
patient should be comfortable and suitably undressed.
Measure
|
Starting
Position
|
Method
|
Notes |
Lumber
Side Flexion
|
Standing
bare feet; back towall; knees straight; scapulae, buttocks, heels
against wall; shoulders level; outer edges of feet30cm apart &
feet parallel. |
Before
any movement occurs, keeping arms, wrist & fingers straight,
measure from tip of middle finger to floor. With palms placed
on lateral aspect of thighs, patient
reaches towards floor by side flexing. Re-measure from tip of
middle finger to floor.
Difference between 2 measurements represents amount side flexion.
Repeat on other side.
|
Ensure
patient keeps arms, fingers & knees straight and heels on
floor. Ensure any forward flexion, extension or rotation of the
trunk is avoided. Best to use a
wall without a skirting board. May need to accommodate a leg length
discrepancy with block under foot. |
| Tragus
to Wall |
Maintain
same starting position as above. Ensure head in as neutral position
(anatomical alignment) as possible. |
Patient
draws chin in as far as possible (retraction). With both eyes open
and side of face against wall, examiner measures the distance between
the tragus of the ear & the wall, using a rigid ruler. |
Ensure
no cervical extension, rotation, flexion or side flexion occurs.
Best to use a wall without a skirting board. Ensure retraction is
maintained whilst both
sides are measured |
Lumbar
Flexion
(modified
Schober’s)
|
Standing
with outer edges of bare feet 30cm apart and feet in line. Examiner
marks a point midway along a line level with the iliac crests (at
the L4/5 junction). A second point is marked 10cm above this &
a third 5cm below the first to give a 15cm line. |
Patient
flexes forward from the waist with knees fully extended. The distance
between the upper and lower 2 marks is measured. Any increase beyond
15cm
represents the amount of movement achieved. |
At
the end of the movement, you may choose to allow slight knee flexion
to decrease influence of hamstrings. This should be documented. |
Intermalleolar
Distance |
Patient
lies supine on the floor or a wide plinth. Knees in extension. |
Keeping
knees straight & legs in contact with the resting surface, patient
is asked to take legs as far apart as possible. Distance between
the medial malleoli is measured. |
Measure quickly as movement can be painful. Be ready to measure
before asking patient to
achieve movement. |
Cervical
Rotation |
Patient
supine on plinth. Forehead horizontal & head in neutral position.
May need to use pillow, books or foam block to achieve this. Carefully
document to ensure same set up on future re-assessments. |
Use
goniometer / inclinometer as per manufacturers instructions. Patient
rotates his/her head as far as possible, keeping shoulders still.
Measure both sides. |
Ensure
no neck flexion / side flexion occurs. If good ROM may need to lie
near edge of bed to allow movement to occur. |
