Which statement is true regarding seated flexion testing?

• A. A positive seated flexion test indicates dysfunction on the side of the positive test.
• B. A negative seated flexion test indicates dysfunction on the opposite side.
• C. The seated flexion test is not used in sacral diagnosis.
• D. A positive seated flexion test always indicates bilateral involvement.

Answer: (A)

The seated flexion test localizes sacral dysfunction to the side that tests positive. As the patient sits and flexes forward, the PSIS on the dysfunctional side tends to rise higher than the other side. So a positive result on one side points to dysfunction on that same side of the sacrum. A negative result means there isn’t an evident sacral dysfunction on either side. A positive test can occur bilaterally if both sides are involved, but it does not automatically indicate bilateral dysfunction. This is why the statement that a positive seated flexion test indicates dysfunction on the side of the positive test is the correct interpretation.