Schober test is not a valid assessment tool for lumbar mobility

Area of Science:

• Orthopedics
• Physical Therapy
• Biomedical Engineering

Background:

• The Schober test is a common clinical assessment for lumbar mobility.
• Identifying functional restrictions is crucial for managing chronic low back pain (cLBP).
• The 5 cm cut-off of the Schober test is widely used to distinguish between restricted and unrestricted lumbar mobility.

Purpose of the Study:

• To evaluate the validity of the 5 cm Schober test cut-off in differentiating lumbar mobility.
• To compare the Schober test with two modern measurement devices: Epionics SPINE® and Idiag M360®.
• To assess the influence of lumbar lordosis (LL) on the agreement between the Schober test and device measurements.

Main Methods:

• The study involved 187 participants with and without cLBP (18-65 years).
• Agreement between the Schober test and Epionics SPINE®/Idiag M360® range of motion (RoF) was analyzed.
• Sensitivity and specificity of the Schober test were calculated, considering LL variations.

Main Results:

• There was a lack of consistent agreement between the Schober test and both measurement devices.
• For Epionics SPINE®, 50.4% of participants showed non-agreement with the Schober test.
• For Idiag M360®, 49.6% of participants showed non-agreement; sensitivity and specificity were below optimal thresholds.

Conclusions:

• The Schober test's validity in predicting lumbar mobility impairment is not established by this study.
• Significant discrepancies exist between the Schober test and device-based measurements.
• The Schober test may be best utilized as an adjunct for monitoring individual patient progress rather than a standalone diagnostic tool.