Range of Motion (ROM) Measurement

T12 and L5 were located by surface bony landmarks (the posterior superior iliac spine and the inferior angle of scapula) with the patients in the prone position. Then, the T12–L1 and L5–S1 interspinous spaces were marked on the skin. After a brief warmup procedure (including trunk flexion, extension, lateral flexion, and axial rotation on both sides), the ROM of the lumbar spine was performed with an dual digital inclinometer (6 ROM Microfet, Hoggan, UT) with 2-point contact at its base for which the application in IS patients have been described.¹² The device can be easily used in daily practice. The participant stood against a low wall in relaxed posture with feet about shoulder width apart to restrain the movement of the pelvis. After that, the inclinometer was placed on premarked spots and calibrated again to zero. Thereafter, the participant was asked to bend forward and then backward to the maximal level. The readings at T12–L1 and L5–S1 were recorded, and the range of flexion motion (ROMF) and the range of extension motion (ROME) were calculated by subtracting the measurement at L5–S1 (reflecting the pelvic movement) from the measurement at T12–L1 (reflecting both lumbar and pelvic movement) gives the regional lumbar motion. The total range of motion (ROM) was the sum of the ROMF and ROME.