Core Assessment and Screening
Domain 2: Core Assessment and Screening
This domain tests a repeatable screen: history, red flags, posture, movement quality, endurance, and motor control.
Screen sequence
- History and informed consent first. Ask about pain, prior surgery, pregnancy, osteoporosis, and neurological symptoms.
- Static posture: note rib flare, pelvic tilt, and scoliosis, but posture alone does not diagnose.
- Dynamic screens: overhead squat, single-leg stance, loaded carry, and rolling. Watch for loss of neutral spine, breath holding, and asymmetry.
- Endurance: McGill torso endurance battery-trunk flexor, extensor, and side-bridge holds. Compare left and right side-bridge times; a difference greater than about 5% flags asymmetry. A flexor:extensor ratio above 1.0 commonly flags relatively poor extensor endurance.
- Motor control: prone hip extension, active straight-leg raise, and breathing mechanics.
Worked example
A client holds the left side bridge 40 seconds and the right 30 seconds. The 10-second difference is 25% of the longer hold, well above 5%. Do not simply add time; check pain, rib-pelvis alignment, and shoulder position, then prescribe a regressed side bridge on the weaker side and retest in two weeks.
Traps
- Using maximal strength tests instead of endurance and control.
- Screening through pain or ignoring red flags.
- Treating one asymmetry as a diagnosis.
- Failing to record a baseline for retesting.