Scoliosis Diagnosis: The Adams Forward Bend Test Back Clinic

The Adams forward bend test is a simple screening method that can help with scoliosis diagnosis and help in developing a treatment plan. The exam is named after the English physician William Adams. As part of an examination, a doctor or chiropractor will look for an abnormal side-to-side bend in the spine.

Scoliosis Diagnosis

• The Adams forward-bend test can help determine if there are indicators for scoliosis.
• It is not an official diagnosis, but the results can be used as a starting point.
• The test is done with school-age children between 10 and 18 to detect adolescent idiopathic scoliosis or AIS.
• A positive test is a noticeable asymmetry in the ribs with a forward bend.
• It can detect scoliosis in any part of the spine, especially in the thoracic middle and upper back.
• The test is not only for kids; scoliosis can develop at any age, so it is also effective for adults.

Adams Forward Bend Test

The test is quick, easy, and painless.

• The examiner will check to see if anything is uneven when standing straight.
• Then the patient will be asked to bend forward.
• The patient is asked to stand with their legs together, facing away from the examiner.
• Then patients bend forward from the waist, with arms hanging vertically downward.
• The examiner uses a scoliometer-like level to detect asymmetries within the spine.
• Deviations are called the Cobb angle.

The Adams test will reveal signs of scoliosis and/or other potential deformities like:

• Uneven shoulders
• Uneven hips
• Lack of symmetry between the vertebrae or the shoulder blades.
• The head does not line up with a rib hump or the pelvis.

Detection of Other Spinal Issues

The test can also be used to find spinal curvature issues and conditions like:

• Kyphosis or hunchback, where the upper back is bent forward.
• Scheuermann’s disease is a form of kyphosis where the thoracic vertebrae can grow unevenly during a growth spurt and cause the vertebrae to develop into a wedge-like shape.
• Congenital spine conditions that cause an abnormal curve of the spine.

Confirmation

The Adams test by itself is not enough to confirm scoliosis.

• A standing X-ray with Cobb angle measurements above 10 degrees is required for diagnosing scoliosis.
• The Cobb angle determines which vertebrae are tilted the most.
• The higher the angle, the more severe the condition and the more probable it will produce symptoms.
• Computed tomography or CT and magnetic resonance imaging or MRI scans can also be used.

---

Forward Bend Test

---

References

Glavaš, Josipa et al. “The role of school medicine in the early detection and management of adolescent idiopathic scoliosis.” Wiener klinische Wochenschrift, 1–9. 4 Oct. 2022, doi:10.1007/s00508-022-02092-1

Grossman, T W et al. “An evaluation of the Adams forward bend test and the scoliometer in a scoliosis school screening setting.” Journal of pediatric orthopedics vol. 15,4 (1995): 535-8. doi:10.1097/01241398-199507000-00025

Letts, M et al. “Computerized ultrasonic digitization in the measurement of spinal curvature.” Spine vol. 13,10 (1988): 1106-10. doi:10.1097/00007632-198810000-00009

Senkoylu, Alpaslan, et al. “A simple method for assessing rotational flexibility in adolescent idiopathic scoliosis: modified Adam’s forward bending test.” Spine deformity vol. 9,2 (2021): 333-339. doi:10.1007/s43390-020-00221-2