Test the following motions:
After testing each motion, put down if it feels Normal’ish (None),
Low amount of restriction/pain/sensation (Low),
Medium amount restriction/pain/sensation (Medium),
High amount restriction/pain/sensation (High)
Neck Motions
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Rotate Right - None, Low, Medium, High
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Rotate Left - None, Low, Medium, High
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Neck Forward Center - None, Low, Medium, High
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Neck Forward Right - None, Low, Medium, High
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Neck Forward Left - None, Low, Medium, High
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Neck Extenstion Center - None, Low, Medium, High
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Neck Extension Right - None, Low, Medium, High
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Neck Extension Left - None, Low, Medium, High
Neck Motion Scores: # of Lows _____; # of Mediums_____ ; # of Highs_____
Arm Motions
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Forward Right (straight elbow) - None, Low, Medium, High
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Forward Left (straight elbow) - None, Low, Medium, High
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Side Out Right (straight elbow) - None, Low, Medium, High
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Side Out Left (straight elbow) - None, Low, Medium, High
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Chicken Wing Lift Right (bent elbow) - None, Low, Medium, High
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Chicken Wing Lift Left (bent elbow) - None, Low, Medium, High
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Baseball Throw Back Right - None, Low, Medium, High
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Baseball Throw Back Left - None, Low, Medium, High
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Baseball Throw Forward Right - None, Low, Medium, High
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Baseball Throw Forward Left - None, Low, Medium, High
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Hand Behind Back Right - None, Low, Medium, High
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Hand Behind Back Left - None, Low, Medium, High
Arm Motion Scores: # of Lows _____; # of Mediums_____ ; # of Highs_____
Trunk Motions
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Rotate Right - None, Low, Medium, High
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Rotate Left - None, Low, Medium, High
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Forward Crunch Center - None, Low, Medium, High
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Forward Crunch Forward Right - None, Low, Medium, High
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Forward Crunch Forward Left - None, Low, Medium, High
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Forward Bend Center - None, Low, Medium, High
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Forward Bend Right - None, Low, Medium, High
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Forward Bend Left - None, Low, Medium, High
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Extenstion Center - None, Low, Medium, High
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Extension Right - None, Low, Medium, High
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Extension Left - None, Low, Medium, High
Trunk Motion Scores: # of Lows _____; # of Mediums_____ ; # of Highs_____
Leg Motions
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Forward Right (straight knee) - None, Low, Medium, High
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Forward Left (straight knee) - None, Low, Medium, High
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Lift Foot to Opposite Knee Right (bent knee) - None, Low, Medium, High
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Lift Foot To Opposite Knee Left (bent knee) - None, Low, Medium, High
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Lift Knee &Kkick foot Out Right (bent elbow) - None, Low, Medium, High
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Lift Knee & Kick Foot Out Left (bent elbow) - None, Low, Medium, High
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Sit To Stand Right - None, Low, Medium, High
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Sit To Stand Left Left - None, Low, Medium, High
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Step Down From Step - Right - None, Low, Medium, High
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Step Down From Step - Left - None, Low, Medium, High
Leg Motion Scores: # of Lows _____; # of Mediums_____ ; # of Highs_____
# of Total Lows: _____ # of Total Mediums: _____ # of Total Highs: _____
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