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MediGraph Testing Facilty

AAOS Cervical Spine Active Range Of Motion


Name: _____________________________________________
Dates of Examinations
Cervical

____/____/____

____/____/____

____/____/____

____/____/____

Flexion

________(45)

________(45)

________(45)

________(45)

Extension

________(45)

________(45)

________(45)

________(45)

Rt. Lateral Flexion


Lt. Lateral Flexion

________(45)
________(45)

________(45)
________(45)

________(45)
________(45)

________(45)
________(45)

Rt. Rotation
Lt. Rotation

________(60)
________(60)

________(60)
________(60)

________(60)
________(60)

________(60)
________(60)

Dates of Examinations
Cervical

____/____/____

____/____/____

____/____/____

____/____/____

Flexion

________(45)

________(45)

________(45)

________(45)

Extension
Rt. Lateral Flexion

________(45)
________(45)

________(45)
________(45)

________(45)
________(45)

________(45)
________(45)

Lt. Lateral Flexion


Rt. Rotation

________(45)
________(60)

________(45)
________(60)

________(45)
________(60)

________(45)
________(60)

Lt. Rotation

________(60)

________(60)

________(60)

________(60)

Dates of Examinations
Cervical

____/____/____

____/____/____

____/____/____

____/____/____

Flexion
Extension

________(45)
________(45)

________(45)
________(45)

________(45)
________(45)

________(45)
________(45)

Rt. Lateral Flexion


Lt. Lateral Flexion

________(45)
________(45)

________(45)
________(45)

________(45)
________(45)

________(45)
________(45)

Rt. Rotation

________(60)

________(60)

________(60)

________(60)

Lt. Rotation

________(60)

________(60)

________(60)

________(60)

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