What is the Adam’s Forward Bend Test?
The Adam’s Forward Bend Test, or the Adam’s Test for short, is a physical examination developed to help healthcare professionals gauge patients suspected of having scoliosis.
Scoliosis is a spinal condition in which the spine has an abnormal lateral curvature, and the degree of the curvature varies depending on the person. Small curves are normally fine and do not cause any major problems save for mild discomfort, however, extreme curves can adversely affect a person’s body. Large curves can cause lung problems, can make ribs rub against the pelvis (which is something that definitely should not happen), and can even develop arthritis that damages the spinal joints, which can cause bone spurs to appear.
If left unchecked, scoliosis can impact a person’s quality of life and functional capabilities. Through the Adam’s Forward Bend Test, healthcare professionals can check for signs of scoliosis or other spinal abnormalities, hopefully as early as possible, so that they can proceed with examining the patient further, confirm the specific problem using imaging tests, plus, develop and implement a treatment plan that will help rehabilitate the patient, restore the spine to a good state, and educate the patient about the benefits of maintaining good posture and other exercises that will benefit the spine.
Have a look at this video to see a further explanation of the Adam's Forward Bend Test:
How to perform the Adam’s Forward Bend Test
The Adam’s Forward Bend Test doesn’t require much from the healthcare professional. The only things they would need for this test are the following:
- A place that’s spacious enough to observe your patient in a 360-degree fashion. The space must also ensure the patient’s privacy, because one of the things that they have to do is to take off their shirt.
- A scoliometer, which will be used to measure any rotation deformities or rib humps
Once you’re ready to perform this test on your patient, just follow these instructions:
- Have your patient take off their shirt. This test requires that you can see the body of the patient.
- First, take a look at the head and neck. They should be midline.
- Then, check if one shoulder is higher than the other.
- Look at the anterior rib cage. It should be symmetric.
- Look at the distance between the arms from their respective elbows and the torso. They should be equal in length.
- Now, for the posterior part of the test. First, ensure their feet are parallel, and their knees are straight.
- Check the waistline. The waistline should be the same on both sides.
- Check the pelvis. The pelvis should be level. If it’s not, there may be a difference in the patient’s leg lengths.
- Check the hips. They should be level and symmetrical. Check if one side is higher or prominent.
- Look at the scapula area. Check if one side is higher or more prominent than the other.
- Have your patient adjust their position so that you are facing their side.
- Check if they have accentuated roundness in the upper back.
- Check if they have an accentuated arch in the lower back.
- Next is the Adam’s Forward Bend Test Proper. Have your patient bend forward as far as they can. Make sure their knees are extended. Ensure the palms of their hands are together and their head is down.
- While they’re bent, check if they have a rib hump.
- You can also check if they have an exaggerated midline hump.
These are all the steps that you need to follow to perform the Adam’s Forward Bend Test.
How to interpret the findings of the Adam’s Forward Bend Test
The Adam’s Forward Bend Test doesn’t involve any calculations and scores, so if you’re not good with numbers, you don’t have to worry. Interpreting the test results is quite easy because it will be based on your observations.
If you notice that, at any point, especially when observing the posterior of the patient as well as during the Adam’s Forward Bend Test proper, there are signs of asymmetry in their spine and shoulders, if there is a difference in the length between the arms and torso from the elbow, and if you notice any exaggerated midline or rib humps, then the patient is positive for this test. The next step is to endorse them for further examination so that the specific problem can be identified.
If there is no sign of asymmetry in the patient’s body, then they are negative for this test because their spine seems fine. Remind them about maintaining good posture to reduce the chances of the spine curving!
Adam’s Forward Bend Test Example
Now that you know what the Adam’s Forward Bend Test is for, how to conduct it, and what to look out for while conducting the test, it’s time for you to see what a results sheet looks like! This physical examination normally does not come with a test sheet, so we at Carepatron took the liberty of creating a template for it!
Our template contains the instructions to help remind you about what you need to do and to look out for when performing the Adam’s Forward Bend Test, there are tickboxes that will allow you to indicate a positive or negative designation for your patient, and an additional comments box where you can jot down your observations and note what your decisions are for the patient moving forward.
If you like what you see and think it’ll be a good fit for your work, then feel free to download our template! It’s free! You can print it and fill it out with a pen, or if going paperless is your thing, you can just engage with the editable portions of the PDF!
When is it best to conduct the Adam’s Forward Bend Test?
The obvious answer is when a patient presents themselves to you to discuss back problems they’ve been dealing with. So, let’s go with two other appropriate times as to when this test should be conducted.
The Adam’s Forward Bend Test is often used to check on adolescents who have just hit puberty. This is the point in their lives where they get growth spurts, and more often than not, this is also the period when scoliosis develops because of the rapid growth. This is one of the best time’s in a person’s life when the test should be conducted because it can lead to an early diagnosis of scoliosis while it is nowhere near adverse. An early diagnosis can lead to early interventions and treatment that will help correct the spine.
