Schober’s Test
- Fysiobasen
- Sep 13
- 3 min read
Schober’s test is used to assess lumbar spine mobility during flexion. It is particularly applied to detect reduced mobility in inflammatory back diseases such as ankylosing spondylitis (AS)¹. The test is also valuable in monitoring disease progression and treatment outcomes in spondyloarthropathies and other causes of restricted lumbar flexion².
By measuring the change in distance between two points on the back during forward flexion, clinicians can evaluate lumbar mobility, especially in the segments between L1 and S1, depending on the version of the test³.
Original Schober’s Test
Purpose:
To assess lumbar spine mobility, especially when AS is suspected.
Execution:
The patient stands upright.
The examiner marks L5 by drawing a horizontal line over the spinous process.
A second line is drawn 10 cm above the first.
The patient bends forward as if to touch the toes.
The examiner measures the new distance between the lines during maximal flexion.
Interpretation:
An increase of less than 5 cm indicates reduced lumbar flexion and possible inflammatory back disease¹.
Modified Variants
Modified Schober Test (MST):
First line at the posterior superior iliac spines (PSIS).
Second line 5 cm below, third line 10 cm above.
The new distance between the upper and lower lines is measured during flexion².
Covers segments L2/L3–S1.
Modified Modified Schober Test (MMST):
First line at PSIS level.
Second line 15 cm above.
Frequently used as it covers more of the lumbar spine (L1/L2–S1) and is more precise³.
Wolfson Modified Schober Test (WMST):
Same as MMST, but measurement 16 cm above the PSIS line.
Extends coverage up to T12/L1, nearly the entire lumbar spine⁴.
What the Test Measures
Lumbar flexion, particularly between L1 and S1.
Indirect signs of stiffness or degenerative changes.
Progression or improvement over time (e.g., in patients receiving biologics for AS).
Positive test:
Less than 5 cm increase in distance (original test) or similarly low change in modified versions.
Suggests restricted mobility, usually due to inflammatory stiffness or structural changes.
Clinical Relevance
While Schober’s test is a quick and simple tool in clinical practice, the original version has limitations in covering the upper lumbar segments. This led to several modifications:
MMST provides better segment coverage and is most widely used today.
WMST offers the most accurate coverage but risks including T12–L1.
The test is especially useful for tracking disease progression over time. However, results may be influenced by pain, muscle tension, or posture, and should always be interpreted alongside other clinical findings⁵.
Evidence and Reliability
Clinical Considerations
Schober’s test and its modifications are best applied in combination with other examinations and imaging. When low measurements occur without clear clinical signs of AS, alternative causes such as muscle tension, segmental hypomobility, or prior injuries should be considered⁶.
Sources:
Rezvani A, Ergin O, Karacan I. Validity and reliability of the metric measurements in the assessment of lumbar spine motion in patients with ankylosing spondylitis. Spine. 2012;37(19):E1189–E1196.
Yen YR, Luo JF, Liu ML, Lu FJ, Wang SR. The anthropometric measurement of Schober’s test in normal Taiwanese population. BioMed Research International. 2015;2015.
Hershkovich O, Grevitt MP, Lotan R. Schober test and its modifications revisited – what are we actually measuring? Computerized tomography-based analysis. J Clin Med. 2022;11(23).
Medisavy. Schober’s Test. Tilgjengelig fra: https://medisavvy.com/schobers-test/ (sist åpnet 05.07.2025)
BJC Health. Modified Schober's Test for Ankylosing Spondylitis. Tilgjengelig fra: https://www.youtube.com/watch?v=B9RaFB5BwrQ (sist åpnet 05.07.2025)
Tousignant M, Poulin L, Marchand S. The modified-modified Schober test for range of motion assessment of lumbar flexion in patients with low back pain: a study of criterion validity, intra- and inter-rater reliability and minimum metrically detectable change. Disability and Rehabilitation. 2005;27(10):553–559.
