Modified Schober's test

Figure 1. Spinal Mobility – Modified Schober
A) Patient standing erect. Mark an imaginary line connecting both posterior superior iliac spines (close to the dimples of Venus).
B) A mark is placed 10 cm above.
C) The patient bends forward maximally, measure the difference between the two marks. Report the increase (in cm to the nearest 0.1 cm). The best of two tries is recorded.
Reproduced with permission from ASAS handbook, Ann Rheum Dis 2009; 68 (Suppl II)

Reduced spinal mobility

The most common measures of spinal mobility are listed below.

• Modified Schober’s test (Figure 1): serial measures are valuable in assessing progression of spinal restriction; may be abnormal with disc disease and degenerative lumbar disease.
• Lumbar side flexion: the best measure of overall spinal restriction and disease activity.
• Occiput-to-wall distance: should be zero in normal people.
• Chest expansion (at the fourth intercostal space): abnormal (<5 cm) in only a minority of patients during the first few years of disease

It is important to note that in early disease, spinal mobility may be normal.