It is also used by physicians when they notice a patient is related to people with histories of scoliosis or other spinal abnormalities. Even if the patient doesn’t seem to have one, conducting the Adam’s Forward Bend Test on them wouldn’t hurt. Who knows, maybe they have a spinal abnormality, but it’s not prominent at the moment. It’s the same thing with adolescents. It’s best to check as early as possible to develop ways to prevent the spinal abnormalities from happening or getting worse.
Do note that this test alone is not enough to confirm what the problem is. What this test does is that it checks for asymmetry, which is a sign of a spinal abnormality. Other tests, specifically imaging tests, can confirm what the specific spinal abnormality is. That’s why the next step after conducting the Adam’s Forward Bend Test is to endorse the patient for further examination.
Who can conduct the Adam’s Forward Bend Test?
Since the Adam’s Forward Bend Test is for assessing spinal abnormalities, the healthcare professionals that can conduct this on their patients are the ones who have had extensive training and experience when it comes to analyzing and treating the musculoskeletal system. These healthcare professionals include:
- Orthopedists - These doctors are well-educated and equipped to gauge patients and their possible spinal conditions. They are knowledgeable about the musculoskeletal anatomy and qualified to conduct this test and other similar physical examination techniques. They can also make well-informed decisions regarding what tests the patient should undergo and their treatment.
- Physical therapists and occupational therapists - These professionals are also well-versed in analyzing and treating musculoskeletal disorders, including spinal abnormalities. How they can help is that they create rehabilitation programs for patients to undergo to correct the curvature of their spine as well as to educate them about the benefits of good posture. They may not be able to perform surgical procedures (orthopedic surgeons will be responsible for this), but they can definitely help by providing physical therapy and exercises to patients.
It’s best to leave this test to such professionals because they know what they need to observe to give the patient a well-informed designation.
What are the benefits of the Adam’s Forward Bend Test?
It’s a low-effort but effective physical examination!
The Adam’s Forward Bend Test mostly relies on the healthcare professional’s eyes. They just need to direct the patient to turn around as needed, so the professional can check the front, back, and side of the patient. The test proper will have the patient bend, and the professional must look for obvious signs of asymmetry in the patient’s back. That’s it! It can even be accomplished within ten minutes.
It can detect early signs of spinal abnormalities.
Since the Adam’s Forward Bend Test is normally conducted on adolescents or people related to those with spinal abnormalities, this can allow the healthcare professional to detect early signs of scoliosis or other spinal conditions. Early detection leads to early intervention. If spinal abnormalities are detected, and they are still mild or in their early stages, the professional can develop a treatment plan that will help correct the spin and provide ways of managing the person’s spine so that the abnormalities are halted, and the spine can be corrected.
It can monitor the progression or recovery of the patient over time.
Let’s say you have a patient who is confirmed to have scoliosis. Based on imaging tests, the curve is “moderately” bad, meaning the curve is big but not big enough to cause complications yet. Let’s also stipulate that you made and implemented a treatment plan that requires them to wear a brace and undergo rehabilitation to correct the curvature. You can schedule routine check-ups with them and conduct the Adam’s Forward Bend Test to check if there are changes in their symmetry. Does the spine look better than when you first conducted the test? If so, then the treatment and rehabilitation are working. If the curve is maintained or is somehow worse than before, well, that’s not good. Perhaps tweaking your plan or overhauling it might help. Or, as a last resort, spinal fusion surgery might be the best choice.
Why use Carepatron for orthopedic and physical therapy work?
One of the points we mentioned earlier is that if the patient is given a positive designation for the Adam’s Forward Bend Test, the next step is to endorse them for further examination. If you are equipped and qualified to conduct a further examination of a patient, then we’d like to recommend our resource library!
Carepatron’s resource library spans various healthcare fields, including orthopedics and physical therapy. We have a wide variety of worksheets, assessments (including the Adam’s Forward Bend Test), survey templates, form templates, and much more! We even have other tests that can be used to assess back problems, like Ely’s Test, Prone Instability Test, the Yeoman’s Test. Who knows? Maybe your patient has more than just a spinal abnormality. It wouldn’t hurt to check and confirm.
Take your time and browse our resources! We’re sure you’ll find something to help you down the line!
We also have a super secure storage system that will allow you to store your clinical documents with us in a HIPAA-compliant manner! If you downloaded our Adam’s Forward Bend Test template, you can store filled-out copies with us and even set who can access them besides you! We recommend that you share access with your teammates if ever you’re part of a wider team. That way, you can share results with them easily, and they can share their results for their respective tests via the storage.
We at Carepatron are committed to helping healthcare professionals with their work, so take advantage of our platform so we can find ways to streamline your workflows and help you preserve your work!