Product Manual

7
BASELINE
®
SCOLIOSIS METER - PHYSICIANS WORKSHEETS
PATIENT NAME ADDRESS AGE Date of Eaxamination Examination Results Follow-up Results
Physician’s Signature
SHOULDER TILT PELVIC TILT LUMBAR ROTATIONAL DEVIATION
Degrees Centimeters/Millimeters (in) Degrees Centimeters/Millimeters (in) THORACIC DEVIATION IN POSTERIOR RIB CAGE ANTERIO-POSTERO DEVIATION Degrees Centimeters/Millimeters (in) OF L5-APEX OF SACRUM
Centimeters/Millimeters (in) Normal = 1.3 cm (5.11 in) SPINAL ANALYSIS OF ANTERIO-POSTERO CURVES Centimeters/Millimeters (in) Cervical Curve Thoracic Curve Normal = 1.3 cm (5.11 in) Normal = 1.3 cm (5.11 in)