AGE, WEIGHT, AND THE FRONT ABDOMINAL
POWER TEST AS PREDICTORS OF ISOKINETIC
TRUNK STRENGTH AND WORK IN
YOUNG MEN AND WOMEN
PATRICK M. COWLEY, SHARON FITZGERALD, KYLE SOTTUNG,
Department of Exercise and Sport Sciences, Ithaca College, Ithaca, New York
ABSTRACT
Cowley, PM, Fitzgerald, S, Sottung, K, and Swensen, T. Age,
weight, and the front abdominal power test as predictors of
isokinetic trunk strength and work in young men and women.
J Strength Cond Res 23(3): 915–925, 2009—First we tested
the reliability of two new field tests of core stability (plank to
fatigue test [PFT] and front abdominal power test [FAPT]), as
well as established measures of core stability (isokinetic trunk
extension and flexion strength [TES and TFS] and work [TEW
and TFW]) over 3 days in 8 young men and women (24.0 6 3.1
years). The TES, TFS, TFW, and FAPT were highly reliable,
TEW was moderately reliable, and PFT were unreliable for use
during a single testing session. Next, we determined if age,
weight, and the data from the reliable field test (FAPT) were
predictive of TES, TEW, TFS, and TFW in 50 young men and
women (19.0 6 1.2 years). The FAPT was the only significant
predictor of TES and TEW in young women, explaining 16 and
15% of the variance in trunk performance, respectively. Weight
was the only significant predictor of TFS and TFW in young
women, explaining 28 and 14% of the variance in trunk
performance, respectively. In young men, weight was the only
significant predictor of TES, TEW, TFS, and TFW, and
explained 27, 35, 42, and 33%, respectively, of the variance
in trunk performance. In conclusion, the ability of weight and the
FAPT to predict TES, TEW, TFS, and TFW was more frequent
in young men than women. Additionally, because the FAPT
requires few pieces of equipment, is fast to administer, and
predicts isokinetic TES and TEW in young women, it can be
used to provide a field-based estimate of isokinetic TES and
TEW in women without history of back or lower-extremity injury.
KEY WORDS athletes, core stability, field test, lower-extremity
injury, reliability
Address correspondence to Patrick M. Cowley, pmcowley@syr.edu.
23(3)/915–925
Journal of Strength and Conditioning Research
Ó 2009 National Strength and Conditioning Association
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AND THOMAS SWENSEN
INTRODUCTION
T
he ability of the lumbopelvic skeletal structures
and musculature to withstand compressive force
on the spine and return the body to equilibrium
after perturbation, as well as to effectively transmit
forces generated by the limbs to their intended action, is
increasingly recognized as an essential component in the
successful performance of activities of daily living and athletic
pursuits (1,18,30,36). These processes, referred to as core
stability, involve the complex interplay between the
abdominal, hip, and spine musculature.
Recent data show that poor core stability is a risk factor for
back and lower extremity injury in athletes; this is particularly
true for female athletes, who are more susceptible to knee
injuries than male athletes (2,7,10,15,22,27–29,37,38). To
reduce the risk of injury, athletes are strongly encouraged to
add core stability exercises to their strength and conditioning
program (1,5,11,25,30,34).
Given the well-established link between core instability and
back and lower-extremity injury, it is paramount for sports
medicine professionals to assess core stability to identify those
at the greatest risk of injury. The complex interplay among the
core musculature, however, makes it difficult to fully assess
core stability with a single test. For example, core instability
could result from insufficient muscular strength, power,
endurance, coordination, or some combination of deficiencies
in these or other variables. Common tests of core stability
include isometric measures of strength and endurance, iso-
kinetic measures of strength and work, and isoinertial tests,
such as the field test of trunk flexor endurance recommended
by the American College of Sports Medicine and National
Strength and Conditioning Association (8,13,16,17,26,32).
These tests have limitations. Isometric tests, for example,
only assess core stability at one muscle length, whereas
isokinetic tests require expensive and immovable machines.
Presently, isokinetic testing of trunk extensor and flexor
strength is the standard measure of core stability in clinical
sports medicine, primarily because it is reliable (8,16). Data
from isokinetic tests are used to assess injury or reinjury risk
and to track preoperative and postoperative rehabilitation
VOLUME 23 | NUMBER 3 | MAY 2009 | 915
Predictors of Isokinetic Trunk Strength and Work
status (9,35). Ultimately, there is a need for robust field tests
that require little or no equipment, are fast to administer, and
assess the various aspects of core stability. Data from these
tests should correlate well with isokinetic trunk flexion and
extension strength; they should also help one accurately
predict isokinetic measures of trunk performance, thereby
allowing comparisons to the body of normative data.
We are aware of only one study that has examined the
relationship between easily administered field tests of core
stability and isokinetic trunk performance. In this study,
3 timed sit-up field tests [(a) Kraus-Weber, American Alliance
of Health, (b) Robertson, and Physical Education, Recreation,
