LUMBAR ACTIVE RANGE OF MOTION
ICF category	Measurement of impairment of body function – mobility of several joints
Description	The amount of active lumbar flexion, extension, and sidebending motion measured using an inclinometer.
Measurement Method	Inclinometers are placed at thoracolumbar junction and on the sacrum zeroed with the patient in neutral. The patient is asked to bend forward maximally and motion is recorded at the thoracolumbar junction (total flexion measure) and at sacrum, which is presumed to be motion in the sacroiliac and hip joints. The difference in motion represents the lumbar flexion measure. The patient is then asked to bend backward and the difference in motion is the lumbar extension measure.
Nature of variable	Continuous
Units of measurement	Degrees
Measurement properties	In a study by Saur et al,259 this method approximated lumbar motion obtained with radiographic measures (r-0.93 overall; r = 0.95 with flexion and r = 0.85 with extension). Inter-rater (MD and physiotherapist) was r = 0.88 for flexion standard error of measurement (SEM) = 4.6 and r= 0.42 for extension, SEM = 2.3.
Instrument variations	Two methods utilizing inclinometers have been described. In one method, the placement of the inclinometer is identical to Saur et al’s method but the subject bends forward twice, first with the inclinometer at the thoracolumbar junction and next with the inclinometer on the sacrum.259 The procedure is repeated with inclinometer placement but with the patient moving into extension. Lumbar flexion and extension are calculated as with the Saur et al method. A second method has been described in which total flexion and extension is recorded. The inclinometer is placed and zeroed at thoracolumbar junction and the subject bends forward once and the total flexion is recorded. The subject bends backward and the total extension is recorded.