Position the patient standing with their backside facing the clinician. This test will serve to note the difference in movement between L1 and L5. Note T12 and the sacrum should stay stationary throughout the entire test. First, palpate to find the PSIS. Once the PSIS is located, move central locating L5/SI. Next, moving up the spine using a thumb width measurement locate L1. Place one inclinometer at the spinous process of T12 and the other inclinometer at the sacrum. Make sure both inclinometers are set at zero to start. Actively, instruct the patient to bend forward, as far as they can. Record the degrees on both inclinometers. In order to find the difference between L1 and L5, subtract L1 degrees from L5 degrees. As an example, if L1 read 125 degrees and L2 read 55 degrees, subtract the two numbers. The patient would present with 70 degrees of lumbar flexion. Lastly, note any pain or difficulty present on the recording sheet.

Reference: Norkin pg. 387 for using inclinometers

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