and Dance and (c) (AAHPERD) sit-up protocols] were com-
pared with isokinetic trunk performance in young women and
men (12). There was a significant but weak correlation (r =
0.32–0.42) between the tests and isokinetic trunk perfor-
mance, indicating that timed sit-up field tests are not valid
measures of isokinetic trunk performance when used
individually. Because multiple regression analyses were not
performed, it is not known if results from these field tests,
perhaps combined with selected anthropometric data from the
subjects, can be used to predict isokinetic trunk performance.
The first purpose of this study was to design and test the
reliability of 2 new field tests of core stability: plank to fatigue
test (PFT) and front abdominal power test (FAPT). These
tests were designed to measure the endurance and power of
the core musculature. In conjunction, we examined the
reliability of isokinetic trunk extension and flexion strength
and work. It was expected that the field tests would be reliable
and correlate well with isokinetic measures, but not one
another. Our second purpose was to determine if the results
from those field tests that were reliable could be used, along
with selected anthropometric measures, to accurately predict
isokinetic trunk flexion and extension strength and work in
a group of young men and women.
METHODS
Experimental Approach to the Problem
A preliminary study was conducted to test the reliability of the
selected measures of core stability in a small set of subjects.
This was an a priori decision to ensure the testing protocols
were reliable. Tests of maximal reciprocal concentric iso-
kinetic trunk flexion and extension strength (TFS and TES,
respectively) and work (TFW and TEW, respectively), PFT,
and the FAPT were performed in a single testing session on
3 separate days. Testing sessions 1 and 2 were separated by
7 days, whereas testing sessions 2 and 3 were separated by
2 days. The tests were performed in either of 2 orders: (a)
isokinetic trunk flexion and extension tests, PFT, and the
FAPT, and (b) the reverse order. Half of the participants were
assigned to the first order of tests and half to the reverse order.
The order of tests was the same for each testing session.
We examined the ability of the field tests that were reliable,
along with the subjects’ age and weight, to predict isokinetic
TES, TFS, TFW, and TEW by having subjects perform the
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aforementioned tests in a single testing session. The random-
ization procedure used in the main study was different than in
the preliminary study. For the main study, 24 different order
combinations were generated, and 1 to 2 participants were
assigned to each order combination.
The participants were asked to refrain from exercise,
alcohol consumption, and over-the-counter medications on
the day of testing and not to consume any food or caffeine
30 minutes before the testing session. An exercise and nutri-
tion history questionnaire was used to confirm the absence of
said restrictions.
Subjects
For the preliminary study, 8 subjects (5 women and 3 men)
participated. The mean 6 SD for age, height, and weight of
the women was 24.4 6 4.0 years, 172.2 6 6.6 cm, and 67.5 6
10.2 kg and 23.3 6 0.58 years, 184.6 6 6.4 cm, and 87.3 6
13.7 kg for the men. For the main study, 50 subjects
(31 women and 19 men) participated. The mean 6 SD for
age, height, and weight for the women in this subject cohort
was 19.5 6 1.4 years, 163.2 6 6.8 cm, and 61.8 6 8.8 kg;
corresponding values for the men were 19.2 6 0.8 years,
181.1 6 9.3 cm, and 86.6 6 10.6 kg. Most of the subjects were
physically active, participating in resistance or aerobic exer-
cise training programs 3–7 days per week. Each subject
completed a medical history questionnaire to ensure the
absence of any current or previous back, hip, or leg injury that
would interfere with testing procedures. The Institutional
Review Board at Ithaca College approved the procedures
used in this study, and all subjects gave informed consent
before participation.
Procedures
Isokinetic Trunk Flexion and Extension Strength and Work.
Isokinetic trunk flexion and extension peak torque and work
were determined using a Cybex trunk extension and flexion
dynamometer (Lumex Inc., Ronkonkoma, N.Y.) according
to the protocol of Karatas et al. (16). The subjects were
positioned in the dynamometer according the manufacture’s
recommendations. Briefly, the axis of rotation of the machine
was aligned with the intersection of the midaxillary line and
lumbosacral junction. The leg and calf pads were positioned
to stabilize the lower body in 15 degrees of knee flexion. The
scapular and chest pads were secured so the participant had
a stable pad to exert force against. The range of motion was
set while the subject was in the vertical standing position at
the anatomical reference position of 0 degrees. This also
served as the initial starting position. The total range of
motion was preset to 110 degrees, from 95 degrees of trunk
flexion to 15 degrees of trunk extension. Maximal concentric
trunk flexion and extension contractions were performed
reciprocally at 60 degrees per second. Initially, subjects
performed 4 practice trunk flexion and extension contrac-
tions at minimal exertion. Afterwards, they performed 5
maximal trunk flexion and extension contractions through
the preset range of motion while receiving strong verbal

