Purpose of Test: To identify individuals with scoliosis.
Test Position: Standing.
Performing the Test: Have patient bend forward as far as possible. Look for one side of the rib cage to be higher than the other next to the vertebral column. The convex side is the one with the rib hump.
Diagnostic Accuracy (for thoracic curves): Sensitivity: .92; Specificity: .60 ("A Study of the Diagnostic Accuracy and Reliability of the Scoliometer and Adam's Forward Bend Test").
Importance of Test: A rib hump forms on the side of the convexity, because as the vertebrae are laterally flexed to one side, they must also rotate to the opposite side due to the facet alignment. According to Neumann, the facets are aligned in the frontal plane with a forward tilt of approximately 15-25 degrees. During lateral flexion to the right, the inferior facet of the superior vertebra slides inferiorly and posteriorly on the right and superiorly and anteriorly on the left, which results in rotation as well. The ribs (attached to the vertebrae) follow the rotation and appear to stick out on the ipsilateral side of the convexity. It is important to identify individuals at risk for severe development of scoliosis. It may impact your treatment plan and referral.
Note: tests should only be performed by a properly trained health care practitioner.