Schober test

Purpose

The purpose of the Schober test is to reflect the lumbar ROM during flexion[1]. The measurement of this test is not only useful for screening the status of ankylosing spondylitis disease but also useful for the determination of progression and therapeutic effects of ankylosing spondylitis as well as other pathologic conditions associated with low back pain[2].

Technique

  1. Original Schöber Test
    The patient is standing with his back towards the examiner. The examiner determines the location of the lumbosacral junction and marks it by drawing a horizontal line. A second line is marked 10 cm above the first line. The difference between the measurements in erect and flexion positions indicates the outcome of the lumbar flexion [1].
  2. Modified Schöber Index is also called short Schöber test [3].
    The patient is standing with his back towards the examiner. The examiner determines the location of the lumbosacral junction by pressing the location of the dimples of Venus. The intersection of the top of the dimples of Venus is marked by drawing a horizontal line. This line acts as the landmark. The second line is marked 10 cm above the first and the third is marked 5 cm below the first line. The difference between the measurements in erect and flexion positions indicates the outcome of the lumbar flexion. [1].
[4]


3.Modified-modified Schöber Test
Modified Modified Schober Test (MMST) is a modification of the Modified Schober Test (MST) by Van Adrichen and Van der Korst (1973)[5]. The patient is standing with his back towards the examiner. The examiner locates the inferior margin of the PSIS with the thumbs and then marks the intersections of the SIPS by drawing a horizontal line. The second line is drawn 15 cm above the midpoint of the first horizontal line. The difference between the measurements in erect and flexion positions indicates the outcome of the lumbar flexion[1]. It eliminates the errors in identification of lumbosacral junction and makes sure that the entire lumbar spine was included.


Evidence

  1. Original Schöber Test
    The validity against radiographs was according to Macrae. strong (r=0.90), according to Rahali-Khachlouf. moderate (r=0.68).
    The interclass (r=0.90) and intraclass (r=0.96) reliability was found to be excellent[1].
  2. Modified Schöber Index
    The validity against radiographs was according to Macrae. strong (r=0.97), according to Rahali-Khachlouf. moderate (r=0.59).
    The interclass (r=0.92) and intraclass (r=0.96) reliability were found to be excellent[6].
  3. Modified-modified Schöber Test
    The validity of the modified-modified Schober test is moderate (r=0.67) with an excellent interclass (r=0.91) and intraclass (r=95) reliability[1].


[7]


References

  1. 1.0 1.1 1.2 1.3 1.4 1.5 Rezvani A, Ergin O., Karacan I., Validity and reliability of the Metric Measurements in the Assessment of Lumbar Spine Motion in patients with Ankylosing Spondylitis., 2012, Lippincott Williams & Wilkins, SPINE vol 37, Number 19, pp E1189-E1196 (level of Evidence: 1B)
  2. Yen YR, Luo JF, Liu ML, Lu FJ, Wang SR. The anthropometric measurement of schober’s test in normal taiwanese population. BioMed research international. 2015;2015.
  3. G.Lilius, Laasonen EM, Myllynen P, Harilainen A, Gronlund G, Lumbar facet joint syndrome, Helsinki university hospital, vol 71B, No. 4, August 1989, 681-684 (Level of evidence: 1B)
  4. BJC Health Modified Schober's Test for Ankylosing Spondylitis. Available fromhttps://www.youtube.com/watch?v=B9RaFB5BwrQ
  5. Tousignant M, Poulin L, Marchand S, Viau A, Place C. The Modified–Modified Schober Test for range of motion assessment of lumbar flexion in patients with low back pain: A study of criterion validity, intra-and inter-rater reliability and minimum metrically detectable change. Disability and rehabilitation. 2005 May 20;27(10):553-9.
  6. M Tousignant, Poulin L, Marchand S, , the modified-modified schober test for range of motion assessment of lumbar flexion in patients with low back pain: a study of criterion validity, intra- and inter-rater reliability and minimum metrically detectable change, disability and rehabilitation, 2005, VOL.27, NO.10, Pages 553-559 (Level of evidence: 4)
  7. Schober Test for Lumbar Spine Flexion. Available from: https://www.youtube.com/watch?v=eYOUA9asDu8