encouragement from the investigators. The peak torque
attained during the maximal concentric trunk flexion and
extension contractions was taken as a measure of strength,
and the average work performed for the 5 repetitions was
taken as a measure of work.
Plank to Fatigue Test
The prone plank, performed with the toes and forearms in
contact with the floor, is often used as an isometric exercise in
core stability training programs (11). The prone plank tests
the ability of the subject to maintain a neutral back position.
It is performed by first positioning the elbows directly
underneath the shoulders so the upper arms are perpendic-
ular to the floor. The hips are positioned so that a straight line
can be drawn from the shoulders to the ankles through the
hips. The PFT test required subjects to hold the prone plank
position for as long as possible; they were allowed to place
their feet against a wall to help stabilize themselves, and 10%
of their body weight was set on the upper gluteus region to
expedite fatigue (Figure 1). To ensure that the subjects
maintained the plank position throughout the test, certain
measures were taken. First, they completed a 15-second
unloaded practice trial plank in between two 90-cm-tall
vertical rods to determine the hip height they would be
required to maintain during the test; 1 rod was adjacent to
each hip. Plank height was recorded by placing clamps on
each vertical rod. After the 15-second trial, a back-support
belt was attached to the subject. The belt was fitted with a 20-
cm section of horizontally cut metal tubing with a diameter
of approximately 2 cm. The metal half pipe cradled a 90-cm-
long wooden dowel that was laid across the lower back. The
height of each end of this dowel was to be maintained at the
level of the clamps on the vertical rods during the test. A
Figure 1. The plank to fatigue test (PFT) was performed by first
positioning the elbows directly underneath the shoulders so the upper
arms were perpendicular to the floor. The subjects held the prone plank
position for as long as possible; they were allowed to place their feet
against a wall to help stabilize themselves, and 10% of their body weight
was set on the upper gluteus region to expedite fatigue.
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rubber mat was placed underneath the elbows for comfort.
The experimental trial commenced when the additional
weight was placed upon the subject. Verbal feedback
regarding deviation from the starting position was given to
each subject, and an inability to correct the deviation signified
the end of the test. Subjects were verbally motivated
throughout the test but were not informed of the elapsed
time. Time to task failure was recorded in seconds.
Front Abdominal Power Test
The FAPT was modified from Cowley and Swensen (6).
Briefly, an exercise mat was laid on the floor parallel to an
open area free of objects. Subjects were instructed to lay with
their back on the mat, arms along the sides, and feet shoulder
width apart. Knees were then bent to 90 degrees, at which
point the tips of the feet were aligned with the end of the mat.
The feet were then secured to the ground by an E-Z curl bar
(Champion Barbell, Dallas, Tex) weighted with two 20.5-kg
plates. Subjects then raised their arms over their head by
flexing the shoulder; elbows and wrists were extended with
the hands supinated and thumbs from the left and right hands
touching. A 2-kg medicine ball was placed in the supinated
hands, which then cradled the ball. From here, the subject
was instructed to keep the shoulders, elbows, and wrists
locked in this position with the medicine ball securely
cradled in the hands. The subject was then instructed to
perform an explosive concentric contraction of the abdom-
inal and hip flexor muscles while using the arms as a lever to
project the medicine ball. The feet and buttocks remained in
contact with the floor. The medicine ball was released out of
the hands when they were over the subject’s knees. The
distance the medicine ball was projected was recorded and
measured from the tip of the feet to where the medicine ball
landed. The subject was given 3 practice trials and then
performed 6 trials of the FAPT with a rest period of 2 minutes
between trials. The average of 6 trials was used in the data
analyses.
Statistical Analyses
For the preliminary study, a number of reliability analyses
were performed. To detect for learning effect in the measure-
ment protocol, an analysis of variance with repeated measures
was performed with each testing session (session 1, 2, and 3)
as the within-subject factor. The relative reliability of the data
was determined by calculating intraclass correlation coeffi-
cients. For TES, TFS, TEW, TFW, and PFT, a two-way
random effects model with single-measure reliability intra-
class correlation coefficient was calculated, and a two-way
random effects model with average-measure reliability intra-
class correlation coefficient was calculated for the FAPT. The
absolute reliability of the data was determined using the
limits-of-agreement method, SEM, and coefficient of varia-
tion where applicable. First, Bland-Altman plots were gener-
ated to examine the correlation (i.e., R2) between the absolute
differences and the mean values for each test to detect for the
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Predictors of Isokinetic Trunk Strength and Work
presence or absence of heteroscedasticity in the data (4). If
the R2 was between 0 and 0.1, the data were considered
homoscedastic; accordingly, the SEM, limits-of-agreement
method random error, and systematic bias were calculated.
The SEM was calculated using the square root of the mean
square error term from the analysis of variance model. If the
R2 was .0.1, the data were considered heteroscedastic;
accordingly, the coefficient of variation and limits-of-
agreement method ratio were calculated after transforming
the data using a natural logarithm. The coefficient of
variation was calculated for each participant by dividing
the SD of the 2 testing sessions by the mean of the 2 testing
sessions, then multiplying by 100; the mean coefficient of
variation is reported. We deemed that the test-retest
measurement error for TES, TEW, TFS, TFW, PFT, and
FAPT would be acceptable for use during a single testing
session if: (a) intraclass correlation coefficient exceeded 0.85,
(b) the limits-of-agreement method random error and
systematic bias were less than 20 and 5% of the sample
mean between the testing days, respectively, or the limits-of-
agreement method ratio was less than 20%, and (c) the SEM
was less than 10% of the sample mean between the testing
days or the coefficient of variation was less than 10%.
For the main study, a matrix of Pearson correlation
coefficients (R) was generated to assess the direction and
strength of association among selected anthropometric
variables and any measure of core stability with acceptable
single-test reliability. Backward elimination multiple re-
gression was performed with TES, TFS, TEW, or TFW
entered as the dependent variable and age, weight, and any
measure of core stability with acceptable single-test reliability
as a predictor variable. The alpha-to-remove was set at 0.15.
Separate analyses were performed for men and women.
From these analyses, the coefficient of determination (R2)
was determined; it represents the percentage of explained
variance in the respective trunk isokinetic variable and
indicates the predictive ability of the regression models. The
standard error of estimate (SEE) was also calculated; it
indicates the prediction accuracy of the regression models.
TABLE 1. Mean 6 SD for isokinetic trunk extension strength, trunk extension work, trunk flexion strength, trunk flexion
work, plank to fatigue test, and the front abdominal power test for testing session 1, 2, and 3; n = 8.
Variable Testing session 1
Trunk extension strength (N
m21) 176 6 70.1
Trunk extension work (J) 126 6 63.1
Trunk flexion strength (N
m21) 182 6 54.0
Trunk flexion work (J) 147 6 53.3
Plank to fatigue test (s) 94 6 42.4
Front abdominal power test (m) 1.53 6 0.5
*Significantly higher for testing session 2 compared with testing session 1 (p , 0.05).
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To evaluate the quality of the regression models produced
from our data set, we ran a number of diagnostic tests to look
for the following: (a) the influence of outliers or unusual
observations, (b) nonlinearity between the dependent vari-
able and predictor variable(s), and (c) normality and
homoscedasticity of the residuals. The examination of
outliers or unusual observations was performed by evaluating
partial regression plots and by identifying observations with
a standardized residual of .3, a Cook’s D value of .0.13 for
the female analyses and 0.21 for the male analyses, and
a standardized DFBETA value .0.36 for the females analyses
and 0.46 for the male analyses; values are based on sample
size (n = 50). If an observation was identified by the
aforementioned criteria, it was considered an outlier or
unusual observation, and it was removed from the analysis.
Nonlinearity between the dependent variable and predictor
variable(s) was examined by evaluating partial regression
plots to see if the linear model provided the best fit.
Normality of residuals was tested using the Shapiro-Wilk test
of normality. To examine if the variance of the residuals was
homoscedastic, we evaluated the scatter plot of the
standardized residual and predicted values. Finally, we used
the nonparametric bootstrap method to determine the bias-
corrected 95% confidence intervals (CI) and SE of the R2 and
SEE for the final regression models. To do this, we resampled
the data 1000 times to simulate the sampling distribution of
R2 and SEE that would arise from repeatedly sampling the
population (39). The 95% CI and SE of the R2 and SEE
generated from the bootstrap distribution estimate the
precision of the final regression models (31).
Data are presented as mean 6 SD unless otherwise stated.
The alpha was set at p # 0.05. SPSS 13.0 (SPSS, Chicago, Ill)
and STATA 9.2 (STATA, College Station, Tex) statistical
packages were used for data analysis.
RESULTS
Reliability Analyses
For the preliminary study, the mean 6 SD for TES, TFS,
TEW, TFW, PFT, and FAPT are provided in Table 1. There
Testing session 2 Testing session 3
184 6 81.6 193 6 91.6
128 6 72.9 132 6 74.3
179 6 61.1 184 6 56.2
142 6 58.2 147 6 56.8
111 6 46.2* 116 6 41.0
1.63 6 0.5 1.49 6 0.4
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variables (age, weight, and

