so my question is are there any other diseases that we see restriction in lumbar flexion other than ankylosing spondylitis? I NEED QUİCK ANSWERS PLEASE, MY TEST DUE TOMORROW
In the table showing in min. 1:11, I guess you meant below 4 is mild not above 4, since the normal range is 5 and above. Anything below 5 is not normal
No limitation then. Normal Schober test is measured from the SIPS (spinous process of S2) to 15cm above. We don't know of any threshold values for the original test.
@@Physiotutors SIPS = Spina Iliaca Posterior Superior (eng: PSIS = Posterior Superior Iliac Spine), not necessarily "spinous process of S2" in between PSISes you could be at S1. If you press under and up both PSISes (with two hands) in between you've got S2 spinous process.
I have used and read about the Schobers tests extensively. The modified version mostly. Marking iliac crest level (which corresponds with L4-L5 spinal level) does not seem familiar to me. Source? The modified Schober test (MST) is done by marking the lumbosacral junction and then mark 5 cm below and another mark 10cm above. Note that this test is of its best value in assessing AS patients as described in this video. I have used it to evaluate both healthy an lower backpain subjects, but the MST did not respond to various interventions at all whilst the fingertip to floor test did. I think this might has to do with the elastic property of the human skin as Rezvani described in 2012 for the original Schober. Also note the foundings in correlation of radiographics and the MST to assess lumbar flexion. The correlation differs form excellent (.97 Macrae et al 1969) to poor (.33 by Rezvani et al 2012). The fingertip to floor test assesses more than only lumbar flexion. In my opinion there is no such thing as a clinical test that can accurately assess lumbar flexion.
Hey Steros, the description as mentioned was found in the bath indices, which as you correctly state would be L4-L5 junction. I was unaware of the revised 2016 issue by NASS that states the first marking being at the "dimples of venus". There are several descriptions of the test to be found.
Thanks for the reaction! I have also found "dimples of venus", or "no set procedure", but this is new to me. I'll look into it! Personally, I mark the halfway point between SIPS and iliac crest level to determine the lumbosacral junction. Thought about it a lot and I found this to be the most standardized way of getting close to the lumbosacral junction. Judging by standardisation, I think the modified modified Schober test is best. This test simply uses the SIPS level on the spine and a mark 15cm above this level.
Physiotutors yes please. I'm dismayed and concerned about the volume of non-evidence based, alternative treatments for this condition. Along with wild claims of cures. Any evidence based discussion in this area is vital, and you guys are great influencers. Kudos.
why should you perform the test with straight legs ? because i can imagine that somebody with extremely shortened Hamstring muscles result severe while the joint mobility is actually quiet ok (tested with bend knees)
As it's described that way. I follow your reasoning and there are always exceptions to the applicability to a test. In your case you'll be limited by the fact that there is such a severe HS contracture
It does not matter if the hamstrings are shortened or not, because what is measured is only lumbar mobility and not the distance of the hand from the ground. You will allways flex the lumbar spine as far as you can when doing this maneuver, independently from the hamstrings.
+Abi Marie carrying out it is different as in the original Schober the markings are different where the first mark is applied below S2 which would interfere with TH-cams nudity policy ;-) so the modified is easier to apply
Hi. Thanks for your videos. How would you establish whether the difference comes from the lower back or from tension in the hamstrings?. In the case of tight hamstrings, does this count as a positive BASMI?. Thanks
This video is not correct. The first mark to be done is a the level of the PSIS, and then do the other markings 5cm below and 10cm above. In the video the bottom mark is the one at the level of the PSIS. This way your are measuring both lumbar and lower thoracic spine mobility
LOVE that you guys include validity. It makes the info soo much more reliable. Thanks!
+freeradicalpanda you're welcome!
in the video, it says 1.5cm below the line. I think it should be corrected as 5 cm below the line (5cm below and 10 cm above. all together 15cm)
Great video, clear, brief and to the point. Thanks.
You guys do an awesome job but both BRADDOM and MAGEE's textbooks report using the PSIS - not the Iliac crest...
so my question is are there any other diseases that we see restriction in lumbar flexion other than ankylosing spondylitis? I NEED QUİCK ANSWERS PLEASE, MY TEST DUE TOMORROW
In the table showing in min. 1:11, I guess you meant below 4 is mild not above 4, since the normal range is 5 and above. Anything below 5 is not normal
No, we meant above 4. Do you have any sources mentioning that above 5 is considered "normal"?
@@Physiotutors hutchinson clinical methods
How does this test help in my treatment
0:46 its 5cm below the iliac crest yeah?
yes it is , i think he said 1.5 cm !!
But if mild case is above 4 cm what is the normal difference?
And can you tell me about schober test?
No limitation then. Normal Schober test is measured from the SIPS (spinous process of S2) to 15cm above. We don't know of any threshold values for the original test.
