Fexibility in adolescent idiopathic scoliosis: modified Adam’s forward bending test

Abstract

Introduction: This study evaluated the diagnostic utility of the modified Adam’s Forward Bending Test (mAFBT), which is a new physical examination method assessing rotational flexibility in adolescent idiopathic scoliosis (AIS) patients. Method: This is a prospective cohort study of 40 AIS patients. In the mAFBT, without coming up to an erect position, subjects were asked to bend to the convex side of the curve in the axial plane. Evaluation of the rib/loin hump flexibility was performed during this maneuver. Scoliometric measurements were done during the AFBT and mAFBT. Results: Significant correlations were noted between the Cobb angle and AFBT (p=0.005), fulcrum bending and the mAFBT (p=0.0001), side-bending and mAFBT (p=0,0001), and the postoperative Cobb angles and AFBT (p=0.003). There were significant positive correlations between curve flexibility as based on the fulcrum bend to that of the CFI (r=0.347, p=0.036) and side-bending technique (r=0.416, p=0.008). Based on ROC analyses (AUC range=0.71-0.78), the mAFBT demonstrated high specificity and sensitivity rates for flexible and rigid curves, respectively. Conclusion: This is the first study to report the mAFBT and the CFI for evaluation of AIS. The mAFBT was found to be a reliable test for clinical assessment of rotational flexibility in AIS patients.