A Clinical Tool for Office Assessment of Lumbar Spine Stabilization Endurance: Prone and Supine Bridge Maneuvers

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Schellenberg KL, Lang JM, Chan KM, Burnham RS. A clinical tool for office assessment of lumbar spine stabilization endurance: prone and supine bridge maneuvers. Am J Phys Med Rehabil 2007;86:380–386.Objective:To assess the validity and reliability of an office-based surrogate measure of lumbar spine–stabilization endurance capability; to establish norms and reliability in an asymptomatic group; and to compare their measures with those from a group of chronic mechanical low-back pain patients.Design:Eight healthy subjects participated in the tool-validation portion of the study that consisted of surface electromyographic (EMG) measurements of core muscle activation during prone and supine bridging. Subsequently, normative and test–retest reliability measures of prone and supine bridging duration were recorded from 43 subjects without back pain and were compared with those of 32 subjects with chronic mechanical low-back pain.Results:Surface EMG indicated significantly preferential activation of anterior core muscles during prone bridging and posterior core muscles during supine bridging. Mean bridge durations for subjects without back pain were 72.5 ± 32.6 (mean ± SD) secs in prone and 170.4 ± 42.5 secs in supine. They were significantly less in subjects with back pain: 28.3 ± 26.8 secs in prone and 76.7 ± 48.9 secs in supine. Test–retest reliability using Pearson’s correlation for prone and supine bridging was 0.78 and 0.84, respectively.Conclusions:Bridging maneuvers seem to be practical, reliable, and valid methods of reflecting lumbar spine–stabilization endurance capability. Prone bridging preferentially challenges core flexors, whereas supine bridging recruits primarily the core extensors; both are compromised in patients with low-back pain.

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