FAPT) are provided in Table 4.
TABLE 2. Intraclass correlation coefficient and 95% confidence interval for isokinetic The men were heavier than the
trunk extension strength, trunk extension work, trunk flexion strength, trunk flexion women (p , 0.05), and they also
work, plank to fatigue test, and the front abdominal power test over the 3 testing
sessions (n = 8). exhibited greater TES, TEW,
TFS, and TFW (p , 0.05). The
Intraclass correlation coefficient mean distance on the FAPT was
Variable (95% confidence interval) greater for the men than the
Trunk extension strength (N
m ) 21
0.93 (0.80–0.99) women (p , 0.05).
Trunk extension work (J) 0.95 (0.86–0.99) The matrix of Pearson corre-
Trunk flexion strength (N
m21) 0.97 (0.90–0.99) lation coefficients is provided in
Trunk flexion work (J) 0.98 (0.93–0.99) Table 5. For women, weight was
Plank to fatigue test (s) 0.85 (0.61–0.97) significantly correlated with the
Front abdominal power test (m) 0.95 (0.83–0.99)
FAPT (R = 0.41), TFS (R =
0.43), and TFW (R = 0.37).
In addition, the FAPT was
significantly correlated with
was no difference in the mean between the testing sessions TES (R = 0.40), TFW (R = 0.39), and TFS (R = 0.33). For
for TES, TFS, TEW, TFW, and FAPT. There was a signifi- men, weight was significantly correlated with TES (R = 0.52),
cant difference between the mean for the PFT between TEW (R = 0.59), TFS (R = 0.65), and TFW (R = 0.58).
testing session 1 and 2 (94 6 15.0 vs. 111 6 16.3 seconds; p = The results of the regression analyses are provided in Table
0.01). The intraclass correlations coefficients and 95% CI for 6. For women, the only significant predictor of TES and
TES, TFS, TEW, TFW, PFT, and FAPT are provided in TEW was the FAPT, which explained 16 and 15% of the
Table 2. The intraclass correlation coefficients indicate high variance in TES and TEW, respectively. The SEE for the
reliability for all tests. The results of the Bland-Altman plot respective models was 35 N
m21 and 22 N
m21. The only
analyses and the applicable reliability statistics are provided significant predictor of TFS and TFW in women was weight,
in Table 3. Based on the criteria we deemed acceptable for explaining 28 and 14% of the variance in TFS and TFW,
test-retest measurement error, the TES, TFS, TFW, and respectively. The SEE for the respective models was 19
FAPT were shown to possess high reliability for use during N
m21 and 16 N
m21. For men, the only significant predictor
a single testing session, whereas TEW was moderately of TES, TEW, TFS, and TFW was weight, which explained
reliable, and the PFT was not reliable. 27, 35, 42, and 33% of the variance in TES, TEW, TFS, and
TFW, respectively. The SEE for the respective models was
Correlation and Regression Analyses 40 N
m21, 28 N
m21, 20 N
m21, and 19 N
m21. Finally, age
For the main study, the mean 6 SD for the dependent was not a significant predictor of TES, TEW, TFS, and TFW
variables (TES, TFS, TEW, and TFS) and potential predictor in either sex.

