While the patient is in a standing position the examiner makes a mark approximately at the level of L5. Two points are marked: 5 cm below and 10 cm above this point. Then the patient is asked to touch his/her toes while keeping the kneesstraight. If the distance of the two points do not increase by at least 5 cm, then this is a sign of restriction in the lumbar flexion. This can be useful in examining a patient suspected of ankylosing spondylitis.