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Sport-specific endurance plank test for evaluation of global core muscle

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Article  in  Physical therapy in sport: official journal of the Association of Chartered Physiotherapists in Sports Medicine · July 2013
DOI: 10.1016/j.ptsp.2013.03.003 · Source: PubMed

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Physical Therapy in Sport 15 (2014) 58e63

Contents lists available at SciVerse ScienceDirect

Physical Therapy in Sport

journal homepage: www.elsevier.com/ptsp

Original research

Sport-specific endurance plank test for evaluation of global core

muscle function
Tom K. Tong a, *, Shing Wu a, Jinlei Nie b
a
Dr. Stephen Hui Research Centre for Physical Recreation and Wellness, Department of Physical Education, Hong Kong Baptist University, Hong Kong, China
b
School of Physical Education and Sports, Macao Polytechnic Institute, Macao, China

a r t i c l e i n f o a b s t r a c t

Article history: Objective: To examine the validity and reliability of a sports-specific endurance plank test for the eval-
Received 6 June 2012 uation of global core muscle function.
Received in revised form Design: Repeated-measures study.
28 February 2013
Setting: Laboratory environment.
Accepted 15 March 2013
Participants: Twenty-eight male and eight female young athletes.
Main outcome measures: Surface electromyography (sEMG) of selected trunk flexors and extensors, and
Keywords:
an intervention of pre-fatigue core workout were applied for test validation. Intraclass correlation co-
Sport
Core muscle
efficient (ICC), coefficient of variation (CV), and the measurement bias ratio */O ratio limits of agreement
Plank test (LOA) were calculated to assess reliability and measurement error.
Results: Test validity was shown by the sEMG of selected core muscles, which indicated >50% increase in
muscle activation during the test; and the definite discrimination of the w30% reduction in global core
muscle endurance subsequent to a pre-fatigue core workout. For test-retest reliability, when the first
attempt of three repeated trials was considered as familiarisation, the ICC was 0.99 (95% CI: 0.98e0.99),
CV was 2.0
1.56% and the measurement bias ratio */O ratio LOA was 0.99 */O 1.07.
Conclusion: The findings suggest that the sport-specific endurance plank test is a valid, reliable and
practical method for assessing global core muscle endurance in athletes given that at least one famil-
iarisation trial takes place prior to measurement.
Ó 2013 Elsevier Ltd. All rights reserved.

1. Introduction
It is known that the definitions of core stability and associated
anatomy in the rehabilitation sector differ to those in the sporting
sector (Hibbs, Thompson, French, Wrigley, & Spears, 2008). In view of
low back injury rehabilitation, which aims to enhance the ability of
the lumbopelvic-hip structures and musculature for maintaining the
intervertebral range of motion within a safe limit when daily activities
are carried out, the musculatures of the diaphragm, abdominals,
paraspinals, gluteals, pelvic floor and hip girdle are core (Richardson,
Jull, Hodges, & Hides, 1999). In a sporting environment, core stability
is defined as the ability to control the position and motion of the trunk
over the pelvis to allow the optimum transfer of energy from the torso
to extremities when performing athletic activities, which are often
composed of highly loaded movements (Kibler, Press, & Sciascia,
2006). For this specific purpose, core muscles are commonly
* Corresponding author. DLB642, L6, David C. Lam Bldg., Department of Physical
Education, Shaw Campus, Hong Kong Baptist University, Renfrew Rd., Kowloon
Tong, Hong Kong, China. Tel.: 852 3411 7770; fax: 852 3411 5756.
E-mail address: tongkk@hkbu.edu.hk (T.K. Tong).
referred to as all the muscles between the knee and sternum with a
focus on the abdominal region, low back and hip (Fig, 2005).
As a result of awareness of the importance of core stability to
sports performance, core muscle training became a routine part of
athletic training in most sports (Hibbs et al., 2008). For monitoring the
specific training, core stability field tests were usually applied due to
their convenience. These tests, in general, consisted of isometric
measures of endurance and were originally designed for rehabilita-
tion use (McGill, 2007). It has been shown that the core muscle load
during various stability field tests depends on the joint torques
required to hold a specific posture (McGill, Belore, Crosby, & Russell,
2010). Hence, testing results are specific and not interchangeable.
This implies that those core tests established in rehabilitation settings
may not be accurate to reveal the functional capacity of the complex
core anatomy that is specific to dynamic athletic performance.
Due to the need for a means of monitoring the development of
core muscle function in athletes, Mackenzie (2005) developed a
sport-specific core muscle test. The core test requires the athlete to
maintain a prone bridge (plank) position with their arms and legs
lifted up alternatively for 15 s in each stage for eight stages, over a
total of three minutes. Core muscle function is assessed based on

