Schober Test: Difference between revisions

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== Purpose ==
== Purpose ==
[[File:Schober Test.jpg|right|frameless]]
[[File:Schober Test.jpg|right|frameless]]
Schober’s test is classically used to determine if there is a decrease in lumbar spine range of motion (flexion), most commonly as a result of ankylosing spondylitis.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).
Schober’s test is classically used to determine if there is a decrease in lumbar spine range of motion (flexion), most commonly as a result of ankylosing spondylitis.Rezvani A, Ergin O., Karacan I.,[https://scholar.google.com/scholar_url?url=https://journals.lww.com/spinejournal/FullText/2012/09010/Validity_and_Reliability_of_the_Metric.24.aspx&hl=en&sa=T&oi=gsb&ct=res&cd=0&d=1650841721618701442&ei=MlDnYsOdBI6yyATixq7YDg&scisig=AAGBfm2SoNjSNgSpapsrziAvsnKbarbqSgValidity 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).


The measurement of this test is useful for
The measurement of this test is useful for
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== Technique ==
== Technique ==
Schöber Test
===Schöber Test===
* Patient is standing, examiner marks the L5 spinous process by drawing a horizontal line across the patients back.
* Patient is standing, examiner marks the L5 spinous process by drawing a horizontal line across the patients back.
* A second line is marked 10 cm above the first line.
* A second line is marked 10 cm above the first line.
* Patient is then instructed to flex forward as if attempting to touch his/her toes, examiner remeasures distance between two lines with patient fully flexed.
* Patient is then instructed to flex forward as if attempting to touch his/her toes, examiner remeasures distance between two lines with patient fully flexed.
* The difference between the measurements in erect and flexion positions indicates the outcome of the lumbar flexion .
* The difference between the measurements in erect and flexion positions indicates the outcome of the lumbar flexion .
Modified Schober Test(eliminates the errors in identification of lumbosacral junction and makes sure that the entire lumbar spine was includedTousignant M, Poulin L, Marchand S, Viau A, Place C. [https://www.ncbi.nlm.nih.gov/pubmed/16019864 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.
===Modified Schober Test===
This testeliminates the errors in identification of lumbosacral junction and makes sure that the entire lumbar spine was includedTousignant M, Poulin L, Marchand S, Viau A, Place C. [https://www.ncbi.nlm.nih.gov/pubmed/16019864 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.
* Patient is standing, examiner marks both posterior superior iliac spine (PSIS) and then draws a horizontal line at the centre of both marks
* Patient is standing, examiner marks both posterior superior iliac spine (PSIS) and then draws a horizontal line at the centre of both marks
* A second line is marked 5 cm below the first line.
* A second line is marked 5 cm below the first line.
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== Interpretation ==
== Interpretation ==
[[File:AnkylosingSpondylitis.png|right|frameless]]
For both versions of the test, an increase of less than 5cm is a positive test and may indicate ankylosing spondylitis (AS). (Image shows region of spine mainly involved in AS)
For both versions of the test, an increase of less than 5cm is a positive test and may indicate ankylosing spondylitis (AS). (Image shows region of spine mainly involved in AS)


