In cervical flexion/extension assessment, what is the correct patient position and stabilization to prevent unwanted movement while using the goniometer?

• A. Position: Sitting; Stabilize: shoulder girdle or sternum to prevent thoracic flexion; Fulcrum: External Auditory Meatus; Stationary Arm: Perpendicular or Parallel to the ground; Moving Arm: Base of the Nares
• B. Position: Standing; Stabilize: pelvis to prevent trunk movement; Fulcrum: center of the cranial aspect of head; Stationary Arm: horizontal to ground; Moving Arm: base of nares
• C. Position: Prone; Stabilize: scapula; Fulcrum: center of the occiput; Stationary Arm: vertical; Moving Arm: nose
• D. Position: Supine; Stabilize: chest to prevent thoracic extension; Fulcrum: mastoid process; Stationary Arm: horizontal; Moving Arm: chin

Answer: (A)

When measuring cervical flexion and extension with a goniometer, you want to isolate movement to the neck and prevent any trunk or jaw motion from influencing the reading. Sitting upright with the back supported helps you control posture, and stabilizing the shoulder girdle or sternum prevents unwanted thoracic flexion or trunk movement. Placing the fulcrum over the external auditory meatus gives a consistent, head–neck pivot point, which is essential for accurate cervical motion measurement. The stationary arm being perpendicular to the floor provides a stable reference, while aligning the moving arm with the base of the nares follows the actual angular change of the head relative to the neck during flexion and extension. This setup minimizes compensations from the thorax and jaw, yielding a true assessment of cervical ROM.