The Adams Forward Bend Test

The purpose of the Adam's forward bend test is detecting structural or functional scoliosis. Adams test is clinical test to assess scoliosis.

The Adams Forward Bend Test 


The examiner stands at the back of the patient and looks along the horizontal plane of the spine, searching for abnormalities of the spinal curve, like increased or decreased lordosis/ kyphosis, and an asymmetry of the trunk.


Clinically Relevant Anatomy

The spine consists of 7 vertebrae cervicales, 12 vertebrae thoracicae, 5 vertebrae lumbales and an os sacrum composed of 5 vertebrae sacrales. When you look at the vertebral column in the sagittal plane, you see a cervical lordosis, thoracic kyphosis, lumbar lordosis and sacral kyphosis.

Normally, the processus spinosi form a straight line. In patients with scoliosis, you see a lateral deviation in the frontal plane and a vertebral rotation, which can develop into a rib hump.

When the scoliosis progresses, the prossesus spinosi will rotate to the concave side of the column vertebrae. The costae are close together at the concavity of the curve and more separated at the convex side. The ribs follow the rotation of the corpus vertebrae and thus those of the processus spinosi. The rib hump develops because the posterior ribs on the convex side are being pushed to posterior and the anterior ribs on the concave side are pushed anteriorly.

The Adams Forward Bend Test 

Purpose

The purpose of the Adam’s forward bend test is detecting structural or functional scoliosis. This test is most often used during school screening for scoliosis.

It can also be used with patients who have a family history of scoliotic posture or with patients who have detectable scoliosis of uncertain etiology. The scoliosis is functional when the characteristics of scoliosis becomes more visible while the patient bends. With a structural scoliosis, the scoliotic deformity will remain the same as in the standing position.

If there is an increased kyphosis when bending forward, Scheuermann’s disease or congential kyphosis is also possible.

The Adams Forward Bend Test 

Technique

Before you perform the Adam’s forward bend test, it is best to look for limb length discrepancy. The spine needs to be visible. The patient bends forward at the waist until the back comes in the horizontal plane, with feet together, arms hanging and knees extended.

The palms are held together. The examiner looks from behind, along the horizontal plane of the column vertebrae. The examiner looks for indicators of scoliosis, such as spinal asymmetry, unlevel shoulders, scapula asymmetry, unlevel hips, the head that does not line up with the pelvis or a rib hump.

An increased or decreased lordosis/kyphosis can also be a sign for scoliosis. The rotation deformity or rib hump can be measured with a scoliometer.

Clinical Bottom Line

The Adam’s forward bend test is a screening test for scoliosis. The test is most powerful for thoracic scoliosis. It is best combined with other test for scoliosis, like the scoliometer.

Dr Rohit Bhaskar, Physio
Dr Rohit Bhaskar, Physio Dr. Rohit Bhaskar, Physio is Founder of Bhaskar Health and Physiotherapy and is also a consulting physiotherapist. He completed his Graduation in Physiotherapy from Uttar Pradesh University of Medical Sciences. His clinical interests are in Chest Physiotherapy, stroke rehab, parkinson’s and head injury rehab. Bhaskar Health is dedicated to readers, doctors, physiotherapists, nurses, paramedics, pharmacists and other healthcare professionals. Bhaskar Health audience is the reason I feel so passionate about this project, so thanks for reading and sharing Bhaskar Health.

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