Table One: A Guide to Obtaining
the BASMI Measurements
.................................(Adapted by AStretch members from Jenkinson et al, 1994)

The following table is a guide for clinicians in how to obtain the five BASMI measurementsin a standardised fashion. It is recognised that this represents an ‘ideal’ scenario that mayneed adapting depending on the patient’s individual posture / circumstances. However, itis recommended that any changes be carefully documented to enable measurements tobe reproducible. With all measurements, the patient should be comfortable and suitably undressed.

Measure	Starting Position	Method	Notes
Lumber Side Flexion	Standing bare feet; back towall; knees straight; scapulae, buttocks, heels against wall; shoulders level; outer edges of feet30cm apart & feet parallel.	Before any movement occurs, keeping arms, wrist & fingers straight, measure from tip of middle finger to floor. With palms placed on lateral aspect of thighs, patient reaches towards floor by side flexing. Re-measure from tip of middle finger to floor. Difference between 2 measurements represents amount side flexion. Repeat on other side.	Ensure patient keeps arms, fingers & knees straight and heels on floor. Ensure any forward flexion, extension or rotation of the trunk is avoided. Best to use a wall without a skirting board. May need to accommodate a leg length discrepancy with block under foot.
Tragus to Wall	Maintain same starting position as above. Ensure head in as neutral position (anatomical alignment) as possible.	Patient draws chin in as far as possible (retraction). With both eyes open and side of face against wall, examiner measures the distance between the tragus of the ear & the wall, using a rigid ruler.	Ensure no cervical extension, rotation, flexion or side flexion occurs. Best to use a wall without a skirting board. Ensure retraction is maintained whilst both sides are measured
Lumbar Flexion (modified Schober’s)	Standing with outer edges of bare feet 30cm apart and feet in line. Examiner marks a point midway along a line level with the iliac crests (at the L4/5 junction). A second point is marked 10cm above this & a third 5cm below the first to give a 15cm line.	Patient flexes forward from the waist with knees fully extended. The distance between the upper and lower 2 marks is measured. Any increase beyond 15cm represents the amount of movement achieved.	At the end of the movement, you may choose to allow slight knee flexion to decrease influence of hamstrings. This should be documented.
Intermalleolar Distance	Patient lies supine on the floor or a wide plinth. Knees in extension.	Keeping knees straight & legs in contact with the resting surface, patient is asked to take legs as far apart as possible. Distance between the medial malleoli is measured.	Measure quickly as movement can be painful. Be ready to measure before asking patient to achieve movement.
Cervical Rotation	Patient supine on plinth. Forehead horizontal & head in neutral position. May need to use pillow, books or foam block to achieve this. Carefully document to ensure same set up on future re-assessments.	Use goniometer / inclinometer as per manufacturers instructions. Patient rotates his/her head as far as possible, keeping shoulders still. Measure both sides.	Ensure no neck flexion / side flexion occurs. If good ROM may need to lie near edge of bed to allow movement to occur.

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