Passive physiological intervertebral movements (PPIVM): Patient is in sidelying position. Hips and knees are flexed while the knees are locked, and the therapist moves the patient’s spine through flexion and extension movements. Therapist palpates between the spinous processes to assess the motion as normal, hypomobile or hypermobile.
This test should not be used to assess the entire lumbar spine’s mobility, and should not be used as a single examination technique (Shreiner, 2008). Reported to have a 5% (flexion) and 16% (extension) sensitivity and 98% (extension) 99.5% (flexion) specificity (Abbott et al. 2005).