@@Physiotutors SIPS = Spina Iliaca Posterior Superior (eng: PSIS = Posterior Superior Iliac Spine), not necessarily "spinous process of S2" in between PSISes you could be at S1. If you press under and up both PSISes (with two hands) in between you've got S2 spinous process.
I have used and read about the Schobers tests extensively. The modified version mostly. Marking iliac crest level (which corresponds with L4-L5 spinal level) does not seem familiar to me. Source? The modified Schober test (MST) is done by marking the lumbosacral junction and then mark 5 cm below and another mark 10cm above.
Note that this test is of its best value in assessing AS patients as described in this video. I have used it to evaluate both healthy an lower backpain subjects, but the MST did not respond to various interventions at all whilst the fingertip to floor test did. I think this might has to do with the elastic property of the human skin as Rezvani described in 2012 for the original Schober.
Also note the foundings in correlation of radiographics and the MST to assess lumbar flexion. The correlation differs form excellent (.97 Macrae et al 1969) to poor (.33 by Rezvani et al 2012). The fingertip to floor test assesses more than only lumbar flexion.
In my opinion there is no such thing as a clinical test that can accurately assess lumbar flexion.
Hey Steros, the description as mentioned was found in the bath indices, which as you correctly state would be L4-L5 junction. I was unaware of the revised 2016 issue by NASS that states the first marking being at the "dimples of venus". There are several descriptions of the test to be found.
Thanks for the reaction!
I have also found "dimples of venus", or "no set procedure", but this is new to me. I'll look into it!
Personally, I mark the halfway point between SIPS and iliac crest level to determine the lumbosacral junction. Thought about it a lot and I found this to be the most standardized way of getting close to the lumbosacral junction.
Judging by standardisation, I think the modified modified Schober test is best. This test simply uses the SIPS level on the spine and a mark 15cm above this level.
Could you please make a video for modified-modified schober test?
We could do that
Will put it on the list
Hi. Have you made a video about scoliosis assessment and grades. Searching, but cannot find one.
Hey Megan
No we have not made a video on its assessment. It may be a topic for the future though
Physiotutors yes please. I'm dismayed and concerned about the volume of non-evidence based, alternative treatments for this condition. Along with wild claims of cures. Any evidence based discussion in this area is vital, and you guys are great influencers. Kudos.
Completely agree. Not only for scoliosis though but unfortunately for a lot of conditions.
why should you perform the test with straight legs ? because i can imagine that somebody with extremely shortened Hamstring muscles result severe while the joint mobility is actually quiet ok (tested with bend knees)
As it's described that way. I follow your reasoning and there are always exceptions to the applicability to a test. In your case you'll be limited by the fact that there is such a severe HS contracture
It does not matter if the hamstrings are shortened or not, because what is measured is only lumbar mobility and not the distance of the hand from the ground. You will allways flex the lumbar spine as far as you can when doing this maneuver, independently from the hamstrings.
Question, the walk in toe and heel test is for what? Is the patient fell hurt what is that mean?
Not familiar with this test
So in terms of actually carrying out the test the 'Schobers' is no different to the 'Modified Schobers'?
+Abi Marie carrying out it is different as in the original Schober the markings are different where the first mark is applied below S2 which would interfere with TH-cams nudity policy ;-) so the modified is easier to apply
Physiotutors Okay that makes sense - thank you!
Can we use in PIVD patients this scale
Hi. Thanks for your videos. How would you establish whether the difference comes from the lower back or from tension in the hamstrings?. In the case of tight hamstrings, does this count as a positive BASMI?. Thanks
With the Schober you're only measuring lumbar flexion. The hamstrings don't limit lumbar flexion
@physiotutors do you mean that as long as the hips are not hinging/going in flexion, then this means only the lumbar is in flexion…?
new content cop hell yea
Three times per week 😛
This video is not correct. The first mark to be done is a the level of the PSIS, and then do the other markings 5cm below and 10cm above. In the video the bottom mark is the one at the level of the PSIS. This way your are measuring both lumbar and lower thoracic spine mobility
There is always the discussion about the Schober and modified Schober test. 5cm below the PSIS you'll end up in a patient's anus!;)
@@Physiotutors HAHA
Can this test be used for assessing Erector spinae muscles shortness?
No
This is only for AS?
It has been evaluated in AS, but can be used to assess flexbility of the lumbar spine in general.
I'm not able to find the articel from the autor Castille, 2015..?
It's Castro et al. (2015): www.ncbi.nlm.nih.gov/pubmed/26337175
You can always find the articles mentioned in the video in the description below!
Thanx!
@physiotutors i m searching for coccydynia.plzz upload it soon.
Hi Raju, not really our area of expertise as in the Netherlands we have specialized pelvic floor physios who know much more about that region.
Physiotutors okk sir thn plzz upload kegel exercise
i.did this test .its 5 cm...is this good???i.m 53 yrs old
20 cm after flexion is normal?
Yes
mu med 27 approved
0:37
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your look whit out bare muchnbetter
Agree, at one point his Andreas' beard got out of hand!;) - Kai
Get rid of the annoying music, it's too loud