Spine
Lumbo-Sacral Spine
Evidence: confirmed
Standing Flexion Test Special Test
Orthopedic Physical Examination & Clinical Assessment Guide
What is it used for?
- Assessing Sacroiliac Joint Stiffness (Hypomobility).
How to Perform
- Position: Patient stands. Examiner places thumbs on both PSIS (back dimples).
- Action: Patient bends forward to touch their toes.
Interpretation of Results
- Positive Test: One thumb moves much higher (more superiorly) than the other.
- Meaning: The side that moves higher is the blocked/stiff joint because it is stuck to the ilium and moves with it.
Clinical Context & Limitations
The Standing Flexion Test should be considered as one component of a comprehensive musculoskeletal assessment. No single special test has perfect diagnostic accuracy; thus, clinical decision-making should integrate test results with patient-reported symptoms, mechanism of injury, functional impairment, and relevant imaging.
Clinicians should be aware of potential false-positive results in patients with pain sensitisation, muscle guarding, or poor relaxation. For the Spine region, combining the Standing Flexion Test with complementary examination tests significantly improves overall diagnostic confidence.
References
- Clinical Tests for the Musculoskeletal 3rd Ed. Book