TABLE 3. Results of the Bland-Altman plot analyses and applicable reliability statistics (limits-of-agreement [LOA], SEM,
and coefficient of variation [CV]) for isokinetic trunk extension strength (TES), trunk extension work (TEW), trunk flexion
strength (TFS), trunk flexion work (TFW), plank to fatigue test (PFT), and the front abdominal power test (FAPT) over the
3 testing sessions (n = 8).

Testing session

TES (N
m21) TEW (J) TFS (N
m21) TFW (J) PFT (s) FAPT (m)

Statistic 1 vs. 2 2 vs. 3 1 vs. 2 2 vs. 3 1 vs. 2 2 vs. 3 1 vs. 2 2 vs. 3 1 vs. 2 2 vs. 3 1 vs. 2 2 vs. 3

Heteroscedastic? YES YES YES YES YES NO YES YES NO NO YES YES
Random error 33 28 36
Systematic bias 5 16.5 5.9
LOA ratio (%) 15 17 23 13 9 15 17 15 17
SEM 12 10 13
CV (%) 9 9 12 7 6 9 9 9 9

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Predictors of Isokinetic Trunk Strength and Work

For the final models, the partial

TABLE 4. Mean 6 SD for front abdominal power test, isokinetic trunk extension
strength, trunk extension work, trunk flexion strength, and trunk flexion work.
Sex Variable
Women (n = 31) Age (y)
Weight (kg)
Front abdominal power test (m)
Trunk extension strength (N
m21)
Trunk extension work (J)
Trunk flexion strength (N
m21)
Trunk flexion work (J)
Men (n = 19) Age (y)
Weight (kg)
Front abdominal power test (m)
Trunk extension strength (N
m21)
Trunk extension work (J)
Trunk flexion strength (N
m21)
Trunk flexion work (J)
*Significantly higher for men than women (p , 0.05).
The diagnostic tests indicated that these regression models
provided an acceptable description of the data because no
violations of the assumptions were observed. Only one outlier
or unusual observation was identified during the regression
analysis for women with TFS serving as the dependent
variable. The observation was omitted from the analysis
because the standardized residual was .4, Cook’s D value
was .0.13, and the standardized DFBETA value was .0.36.
regression plots of the depen-
dent and predictor variables
indicated the linear model pro-
Mean 6 SD vided the best fit for the data.
The Shapiro-Wilk test of nor-
19.0 6 1.4 mality indicated the residuals
61.8 6 8.8
were normally distributed (p .
0.87 6 0.2
120.8 6 37.5 0.05). Finally, the scatter plot of
75.2 6 23.8 the standardized residual and
139.5 6 28.0 predicted values suggested ho-
91.1 6 17.0 moscedasticity for all models.
19.0 6 0.8
The bootstrap bias-corrected
86.6 6 10.6*
1.3 6 0.3* 95% CI and SE for R2 and the
267.5 6 45.0* SEE are provided in Table 6.
178.7 6 33.1* The results indicate the true
247.5 6 25.8* value of the SE of R2 in the
181.1 6 22.1*
population for the TES, TEW,
TFS, and TFWregression models
ranges from 0.11 to 0.12 for
women and 0.16 to 0.19 for
men. The true value of R2 in the
population for the TES, TEW,
TFS, and TFW regression models likely falls between 0.001
and 0.51 in women and 0.003 and 0.77 in men. Further, the
true value of the SE of the SEE in the population for the TES,
TEW, TFS, and TFW regression models ranges from 1.8 to
3.1 N
m21 in women and 3.2 to 5.3 N
m21 in men. The true
value of the SEE in the population for the TES, TEW, TFS,
and TFW regression models likely falls between 13.3 and
41.6 N
m21 in women and 13.2 and 50.0 N
m21 in men.

TABLE 5. Pearson correlation coefficients between age, weight, front abdominal power test (FAPT), isokinetic trunk
extension strength (TES), trunk extension work (TEW), trunk flexion strength (TFS), and trunk flexion work (TFW) for men
and women (n = 50).

Sex Age Weight FAPT TES TEW TFS TFW

Women Age 1.00

Weight 20.09 1.00
FAPT 20.24 0.41* 1.00
TES 20.05 0.10 0.40* 1.00
TEW 20.10 0.11 0.39* 0.95* 1.00
TFS 20.14 0.43* 0.33* 0.51* 0.48* 1.00
TFW 20.03 0.37* 0.27 0.50* 0.52* 0.76* 1.00
Men Age 1.00
Weight 0.00 1.00
FAPT 0.38 20.33 1.00
TES 0.22 0.52* 20.12 1.00
TEW 0.11 0.59* 20.13 0.94* 1.00
TFS 0.17 0.65* 20.22 0.46* 0.58* 1.00
TFW 0.16 0.58* 20.07 0.55* 20.13 0.89* 1.00
*Correlation is significantly higher than 0.

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DISCUSSION
The purpose of this study was to test the reliability of 2 new
(TFS), or trunk flexion work (TFW) serving as the dependent variable and potential predictor variables of age, weight, and front abdominal power test (FAPT). The
TABLE 6. Regression prediction equations for men and women with isokinetic trunk extension strength (TES), trunk extension work (TEW), trunk flexion strength

of estimate (SEE) for the model, SE of the SEE from the bootstrap distribution, and bias-corrected 95% CI of the SEE from the bootstrap distribution are provided.
p-value, R2 for the model, SE of R2 from the bootstrap distribution, bias-corrected 95% confidence interval (CI) of R2 from the bootstrap distribution, standard error

30.4–41.6
18.3–27.8
14.5–24.2
13.3–20.8
29.2–50.0
20.8–37.0
15.0–26.5
13.2–25.3
95% CI
field tests of core stability: PFT and FAPT. We also

SEE
reexamined the reliability of isokinetic TES and TFS, which
are the current standard measures used to assess core stability.
In conjunction, we tested the reliability of isokinetic TFWand
TEW. Afterwards, we examined the relationship among the
various tests and then assessed if the field tests, along with
SE of the
SEE

selected anthropometric data, were predictive of isokinetic

3.1
2.4
2.5
1.8
5.3
4.1
3.2
3.2
TES, TEW, TFS, and TFW.

