Whenever I go see my physical therapist for the old back and leg pain that seems to plague me, he has me try to touch the floor with my fingers. What does this test really tell him?

The fingers-to-floor test is a valid test used to assess the level of disability of physical incapacity of patients with low back pain that radiates down the leg. Physical therapists often use two specific tests of disability: fingertip-to-floor and straight leg raise tests.

As the name suggests, the fingers-to-floor test is done in the standing position. The person bends as far forward as possible reaching toward the floor with the fingers. The number of inches or centimeters from the tip of the index finger to the floor is the test result.

Change in fingers-to-floor has been shown to be associated with improvements in daily function (as measured by a self-report survey known as the Roland Morris Disability Questionnaire). Patients who have improvements in the fingers-to-floor measurement in the first 30-days of treatment also have the best long-term results.

A recent study from Sweden showed that the fingers-to-floor can be used as a valid measure of change and a predictor of who will improve with treatment. The fingers-to-floor is a more valid test to predict change in disability over time than the straight leg raise test.

They narrowed their focus to a subgroup of just patients with radicular pain (back pain with pain down the leg). Each of the 65 patients in the study was diagnosed with acute or subacute low back pain (meaning their painful symptoms were fairly new: less than 13 weeks).

Patients who had improvements in the fingers-to-floor measurement in the first 30-days of treatment had the best long-term results. Your therapist is right on! The authors of this study suggest using the fingers-to-floor as a measure of change and a predictor of who will improve with treatment. They say the fingers-to-floor is a more valid test to predict change in disability over time than the straight leg raise rest.