Which method is best used to assess a global decrease in lumbar-pelvic range of motion in suspected inflammatory spinal disease?

• A. Spinal palpation method
• B. Goniometric lumbar ROM
• C. Straight leg raise test
• D. Schober method

Answer: (D)

Assessing global lumbar-pelvic motion is best done with the Schober test. In inflammatory spinal diseases like suspected ankylosing spondylitis, the spine and sacroiliac joints stiffen, leading to a noticeable reduction in overall lumbar flexion. The Schober test directly measures this global motion: you place two skin marks along the lumbar region (one at the lumbosacral junction and another about 10 cm above), have the patient stand and bend forward, and then re-measure the distance. The amount of increase from flexion reflects the capacity of the lumbar-pelvic unit to lengthen during movement. A small change indicates restricted global motion, which is exactly what you’re looking for in inflammatory disease.

Spinal palpation methods don’t quantify movement, and while goniometric lumbar ROM can measure angles, it often assesses more limited, segmental motion and is more technically demanding. The straight leg raise test evaluates nerve tension and leg neurodynamics rather than global lumbar-pelvic mobility.