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Core Stability: Inter- and Intraobserver Reliability of 6 Clinical Tests

Weir, Adam MBBS*; Darby, Jennifer*; Inklaar, Han MD† ; Koes, Bart PhD‡ ; Bakker, Erik PhD§; Tol, Johannes L MD, PhD*

Clinical Journal of Sport Medicine: January 2010 - Volume 20 - Issue 1 - pp 34-38
doi: 10.1097/JSM.0b013e3181cae924
Original Research

Objective: Core stability is a complex concept within sports medicine and is thought to play a role in sports injuries. There is a lack of reliable and valid clinical tests for core stability. The inter- and intraobserver reliability of 6 tests commonly used to assess core stability was determined.

Design: A video of the tests was shown to 6 observers. A second observation took place 5 weeks later with the same observers.

Setting: Sports medicine department of a hospital.

Participants: Forty male athletes.

Assessment of Variables: Core stability was rated as poor, moderate, good, or excellent by each observer for each of the 6 tests.

Main Outcome Measures: Inter- and intraobserver reliability.

Results: The mean score of all tests was 13.4% poor, 33.3% moderate, 40.1% good, and 13.2% excellent. The intraclass correlation coefficients (ICCs 2,1) for the interobserver reliability for frontal, sagittal, and transverse plane evaluation were 0.09, 0.32, and 0.51, respectively. The ICCs for the unilateral squat, the lateral step-down, and the bridge were 0.41, 0.39, and 0.36, respectively. The ICCs for the intraobserver reliability for frontal, sagittal, and transverse plane evaluation were 0.31, 0.40, and 0.55, respectively. The ICCs for the unilateral squat, the lateral step-down, and the bridge were 0.55, 0.49, and 0.21, respectively.

Conclusions: The 6 clinical core stability tests are not reliable when a 4-point visual scoring assessment is used. Future research on movement evaluation should be focused on more specific rating methods and training for the observers.

From the *Department of Sports Medicine, The Hague Medical Centre, Leidschendam, the Netherlands; †KNVB, Zeist, the Netherlands; ‡Department of General Practice, Erasmus University, Rotterdam, the Netherlands; and §Department of Clinical Epidemiology, Biostatistics, and Bioinformatics, Academic Medical Centre, Amsterdam, the Netherlands.

Submitted for publication July 3, 2009; accepted November 13, 2009.

Reprints: Adam Weir, MBBS, Department of Sports Medicine, The Hague Medical Centre, Antoniushove, PO Box 411, Burgemeester Banninglaan 1, 2260 AK Leidschendam, the Netherlands (e-mail: a.weir@mchaaglanden.com).

© 2010 Lippincott Williams & Wilkins, Inc.