Reliability of Selected Measures of Core Stability

35.0
22.3
19.3
16.1
39.6
27.5
20.2
18.6
SEE

It is important to know the reliability or consistency of a

measure because it allows one to effectively interpret the
outcome of a training program. For example, is a change in
strength, either from injury or rehabilitation, real or is it an
0.03–0.51

0.05–0.65
0.03–0.77
0.02–0.68
0.007–0.43
0.004–0.43

0.001–0.40
0.003–0.58
95% CI

artifact of the measurement error associated with the test used

R2

to assess the change? We found TES, TFS, TFW, and the

FAPT were highly reliable during 3 testing sessions in a small
group of young men and women without any history of back,
hip, or leg injury. In contrast, TEW was only moderately
reliable, whereas the PFT was not reliable. Therefore, mea-
SE of

0.12
0.12
0.12
0.11
0.16
0.16
0.19
0.18
R2

sures of TES, TFS, TEW, and TFW using a dynamometer

and the FAPT can be used during a single testing session to
obtain reliable data. This conclusion is drawn from the
process we used.
0.16
0.15
0.28
0.14
0.27
0.35
0.42
0.33
2
R

First, we used an analysis of variance with repeated mea-

sures to look for a learning effect in the measurement proto-
col. We found a small nonsignificant change in TES, TEW,
0.03
0.03
0.00
0.04
0.02
0.01
0.00
0.01

TFS, TFW, and FAPT between the first and second and
P

second and third testing sessions. This finding indicates that

our measurement protocol limited possible learning effects for
these tests. There was, however, a significant increase in per-
TFS = weight (kg) 1.588 + 110.039
TES = FAPT (m) 77.488 + 53.410

TES = weight (kg) 2.202 + 76.797

TEW = weight (kg) 1.853 + 18.228
TFW = weight (kg) 0.701 + 47.740

TFW = weight (kg) 1.205 + 76.789

TEW = FAPT (m) 48.545 + 32.967
TFS = weight (kg) 1.290 + 56.564

formance on the PFT between the first and second testing

Regression prediction equations

session of 18% but not between the second and third testing
session (change in performance of only 5%), which indicates
a learning effect in the measurement protocol between the
first and second testing sessions. Based on these data, we do
not recommend using the PFT when only one testing session
is used.
After looking for possible learning effects, we determined
the relative reliability of each measure by calculating its
intraclass correlation coefficient. The intraclass correlation
coefficients for TES, TFS, TEW, TFW, FAPT, and PFT were
0.93, 0.95, 0.97, 0.98, 0.95, and 0.85, respectively. These data
show that all tests had excellent test-retest reliability.
Although the use of the intraclass correlation coefficient is
31
31
30
31
19
19
19
19
N

recommended as a measure of reliability, it cannot be the only

statistical measure of reliability because it is affected by sample
heterogeneity. Therefore, it is recommended that absolute
Women
Sex

measures of reliability, such as the SEM, coefficient of

Men

variation, and limits-of-agreement method be used in

conjunction with intraclass correlation coefficients to fully
assess the reliability of a test.

