SCHOBER’S TEST: REVISITED

Abstract

Introduction: Schober’s test, along with the modified version have long been used to assess lumbar flexion. The modified Schobers test, as described by McRae et al, is now the more commonly used. Both these tests rely on the assumption that movement of skin over the lumbar spine represents the degree of lumbar spine flexion. To our knowledge neither of these tests have been validated. Our aim is to validate the modified Schobers test as a method for measuring lumbar flexion.

Materials and Methods: Our inclusion criteria were:

• normal subjects with no known structural abnormalities in spine or pelvis.

• no previous spine operations.

• Subjects with acute back pain and those who could not tolerate range of motion measurements were excluded.

Accurate measurement of lumbar spine flexion is possible using a machine made by a Finnish company called Data Based Care (DBC). The machines accurately measure ranges of spine movement by isolating the movement being measured and immobilising any other muscle groups which may interfere with the movement being measured.

We measured lumbar spine flexion as described by Mc Rae et al ie. The modified Schobers test and isolated lumbar spine flexion using the DBC machine.

Two researchers were involved in measuring subjects. One set the subject on the DBC machine and took the measurement, whilst the other assessed when the pelvis began to tilt. Thus only isolated forward lumbar flexion was measured. DBC measurements were carried out in a standardised way. The results were then tabulated and correlated.

Results: Our study included 100 people of whom 54 were male and 46 female. Average age was 38. The median measurements for modified schober’s test and DBC were 5 and 44 cm respectively. The measurements of both modified schober’s test and actual lumbar flexion using DBC were correlated with spearman’s rank correlation test showed no correlation.

Conclusion: Our results show no correlation at all between the actual range of lumbar flexion and the modified Schobers test. We state that this test is invalid and its place in clinical practice unjustified.