To obtain the most accurate thoracic rotation measurement, the patient should be positioned how?

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To measure thoracic rotation accurately, the goal is to move as much of the rotation as possible in the thoracic spine while minimizing contribution from the lumbar spine and pelvis. Standing with the back nearly parallel to the floor and the knees straight but not locked achieves this by stabilizing the lower body and limiting pelvic and lumbar motion. The trunk is positioned in a way that reduces the chance of hips tilting or the lower back compensating, so the rotation you observe comes primarily from the thoracic region.

Other positions tend to invite compensations. Locking the knees can rigidify the legs and pelvis, increasing unwanted pelvic or hip movement during rotation. A stance with the knees bent and the torso flexed forward shifts movement into the lumbar spine and hips, contaminating the measurement. Lying prone with the PSIS supported restricts natural thoracic rotation and relies on a nonneutral pelvis, making it harder to isolate the thoracic segment.