VOLUME 23 | NUMBER 3 | MAY 2009 | 921

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Predictors of Isokinetic Trunk Strength and Work
The appropriate measure of absolute reliability depends on
the presence of heteroscedasticity in the data set. Hetero-
scedasticity is an important issue in sports medicine research
and practice because its presence indicates that the amount of
random error of a test increases as the score on the test
improves. If data are heteroscedastic, an appropriate measure
of absolute reliability is the coefficient of variation, whereas
the SEM is used with homoscedastic data (3). Bland-Altman
plots indicated that TES, TEW, TFW, and FAPT data were
heteroscedastic, whereas the PFT data were homoscedastic.
The TFS data were heteroscedastic between the first and
second testing sessions but homoscedastic between second
and third testing sessions. The appropriate reliability statistics
are displayed in Table 3. Interpreting these statistics is
straightforward; for example, because the SEM for TFS
between the first and second testing sessions was 12 N
m21,
the typical score for TFS will vary by 612 N
m21 on any
given day. Similarly, because the coefficient of variation for
TES is 9% between the first and second testing sessions, 68%
of the difference between repeated TES tests lies within 9% of
the mean of the data.
The limits-of-agreement method can also be used to assess
the absolute reliability of both homoscedastic and hetero-
scedastic data. The major advantage of using the limits-of-
agreement method as a measure of absolute reliability is that it
includes 95% of the variability (or error) in the test, whereas
the SEM and coefficient of variation account for only 68% of
the associated measurement error (3). For example, the
systematic bias and random error for the PFT between the
first and second testing sessions was 16.5 and 28 seconds,
respectively. This indicates the expected systematic bias is
positive, and the range of random error between 2 tests
is 628 seconds with 95% probability. Interpreting the limits-
of-agreement method ratio is also straightforward. For
example, because the limits-of-agreement method ratio
for the FAPT between the second and third testing sessions
was 17%, the expected difference between any two tests
caused by the measurement error will be no more than 617%
in new individuals from the studied population (3).
It is important to note that, whereas the limits-of-
agreement method is recommended by some statisticians
(4), others suggest it is too stringent to help determine if
a change in an individual’s score is real or an artifact of
measurement error (14). For this reason, we reported both
the SEM and coefficient of variation, which are less stringent
then limits of agreement method.
We deemed that the test-retest measurement error for TES,
TEW, TFS, TFW, FAPT, and PFT would be acceptable for
use during a single testing session if: (a) the intraclass
correlation coefficient was .0.85, (b) the limits-of-agreement
method random error and systematic bias were ,20 and 5%
of the sample mean between the testing days, respectively, or
the limits-of-agreement method ratio was ,20% (depending
on the presence or absence of heteroscedasticity), and (c)
SEM was ,10% of the sample mean between the testing days
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922 Journal of Strength and Conditioning Research
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or the coefficient of variation was ,10% (depending on the
presence or absence of heteroscedasticity). According to the
criteria, we found that TES, TFS, TFW, and the FAPT were
highly reliable across a span of the 3 testing sessions, which
indicates they can be used when only 1 testing session is used.
For TEW, the limits-of-agreement method ratio and the
coefficient of variation between the first and second testing
sessions were slightly higher than our established cutoffs but
still acceptable; hence, TEW is moderately reliable when
only 1 testing session is used. The PFT did not meet the
established criteria for high reliability when only 1 testing
session is used. Future investigators may wish to modify the
test or measurement protocol to enhance data reliability.
Our findings that isokinetic reciprocal concentric trunk
flexion and extension peak torque measurements made at
60 degrees per second are highly reliable using a dynamom-
eter support the work of Karatas et al. (16), who used a
measurement protocol similar to ours. They found intraclass
correlation coefficients ranging from 0.89 to 0.95 for TFS and
0.80 to 0.92 for TES during 3 testing sessions, each separated
by 48 hours, in 15 healthy subjects. Our data also extend the
findings of Karatas et al. (16) by providing measures of
absolute reliability, such as the SEM, coefficient of variation,
and limits-of-agreement method. These measures provide
tangible values for measurement errors that one is likely to
find when assessing TES and TFS with an isokinetic
dynamometer, which enables one to better determine if a
change in performance is real or simply an artifact of test
measurement error. The intraclass correlation coefficient, a
measure of relative reliability that is highly affected by
sample heterogeneity, does not provide this pertinent
information.
Others have found tests of isokinetic trunk flexion and
extension strength to be reliable and unreliable using different
protocols than our own (8,17,23). Collectively, the data from
the various studies examining TES and TFS show that the
measurement protocol used in this study and by Karatas et al.
(16) should be used to measure isokinetic trunk flexion and
extension strength in healthy participants.
Our findings also indicate the FAPT is a highly reliable field
test of core stability. These data are consistent with the
findings from Cowley and Swensen (6), who showed that
FAPT was highly reliable in 24 young women across 2 testing
sessions separated by 24 hours. We modified the test by
Cowley and Swensen (6) by anchoring the subjects’ feet to
the ground and using an average of 6 trials as opposed to only
3 trials. Cowley and Swensen (6) reported an intraclass
correlation coefficient for the FAPT of 0.95, a SEM of 0.24 m,
and a random error using the limits-of-agreement method of
0.68 m. These data agree with the findings from the present
study, where the intraclass correlation coefficient for the
FAPT was 0.95, the coefficient of variation was 9% (0.14 m),
and the limits-of-agreement method ratio was 15% (0.24 m).
Collectively, the data from both studies indicate that the
FAPT is a highly reliable field test of core stability.