Positive Schober’s Test
'''Positive Schober’s Test:'''Less than 5cm increase in length with forward flexion: Decreased lumbar spine range of motion, ankylosing spondylitis[[File:AnkylosingSpondylitis.png|frameless|alt=|center]]
Less than 5cm increase in length with forward flexion: Decreased lumbar spine range of motion, ankylosing spondylitis
== Clinical Notes ==
== Clinical Notes ==
This test is almost exclusively associated with Ankylosing Spondylitis but may also be positive due to a decrease in lumbar range of motion due to pain or congenital anomalies or segmental fusionMedisavy [https://medisavvy.com/schobers-test/ Schobers Test] Available from:https://medisavvy.com/schobers-test/ (last accessed 30.5.2020).{{#ev:youtube|B9RaFB5BwrQ}}BJC Health Modified Schober's Test for Ankylosing Spondylitis. Available fromhttps://www.youtube.com/watch?v=B9RaFB5BwrQ
This test is almost exclusively associated with Ankylosing Spondylitis but may also be positive due to a decrease in lumbar range of motion due to pain or congenital anomalies or segmental fusionMedisavy [https://medisavvy.com/schobers-test/ Schobers Test] Available from:https://medisavvy.com/schobers-test/ (last accessed 30.5.2020).{{#ev:youtube|B9RaFB5BwrQ}}BJC Health Modified Schober's Test for Ankylosing Spondylitis. Available fromhttps://www.youtube.com/watch?v=B9RaFB5BwrQ
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== Evidence ==
== Evidence ==
#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.
#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.
#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 excellentM 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).
#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 excellentM Tousignant, Poulin L, Marchand S, ,[https://scholar.google.com/scholar_url?url=https://www.tandfonline.com/doi/abs/10.1080/09638280400018411&hl=en&sa=T&oi=gsb&ct=res&cd=0&d=12065143981396519582&ei=D1DnYpnZIoakywTS6Y6IDQ&scisig=AAGBfm0-I_3_wLv7wkmO84syuFc_Fe-bowthe 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).
#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.
#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.
{{#ev:youtube|eYOUA9asDu8}}Schober Test for Lumbar Spine Flexion. Available from: https://www.youtube.com/watch?v=eYOUA9asDu8
{{#ev:youtube|eYOUA9asDu8}}Schober Test for Lumbar Spine Flexion. Available from: https://www.youtube.com/watch?v=eYOUA9asDu8

Revision as of 05:53, 1 August 2022

Original Editor-Shauni Van Overstraeten Top Contributors-Vidya Acharya,Kim Jackson,Jolien Wauters,Shauni Van Overstraeten,WikiSysop,Lucinda hampton,Kai A. Sigel,Chelsea McleneandAnne Dixie Lim

Purpose[edit|edit source]

Schober Test.jpg

Schober’s test is classically used to determine if there is a decrease in lumbar spine range of motion (flexion), most commonly as a result of ankylosing spondylitis.[1].

The measurement of this test is useful for

  • Screening the status ofankylosing spondylitisdisease
  • Determination of progression and therapeutic effects of ankylosing spondylitis and other pathologic conditions associated with low back pain[2].

Technique[edit|edit source]

Schöber Test[edit|edit source]

  • Patient is standing, examiner marks the L5 spinous process by drawing a horizontal line across the patients back.
  • A second line is marked 10 cm above the first line.
  • Patient is then instructed to flex forward as if attempting to touch his/her toes, examiner remeasures distance between two lines with patient fully flexed.
  • The difference between the measurements in erect and flexion positions indicates the outcome of the lumbar flexion[1].

Modified Schober Test[edit|edit source]

This test eliminates the errors in identification of lumbosacral junction and makes sure that the entire lumbar spine was included[1][3]

  • Patient is standing, examiner marks both posterior superior iliac spine (PSIS) and then draws a horizontal line at the centre of both marks
  • A second line is marked 5 cm below the first line.
  • A third line is marked 10 cm above the first line.
  • Patient is then instructed to flex forward as if attempting to touch his/her toes, examiner remeasures distance between the top and bottom line.[1].

Interpretation[edit|edit source]

For both versions of the test, an increase of less than 5cm is a positive test and may indicate ankylosing spondylitis (AS). (Image shows region of spine mainly involved in AS)

Positive Schober’s Test:Less than 5cm increase in length with forward flexion: Decreased lumbar spine range of motion, ankylosing spondylitis

Clinical Notes[edit|edit source]

This test is almost exclusively associated with Ankylosing Spondylitis but may also be positive due to a decrease in lumbar range of motion due to pain or congenital anomalies or segmental fusion[4].

[5]

Evidence[edit|edit source]

  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[edit|edit source]

  1. ↑1.01.11.21.31.41.5Rezvani 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. ↑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.
  4. ↑MedisavySchobers TestAvailable from:https://medisavvy.com/schobers-test/(last accessed 30.5.2020)
  5. ↑BJC Health Modified Schober's Test for Ankylosing Spondylitis. Available fromhttps://www.youtube.com/watch?v=B9RaFB5BwrQ
  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
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