Trunk Stability Push-Up screening and scoring
Setup and purpose
The Trunk Stability Push-Up tests sagittal trunk stability, core control, and scapular stability. The patient lies prone with hands shoulder-width apart. Hand position depends on sex and score level. For men, thumbs at the forehead is the 3 position; thumbs at the chin is the 2 position. For women, thumbs at the chin is the 3 position; thumbs at the clavicle is the 2 position. The patient performs one push-up with the body moving as one unit, ankles dorsiflexed, no sagging or piking. The test is not a measure of upper-body strength; it assesses trunk stability.
Scoring criteria
- 3: One repetition in the 3 hand position with no compensation.
- 2: One repetition in the 2 hand position with no compensation.
- 1: Unable to perform a repetition in the 2 position.
- 0: Pain with the spinal extension clearing test. The clearing test is a prone press-up: press the chest up while keeping the hips on the floor. Pain is a 0.
Worked example
A male patient performs one push-up with thumbs at the forehead. His hips do not sag, and his shoulders and hips rise together. Score 3. A second male patient sags at the lumbar spine in the forehead position. The examiner moves his thumbs to the chin. He now performs one clean repetition. Score 2. If he still sags or cannot press up, score 1. If the press-up clearing test causes low-back pain, score 0.
Traps
- Using the same hand position for men and women.
- Allowing lumbar extension or hip piking.
- Not retesting at the lower hand position before scoring 1.
- Skipping the clearing test.
- Treating it as a strength or endurance test; it is a single repetition. Observe the hips and shoulders together.