Evaluating Core Stability in Physical Therapy

Evaluation of Core Stability

• Prone Instability Test:
  • Purpose: Assess instability of lumbar segments (L1-L2 to L5-S1)
  • Patient position: Prone lying with legs over the edge of the table and feet resting on the floor
  • Therapist position: Standing at the side of the patient's lumbar spine
  • Hand placement: Left hand on targeted spinous process with wrist extended, right hand supporting left hand
  • Procedure: Apply posteroanterior pressure to each targeted lumbar vertebra, reapply with feet lifted off the floor if pain is reported
  • Positive sign: Pain reported in first position but decreases or disappears in second position (feet lifted off the floor)
  • Activation of lumbar deep extensors (multifidus and ilicostalis lumborum) relieves patient's pain when feet are lifted off the floor

Prone Extension Endurance Test

• Purpose: Evaluate isometric endurance of hip and back extensor muscles, assess risk of non-specific lower back pain
• Procedure:
  • Patient lies prone on examining table with upper edge of iliac crests in alignment with the edge of the table
  • Lower body is fixed to the table by three straps around pelvis, knees, and ankles
  • Patient isometrically maintains upper body in a horizontal position while time is recorded
  • Test is stopped after 240 seconds if patient experiences no difficulty
• Positive sign: Holding position for less than 163 seconds indicates poor extensor core endurance (LBP), less than 176 seconds predicts low back pain during the next year in males

Side Bridge Endurance Test

• Positive sign: Failure to maintain position for less than 45 seconds indicates poor endurance of TA, obliques, QL, and ES

Flexor Endurance Test

• Positive sign: Patient falls below 60 degrees in less than 160 seconds (interpretation with caution)

Unilateral Supine Bridge Test

• No specific details provided in the text