A Meta-Analysis of the Reliability of Four Field-Based Trunk Extension Endurance Tests.

María Teresa Martínez-Romero,Julio Sánchez-Meca,Mark De Ste Croix,Fernando Santonja-Medina,Fernando Santonja-Medina,Francisco J Vera-Garcia,Pilar Sainz De Baranda,Francisco Ayala

doi:10.3390/ijerph17093088

Abstract

This meta-analysis aimed to estimate the inter- and intra-tester reliability of endurance measures obtained through trunk extension field-based tests and to explore the influence of the moderators on the reliability estimates. The reliability induction rate of trunk extension endurance measures was also calculated. A systematic search was conducted using various databases, and subsequently 28 studies were selected that reported intraclass correlation coefficients for trunk extension endurance measures. Separate meta-analyses were conducted using a random-effects model. When possible, analyses of potential moderator variables were carried out. The inter-tester average reliability of the endurance measure obtained from the Biering-Sorensen test was intraclass correlation coefficient (ICC) = 0.94. The intra-session reliability estimates of the endurance measures recorded using the Biering-Sorensen test, the prone isometric chest raise test, and the prone double straight-leg test were ICC = 0.88, 0.90, and 0.86, respectively. The inter-session average reliability of the endurance measures from the Biering-Sorensen test, the prone isometric chest raise test, and the dynamic extensor endurance test were ICC = 0.88, 0.95, and 0.99, respectively. However, due to the limited evidence available, the reliability estimates of the measures obtained through the prone isometric chest raise, prone double straight-leg, and dynamic extensor endurance tests should be considered with a degree of caution. Position control instruments, tools, and familiarization session demonstrated a statistical association with the inter-session reliability of the Biering-Sorensen test. The reliability induction rate was 72.8%. Only the trunk extension endurance measure obtained through the Biering-Sorensen test presented sufficient scientific evidence in terms of reliability to justify its use for research and practical purposes.

Highlights

The main purpose of the current study was to conduct a reliability generalization (RG) meta-analysis (a) to obtain combined reliability estimates of trunk extension endurance measures obtained through four field-based tests, (b) to identify which characteristics of the studies may influence the variability of the reliability coefficients, and (c) to determine the reliability induction (RI) practice in studies that have used trunk extensor muscle endurance tests
Most of these studies focused on the analysis of the inter-tester reliability of the trunk extension endurance measure obtained through the Biering-Sorensen test [18,23,24,26,66]; the number of studies that explored the inter-tester reliability of the endurance measures recorded from the prone isometric chest raise [18] and the prone double straight-leg [18] tests were very limited, and no studies used the dynamic extensor endurance test
The main findings of the current RG meta-analysis report that only the trunk extension endurance measure obtained through the Biering-Sorensen test may present sufficient scientific evidence in terms of inter- (ICC+ = 0.94, based on 8 cohorts) and intra-tester

Summary

Introduction

In the last two decades, there has been an increased interest in the assessment of trunk extensor muscle endurance, as deficits in trunk extensor endurance and imbalances between trunk muscle groups have been suggested as being primary risk factors for low back disorders [1,2,3,4] and could negatively affect sports performance [5,6]. several sophisticated laboratory-based tests have been developed to quantify trunk extensor muscle endurance (i.e., force platforms, isokinetic dynamometers) [7,8,9], field-based tests seem to be the most popular tests, probably because they are portable, cost-effective, easy to use, and time-efficient methods [10]. The four trunk extension endurance measures identified have been considered operationally valid by medical (American College of Sports Medicine [15]), sport (Swiss Olympic Medical Centers [16]), and educational (Cooper Institute [17]) organizations. Their measures have been shown to be sensitive enough to detect trunk extensor muscle endurance deficits in patients with chronic low back pain [18,19], and are included in many prominent sports medicine textbooks [15,16,17]

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