Quantifies lumbar forward flexion

Performing the Test

  1. Patient: standing
  2. With a pen, mark the lumbosacral junction, 10 cm above, and 5 cm below
    • Lumbosacral junction landmarking: L4 is at plane of iliac wings, palpate down to L5-S1 (lumbosacral junction)
  3. Ask patient to maximally forward flex, reaching for toes
  4. Measure distance between middle mark and top mark
    • Normal: 5cm distance increase
  5. Measure distance between middle mark and bottom mark
    • Normal: should remain same


  1. Bickley L. Bate’s Guide to Physical Examination and History Taking. 10th ed. New York: Lippincott Williams & Wilkins; 2009.
  2. Hurley K. OSCE and Clinical Skills Handbook. Halifax: Elsevier Canada; 2005.