Below is a transcript of a discussion between myself and one of our BJC physiotherapists, Rachael Butterworth about how to perform the Lumbar Spine Side Flexion Test.
You will also find the video below, should you prefer to watch it.
Robert: Hello, my name is Robert Russo, and I'm a rheumatologist at BJC Health. I'm going to ask Rachael Butterworth, who is a physiotherapist here at the practice with expertise in treating ankylosing spondylitis, to show us the lateral lumbar spine movement test. This is a test used to assess lumbar spine mobility. So, thanks Rach.
Rachael: Thanks Rob. So, I'm going to go through the lumbar side flexion test for assessment of lumbar side flexion for ankylosing spondylitis. So, the first thing we have to do is make sure the patient's heels are right up against the wall, approximately hip width apart. Then they have to stand with their back up nice against the wall, arms feeling nice and long with their middle finger extended down as far as they can.
We take that measure from the tip of the middle finger, all the way down to the ground, and measure what that is. Then we ask the patient to side flex to this side, keeping their back against the wall, making sure they don't rotate forward at all. That the back stays flat against the wall, and then we measure from the middle of the finger, again, down to the floor and we take the difference of those two measures.
Robert: Well thank you very much Rachael for showing us a wonderful example of the lumbar side flexion test for ankylosing spondylitis. So, would you do the other side as well?
Rachael: Definitely, and it's really important that you measure the baseline distances of both sides.
Robert: Do you take an average or do you take the worst?
Rachael: No, when you do work out the best mean score, you definitely take an average of the two.
Robert: So, was Errol normal?
Rachael: Just, actually, he was 18 centimeters.
Robert: So, if he was restricted, would that have meant he had ankylosing spondylitis?
Rachael: Definitely not. There are number of reasons that can cause stiffness in the lumbar spine, and further investigations we'd have to find out what that cause is.
Robert: Well, again thank you very much Rachael, for showing us the lumbar side flexion test.