Active ROM
Client moves the joint independently.
Use it to observe:
- available movement
- pain during movement
- movement quality
- willingness to move
Clinical clue: Pain during Active ROM may involve contractile or non-contractile structures.
FREE ROM GUIDE
Cervical Range of Motion
FREE SAMPLELearn when and why to use active, passive and resisted range of motion during a practical cervical assessment.
ROM TESTING OVERVIEW
Active, Passive & Resisted ROM
Passive ROM
Therapist moves the relaxed joint.
Use it to assess:
- available range
- end feel
- pain with passive movement
- joint or non-contractile restriction
Clinical clue: Pain during Passive ROM may suggest involvement of joint, capsule, ligament or other non-contractile structures.
Resisted ROM
Client contracts against resistance without needing large joint movement.
Use it to assess:
- muscle or tendon pain
- strength
- contractile tissue involvement
Clinical clue: Painful resisted contraction may indicate involvement of the muscle-tendon unit being tested.
CERVICAL MOVEMENTS
Cervical movements to assess
Flexion
ACTIVE:
Ask the client to bring the chin toward the chest.
PASSIVE:
Support the head and gently move the cervical spine into flexion.
RESISTED:
Client attempts cervical flexion while gentle resistance is applied against the forehead.
Extension
ACTIVE:
Ask the client to look upward.
PASSIVE:
Support the head and gently move the cervical spine into extension.
RESISTED:
Client attempts cervical extension while gentle resistance is applied against the back of the head.
Left Rotation
ACTIVE:
Ask the client to turn the head to the left.
PASSIVE:
Support the head and gently move the cervical spine into left rotation.
RESISTED:
Client attempts left rotation while gentle resistance is applied against the side of the head.
Right Rotation
ACTIVE:
Ask the client to turn the head to the right.
PASSIVE:
Support the head and gently move the cervical spine into right rotation.
RESISTED:
Client attempts right rotation while gentle resistance is applied against the side of the head.
Left Lateral Flexion
ACTIVE:
Ask the client to bring the left ear toward the left shoulder.
PASSIVE:
Support the head and gently move the cervical spine into left lateral flexion.
RESISTED:
Client attempts left lateral flexion while gentle resistance is applied against the left side of the head.
Right Lateral Flexion
ACTIVE:
Ask the client to bring the right ear toward the right shoulder.
PASSIVE:
Support the head and gently move the cervical spine into right lateral flexion.
RESISTED:
Client attempts right lateral flexion while gentle resistance is applied against the right side of the head.
ASSESSMENT FLOW
A simple assessment sequence
Observe→Active ROM→Passive ROM→Resisted ROM→Compare sides→Special Tests
Use findings from the history, observation and ROM testing together rather than relying on a single test.
Special Tests
Special Tests
Use orthopaedic tests when the history and ROM findings suggest that a more specific structure or symptom pattern needs to be assessed.
Spurling’s Test
Cervical Nerve Root Irritation
Cervical Compression Test
Cervical Compression
Cervical Distraction Test
Cervical Distraction
Upper Cervical / Vertebral Artery Screening
Use appropriate cervical screening procedures according to training and scope of practice.
QUICK REVIEW
Quick Review
History→Observation→Active ROM→Passive ROM→Resisted ROM→Special Tests→Treatment Planning
CHECK YOUR UNDERSTANDING
Test Yourself
1. Which cervical movement brings the chin toward the chest?
2. Which cervical movement turns the head to look over the shoulder?
3. Which test is commonly used when assessing possible cervical nerve root irritation?
4. Cervical ROM findings should be interpreted:
Cervical assessment requires appropriate clinical judgement and attention to red flags. ROM and orthopaedic test findings should be interpreted together with the client’s history, symptoms and other assessment findings. This guide is for educational revision and is not a substitute for diagnosis or professional clinical judgement.
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