Schober’s Test

Introduction

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.

Procedure

  1. Patient is standing, examiner marks the L5 spinous process by drawing a horizontal line across the patients back.
  2. A second line is marked 10 cm above the first line.
  3. 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.
Schober Test for ankylosing spondylitis.

Examiner marks the L5 spinous process by drawing a horizontal line. A second line is marked 10 cm above the first line.

Schober Test

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.

Modified Schober Test

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

Interpretation

For both versions of the test, an increase of less than 5cm is a positive test and may indicate ankylosing spondylitis.

Positive Schober’s Test

    Less then 5cm increase in length with forward flexion : Decreased lumbar spine range of motion, ankylosing spondylitis

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 fusion.