Core stability (CS) is a complex topic. Many different definitions of CS can be found in literature. When defining the term already is a challenge, all the more is assessing it. Choosing the appropriate assessment for a patient is crucial for therapeutic success. A variety of tests is available. The decision for a specific test is not only depended on which aspect of CS (strength, endurance, neuromuscular control) is going to be examined but is furthermore dependent on the patient himself. Core stability assessments place high demands on the patient’s physical abilities which they often cannot fulfill. Therefore, the tests have to be chosen carefully for different patients – from athletes to geriatric patients.
Therefore, the key question discussed in this bachelor thesis is: Which assessments are suitable to re-evaluate core stability in the physiotherapeutic process in prevention and rehabilitation programs?
Core stability plays a key role in physiotherapy. A stable trunk is a fundamental requirement for optimal movement needed by elite athletes for top performances as well as patients after a stroke, relearning basic movements. Furthermore core stability is essential in the prevention and treatment of low back pain. In physical rehabilitation the main goal of core stability exercises is to train the muscles in order to maintain a sufficient spinal stability. Frequently, core stability training is used in prevention and rehabilitation programs. But often neither a baseline measurement nor final tests are made - it lacks a golden standard assessment for CS. To evaluate the effect of core stability exercises in the physiotherapeutic process it is necessary to apply suitable tests. Only then it can be ensured that the interventions lead to therapeutic success.
In the research on core stability it all comes down to one big problem: It lacks universally accepted definitions. There is neither a definition for core stability nor for the muscles comprising the core. How can a topic as sophisticated as core stability be explored properly if there is no common ground on basic definitions?
Even though literature is conflicting on many items, consensus can be found on some aspects influencing trunk stability. It is generally accepted that strength, endurance and neuromuscular control are crucial for stability, whereas endurance and neuromuscular control have a greater impact than strength. So these two aspects should be given more attention in selecting suitable assessments.
Measuring core stability in a clinical setting is challenging. There are different types of tests available that assess only one of the aspects influencing CS, furthermore there are test batteries and functional assessments available like the Sahrman Core Stability Test or the Functional Movement Screen. The latter measures core stability only indirectly. Practicability limits the possibilities. Assessments have to be time and cost efficient. That restricts the use of device-based measuring systems like surface EMG or ultrasound. Therefore simple assessments like movement control tests or endurance tests like the side bridge endurance test, variations of the trunk flexor test or the Biering-Sørensen test, measuring the isometric endurance of the back extensor muscles, are used in the physiotherapeutic process. However, not all available assessments are evidence-based.