Rotary Stability screening and scoring
Setup and purpose
The Rotary Stability pattern tests rotary core stability, coordination, and control in a quadruped position. The patient is positioned with hips and knees at 90 degrees, ankles dorsiflexed, and shoulders over the hands. A dowel is placed along the back, contacting the head, thoracic spine, and sacrum. The patient lifts one arm and one leg. The contralateral lift (opposite arm and leg) is attempted first; if it cannot be performed, the ipsilateral lift (same-side arm and leg) is attempted. Both sides are scored. The test is not a measure of limb strength; it assesses rotary control.
Scoring criteria
- 3: A contralateral lift with the dowel contact maintained and no compensation.
- 2: An ipsilateral lift with the dowel contact maintained and no compensation.
- 1: Unable to perform the ipsilateral lift.
- 0: Pain with the spinal flexion clearing test. The clearing test is a quadruped rock-back toward the heels with the arms extended. Pain is a 0. The lower side score counts, and a left-right difference is an asymmetry.
Worked example
Left side: the patient lifts the right arm and left leg (contralateral), the dowel stays in contact, and the hips do not rotate. Score 3. Right side: the patient cannot perform the contralateral lift without losing dowel contact, but can perform the ipsilateral lift cleanly. Score 2. The asymmetry is flagged. If the patient cannot perform even the ipsilateral lift, score 1. If the rock-back clearing test causes pain, score 0.
Traps
- Testing ipsilateral before contralateral.
- Losing dowel contact and still scoring 3.
- Allowing the hips to rotate or the back to arch.
- Forgetting the spinal flexion clearing test.
- Not testing both sides or not recording asymmetry. Maintain the dowel at all three contact points.