Sex Differences in Selected Measures of Core Stability
The men had greater TES, TEW, TFS, and TFW than the
women, findings that support the literature (8,12). Men also
performed better on the FAPT. This finding has not been
previously reported. A likely explanation for the sex differ-
ences in the aforementioned variables is that young men have
greater fat-free or muscle mass than young women (20,33).
Our reasoning is only speculative, given that we did not
measure body composition in our subject cohort.
Correlation Analyses of Selected Measures of Core Stability
A matrix of Pearson correlation coefficients was generated to
assess the direction and strength of association among
selected anthropometric variables and any measure of core
stability with acceptable single-test reliability. Age was not
significantly correlated with weight, FAPT, TES, TEW, TFS,
and TFS in men and women. This is not surprising, con-
sidering our subjects were young, with no previous history of
low back pain or injury.
For men, there was a significant positive correlation
between weight and TES, TEW, TFS, and TFW (R =
0.52–0.65). These data are similar to findings from Mannion
et al. (24), who showed weight is positively correlated with
isometric trunk extensor strength in men (R = 0.68). In
contrast, there was no relationship between the FAPT and
TES, TEW, TFS, and TFW, suggesting that these tests mea-
sure different aspects of core stability in young men. This
finding confirmed expectations because each measure of core
stability is highly specific, and measures of isokinetic trunk
strength are weakly correlated with timed sit-up field tests
(12,19,21). Finally, the FAPT was not correlated with weight
in men.
For women, there was a significant positive correlation
between weight and TFS and TFW (R = 0.43 and 0.37,
respectively) but not TES and TEW (R = 0.10 and 0.11,
respectively). Our TES data on women are inconsistent with
findings from Mannion et al. (24), who showed weight is
positively correlated with isometric trunk extensor strength
in women (age range, 18–42 years; R = 0.64). There was also
a significant positive relationship between the FAPT, TES,
TEW, and TFS (R = 0.33–0.40) but not TFW (R = 0.27) in
women. In contrast to the men, there was a significant posi-
tive correlation between the FAPT and weight in the young
women.
Combined, the correlation data indicate there is a differen-
tial relationship between weight and TES and TEW between
the sexes because weight is more related to TES and TEW
in men than women. Additionally, there is a differential
relationship between the FAPT and TES, TEW, and TFS
between the sexes because the FAPT is more related to TES,
TEW, and TFS in young women than men. Thus, the
relationship between weight and isokinetic trunk perfor-
mance is apparently stronger in young men than women,
whereas the relationship between the FAPT and isokinetic
trunk performance seen in young women is absent in men.
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Predictors of Isokinetic Trunk Flexion and Extension
Strength and Work
We sought to determine if the PFTand FAPT were predictive
of isokinetic trunk flexion and extension strength and work
capacity in a group of young men and women. We were only
able to include 1 field test in our regression analyses because
the PFT was not reliable for use during a single testing session.
We used age, weight, and the FAPT to predict isokinetic trunk
performance in the hope that this type of prediction equation
could be used by sports medicine professionals working in the
field to adequately predict isokinetic trunk performance in
a short amount of time with few pieces of equipment, thereby
enabling them to make comparisons to the body of normative
data for such measures in the literature.
Results from the regression analyses were consistent with
the correlation analyses and indicated that in young men,
weight was the only significant predictor of TES, TEW, TFS,
and TFW, explaining 27, 35, 42, and 33% of the variance,
respectively. In young women, weight was the only significant
predictor of TFS and TFW, explaining 28 and 14% of the
variance, respectively, whereas the FAPT was the only
significant predictor of TES and TEW, explaining 16 and 15%
of the variance, respectively. This latter finding was un-
expected because the primary body movement during the
FAPT is trunk flexion, whereas TES and TEWprimarily stress
the trunk extensors. Given that the FAPT is a dynamic
movement in which the arms are extended overhead, perhaps
the test required more trunk extensor activity in the women
than the men to help stabilize the body.
Overall, the ability to predict TES, TEW, TFS, and TFW
from weight and the FAPT is less likely in young women than
men because the different regression models explained only
14–28% of the variability in TES, TEW, TFS, and TFW for
young women, compared to 33–42% in young men. The pre-
dictive accuracy of our regression models ranged from 16 to
35 N
m21 in women and 19 to 40 N
m21 in men. Of special
note is that the FAPT was the only significant predictor of
TES and TEW in young women. This finding has practical
significance because the FAPT can be administered fairly
quickly to provide a field based estimation of TES and TEW
in young women using our prediction equation.
To provide an estimate of the predictive ability and
accuracy of our sample regression models in the population at
large, we used the nonparametric bootstrap method to gen-
erate bias-corrected 95% CI and SE for R2 and SEE from our
subject sample (31). The true value of the SE of R2 in the
population for the TES, TEW, TFS, and TFW regression
models ranged from 0.11 to 0.12 in women and 0.16 to 0.19 in
men. Hence, we are 95% confident the true value of R2 in the
population for the TES, TEW, TFS, and TFW regression
models is somewhere between 0.001 and 0.51 in women and
0.003 and 0.77 in men. Similarly, the true value of the SE of
the SEE in the population for the TES, TEW, TFS, and
TFW regression models ranged from 1.8 to 3.1 N
m21 for
women and 3.2 to 5.3 N
m21 for men. Thus, we are 95%
VOLUME 23 | NUMBER 3 | MAY 2009 | 923
Predictors of Isokinetic Trunk Strength and Work
confident the true value of SEE in the population for the TES,
TEW, TFS, and TFW regression models is likely between
13.3 and 41.6 N
m21 in women and 13.2 to 50.0 N
m21 in men.
Ultimately, to fully validate our regression models, additional
population samples (i.e., competitive athletes) must be
examined. Additional potential carriers that correlate with
isokinetic trunk performance could also be added to improve
the predictive ability and accuracy of the equations.
In conclusion, the major findings of this study are: (a) TES,
TFS, TFW, and the FAPTare highly reliable, whereas TEW is
moderately reliable for use during a single testing session in
young men and women, (b) the PFT is not reliable, and future
investigators may wish to develop better measurement
protocols for this test, (c) the FAPT was the only significant
predictor of TES and TEW in young women, (d) weight was
the only significant predictor of TFS and TFW in young
women and the only significant predictor of TES, TEW, TFS,
and TFW in young men, and (e) the ability of weight and the
FAPT to predict TES, TEW, TFS, and TFW was higher in
young men than women. Finally, because the FAPT requires
few pieces of equipment, is fast to administer, and predicts
isokinetic TES and TEW in young women, it may be used to
provide a field-based estimate of isokinetic TES and TEW in
young women without history of back or lower-extremity
injury.
PRACTICAL APPLICATIONS
There is a need for field tests that are reliable, require little or
no equipment, are fast to administer, and assess the various
aspects of core stability. In addition, it would be ideal if these
tests could accurately predict isokinetic trunk flexion and
extension strength, thereby allowing comparisons to the body
of normative data. The FAPT is a reliable field test of core
stability that requires a 2-kg medicine ball and tape measure.
Performing 6 trials of the FAPT during a single testing session
can provide reliable data for this test. It is important, however,
to determine the reliability of this test in your laboratory or
facility before implementation. An example of the usefulness
of our reliability statistics follows: assume performance on the
FAPT was 1.5 m before the implementation of a core stability
training program and improved to 1.8 m afterwards. Is the
0.3-m increase in performance an actual improvement or just
an artifact of test measurement error? Given that the 0.3-m
change is greater than the expected error using the coefficient
of variation (0.14 m) and limits-of-agreement ratio (0.24 m),
performance has likely increased. The results of the FAPTcan
also be used to predict isokinetic trunk extension strength and
work capacity in young women with no previous history of
back or lower-extremity injury. An example of the usefulness
of our regression equation follows: assume performance on
the FAPT for a young woman was 1.25 m. What is the
predicted isokinetic strength for this woman? Multiply the
FAPT distance by 77.488, and then add 53.41; the predicted
isokinetic trunk extension strength for this woman is
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924 Journal of Strength and Conditioning Research
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150.3 N
m21. We are 95% confident the predicted value will
be 150 6 30 to 42 N
m21.
ACKNOWLEDGMENTS
The authors would like to express their appreciation to the
individuals who participated in this study.
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