Fingertips to Floor Distance - Special Test
Original Editor - Lucinda hampton
To assess the total mobility of the lumbo-pelvic region in clients presenting with lumbo-pelvic pain. It is a test that is simple to administer with excellent inter and intra-rater reliability, validity, and responsiveness.
Musculoskeletal conditions of the lumbar-pelvic region eg
- Chronic Low Back Pain
- Ankylosing Spondylitis
- Radiculopathic Low Back Pain
- Osteoarthritis of the Lumbo-pelvic region
Method of Use
The patient is asked to bend forward and attempt to reach for the floor with their fingertips. The physical therapist then measures the distance between the patient’s right long finger and the floor using a standard measuring tape.
Ask the client whether pain, stiffness or both limited the FTF test. If the FTF test is limited by pain, the location and pain score out of 10 should be documented.
If the FTF test is 0cm or the patient is able to place their palms to the floor with no pain, a different outcome measure should be considered.
As forward bending flexibility is highly variable even in the asymptomatic population no normative values exist. Note- Patients with LBP with or without neural symptoms often present with FTF test measures of greater than 20cm.
The intra- and interobserver reliability were excellent ICC (intraclass correlation coefficient) = .99).
The Spearman’s correlation coefficient for trunk flexion assessed by the test and the radiologic measure are excellent (rs =.96).
.97 for SRM ( standardized response mean) and .87 for effect size.
FTF test has been criticized for not measuring isolated lumbar flexion ROM, as forward bending range involves pelvic, hip, thoracic spine, dural and shoulder mobility. However pure lumbar flexion active ROM measures should not be used as an outcome measure to monitor patient progress, as they have been shown to be weakly correlated to the patients’ level of disability.
Rainville J et al also found total lumbosacral flexion may be as equally relevant as true lumbar flexion in the measurement of trunk mobility in the clinical examination of patients with chronic low back pain. In regards to their relationship toa self-reported disability, total flexion seemed to be more relevant to outcome following intensive rehabilitation.
- G Gellerman Finger to Floor Test- Lumbo-Pelvic Mobility Available from: https://www.youtube.com/watch?v=8_f9FpyRSsU (last accessed 22 October 2019)
- Perret C, Poiraudeau S, Fermanian J, Colau MM, Benhamou MA, Revel M. Validity, reliability, and responsiveness of the fingertip-to-floor test. Archives of physical medicine and rehabilitation. 2001;82(11):1566-70.
- Sullivan MS, Shoaf LD, Riddle DL. The relationship of lumbar flexion to disability in patients with low back pain. Physical therapy. 2000;80(3):240-50.
- Rainville J, Sobel JB, Hartigan C. Comparison of total lumbosacral flexion and true lumbar flexion measured by a dual inclinometer technique. Spine. 1994 Dec;19(23):2698-701. Available from: https://www.ncbi.nlm.nih.gov/pubmed/7899966 (accessed 22 October 2019)