Strength Endurance Test: McGill Endurance Tests

With high rates of lower back pain and dysfunction seen worldwide, it is often proposed that poor trunk muscle endurance may be a contributing factor in non-specific lower back pain conditions in athletic and general populations.

The McGill Torso Endurance Tests are a useful battery of tests that assess all sides of the trunk allowing us to assess the endurance capacity of the torso muscles or if there is an imbalance between these three muscle groups which can contribute to low-back dysfunction and core instability.

The testing batteries have been well-researched with useful normative data that can be applied to the people you work with. 

Anderson et al 2014 found the following normative results:

Flexion: 160 seconds 

Extension: 101 seconds

Right Side Plank: 54 seconds

Left Side Plank: 55 seconds.

Evans et al 2007 also investigated this battery of tests in state-level athletes and found the following normative results:

Flexion: 224 seconds 

Extension: 163 seconds

Right Side Plank: 104 seconds

Left Side Plank: 103 seconds.

Flexion/Extension Ratio: <1.0

Side Plank Ratio: 1:1

Side Plank/Extension Ratio: <0.75

Procedure - Trunk Flexor Endurance

1. The starting position requires the client to be seated, with the hips and knees bent to 90 degrees, aligning the hips, knees, and second toe.
2. Instruct the client to fold his or her arms across the chest, touching each hand to the opposite shoulder, lean against a board positioned at a 60-degree incline, and keep the head in a neutral position. If you don't have a board you can approximate the position getting the client to lean against something else.
3. It is important to ask the client to press the shoulders into the board and maintain this “open” position throughout the test after the board is removed.
4. Instruct the client to engage the abdominals to maintain a flat-to-neutral spine. The back should never be allowed to arch during the test.
5. Time how long the client can maintain this position until there is a noticeable change in trunk position such as rounding of the back or needing to place their hands down.

Procedure - Trunk Lateral Endurance

1. The starting position requires the client to be on his or her side with extended legs, aligning the feet on top of each other or in a tandem position (heel-to-toe).
2. Have the client place the lower arm under the body and the upper arm on the side of the body.
3. When the client is ready, instruct him or her to assume a full side-bridge position, keeping both legs extended and the sides of the feet on the floor. The elbow of the lower arm should be positioned directly under the shoulder with the forearm facing out (the forearm can be placed palm down for balance and support) and the upper arm should be resting along the side of the body or across the chest to the opposite shoulder.
4. The hips should be elevated off the floor and the body should be in straight alignment (i.e., head, neck, torso, hips, and legs). The torso should be supported only by the client’s foot/feet and the elbow/forearm of the lower arm.
5. Time how long the client can maintain this position until there is a noticeable change in trunk position such as being able to continue to support themselves or hips moving forward or back in an attempt to maintain balance.

Procedure - Trunk Extensor Endurance

1. The starting position requires the client to be prone, positioning the iliac crests at the table edge while supporting the upper extremity on the arms, which are placed on the floor or on a riser.
2. While the client is supporting the weight of his or her upper body, anchor the client’s lower legs to the table using your own body weight or a strap to support the position.
3. Time how long the client can maintain this position until there is a noticeable change in trunk position such as being unable to hold themselves up any longer.

References:

• McGill, Stuart M., Aaron Childs, and Craig Liebenson. "Endurance times for low back stabilization exercises: clinical targets for testing and training from a normal database." Archives of physical medicine and rehabilitation 80.8 (1999): 941-944.
• Esfahani, Naeemeh Haddadi, Zahra Sadat Rezaeian, and Jan Dommerholt. "The number of repetitions of the McGill tests to reliably determine core muscle endurance in subjects with and without chronic nonspecific low back pain: A cross-sectional study." Medical Science 23.98 (2019): 452-461.
• Abdelraouf, Osama Ragaa, and Amr Almaz Abdel-Aziem. "The relationship between core endurance and back dysfunction in collegiate male athletes with and without nonspecific low back pain." International journal of sports physical therapy 11.3 (2016): 337.