Assessment of Isometric Trunk Strength - The Relevance of Body Position and Relationship between Planes of Movement.

The aim of the study was to assess the differences in maximal isometric trunk extension and flexion strength during standing, sitting and kneeling. Additionally, we were interested in correlations between the maximal strength in sagittal, frontal and transverse plane, measured in the sitting position. Sixty healthy subjects (24 male, 36 female; age 41.3 ± 15.1 yrs; body height 1.70 ± 0.09 m; body mass 72.7 ± 13.3 kg) performed maximal voluntary isometric contractions of the trunk flexor and extensor muscles in standing, sitting and kneeling position. The subjects also performed lateral flexions and rotations in the sitting position. Each task was repeated three times and average of maximal forces was used for data analysis. RANOVA with post-hoc testing was applied to the flexion and extension data. The level of statistical significance was set to p < 0.05. Overall, in both genders together, the highest average force for trunk extension was recorded in sitting posture (910.5 ± 271.5 N), followed by kneeling (834.3 ± 242.9 N) and standing (504.0 ± 165.4 N), compared with flexion, where we observed the opposite trend (508.5 ± 213.0 N, 450.9 ± 165.7 N and 443.4 ± 153.1 N, respectively). Post-hoc tests showed significant differences in all extension positions (p < 0.0001) and between sitting/standing (p = 0.018) and kneeling/standing (p = 0.033) flexion exertions. The extension/flexion ratio for sitting was 2.1 ± 0.4, for kneeling 1.9 ± 0.4, followed by standing, where motion forward approximately equals motion backward (1.1 ± 0.6). Trunk sagittal-transverse strength showed the strongest correlation, followed by frontal-transverse and sagittal-frontal plane correlation pairs (R(2) = 0.830, 0.712 and 0.657). The baseline trunk isometric strength data provided by this study should help further strength diagnostics, more precisely, the prevention of low back disorders. Key pointsMaximal voluntary isometric force of the trunk extensors increased with the angle at the hips (highest in sitting, medium in kneeling and lowest in upright standing).The opposite trend was true for isometric MVC force of trunk flexors (both genders together and men only).In the sitting position, the strongest correlation between MVC forces was found between sagittal (average flexion/extension) and transverse plane (average left/right rotation).IN ORDER TO INCREASE THE VALIDITY OF TRUNK STRENGTH TESTING THE LETTER SHOULD INCLUDE: specific warm-up, good pelvic fixation and visual feedback.