1466-853X/$ e see front matter Ó 2013 Elsevier Ltd. All rights reserved.
http://dx.doi.org/10.1016/j.ptsp.2013.03.003
 Author's personal copy
T.K. Tong et al. / Physical Therapy in Sport 15 (2014) 58e63
the number of stages completed. Advocates of this test claimed that
the plank manoeuvre interspersed with the alternate raising of the
arms and legs challenges the trunk flexors and lumbar extensors in
a manner that is similar to that occurring in performing sports
movements where the muscles are being recruited for giving core
stiffness to maximise the kinetic chains of upper and lower ex-
tremity function (Kibler et al., 2006; Schellenberg, Lang, Chan, &
Burnham, 2007). However, this claim has not been validated, nor
has the reliability of the test been established.
The purposes of this study were to examine the validity and
reliability of the sports-specific core muscle test. In an attempt to
advance the discrimination power of the test, the ceiling of the 3-
min testing time was removed. Instead, the participants were
asked to repeat the 3-min testing circuit until the maintenance of
the prone bridge failed. Such modification was in accordance with
the previous notion that core muscle endurance, rather than
strength, is essential for trunk stability during exercise (Hibbs et al.,
2008). Furthermore, the reliability of the sport-specific endurance
plank test in the present study was evaluated, with the position of
participants’ elbows and feet were found to be identical among
trials, while the hip displacement during the test was limited
objectively within a narrow range.
2. Methods
2.1. Participants
28 male and 8 female participants (age: 22.4
3.7 years, height:
168.6
5.2 cm, weight: 58.7
5.9 kg) were recruited from a
convenient group of athletes in a university who received training in
different sports, including long-distance running, swimming and
team ball games for at least two years. They were trained for 2e
3 h d1, 3e4 days wk1 in order to compete in intercollegiate and
local competitions. All athletes had no orthopaedic or cardio-
respiratory contraindications to exercise. After being fully informed
of the experimental procedures and possible discomfort associated
with the exercise test, athletes gave their written consent. Ethical
approval for this study was obtained from the Committee on the Use
of Human and Animal Subjects in Teaching and Research of Hong
Kong Baptist University.
2.2. Study design
Evaluations of the sport-specific endurance plank test were
conducted in two phases: validation and reliability.
2.2.1. Validation
In the present study, the validity of the test was evaluated based
on the electromyographic analysis of selected core muscles during
the test, and the acute alterations of the performance of the test
subsequent to an intervention of pre-fatigue core workout. For the
surface electromyographic (sEMG) assessment, eight of the 28 male
participants were randomly selected. The sEMG of selected core
muscles during the sport-specific endurance plank test, expressed
as a percentage of the corresponding sEMG output during
maximum voluntary isometric contraction, were analysed. For
further examination of the construct validity of the test, another
eight of the resting male participants were randomly selected. The
performance of the sport-specific endurance plank test with and
without a pre-fatigue core workout was compared. Half of the
participants performed the plank test with and then without pre-
fatigue core workout, while the others performed the tests in
reverse order. Prior to the experiments, a trial was undertaken to
familiarise the participant with the test to exhaustion.
59
2.2.2. Reliability
For examining the reliability of the sport-specific endurance
plank test, the resting 12 male participants and the 8 female par-
ticipants repeated the test three times on separate days. Both the
absolute and the relative measures of reliability were assessed to
determine whether the amount of measurement error fits the
analytical goals of the test (Cowley & Swensen, 2008). Prior to the
tests, a non-exhausted trial was undertaken to familiarise the
participant with the testing protocol.
All experimental and familiarisation trials were performed in an
air-conditioned laboratory with the temperature and relative hu-
midity set at 22  C and 70%, respectively. Before each trial, the
participants refrained from eating for at least two hours and from
participation in strenuous physical activity for at least one day. All
trials were scheduled to occur at the same time of day and were
separated by a minimum of 3 days.
2.3. Sport-specific endurance plank test
Participants started the test by holding a basic plank position e a
prone bridge supported by the forearms and feet (Fig. 1). Elbows
were vertically below the shoulders with the forearms and fingers
extending straight forward. The neck was kept neutral so that the
body remained straight from the head to the heels. Participants
were required to maintain the prone bridge in a good form
throughout the following stages with no rest in between: (1) hold
the basic plank position for 60 s; (2) lift the right arm off the ground
and hold for 15 s; (3) return the right arm to the ground and lift the
left arm for 15 s; (4) return the left arm to the ground and lift the
right leg for 15 s; (5) return the right leg to the ground and lift the
left leg for 15 s; (6) lift both the left leg and right arm from the
ground and hold for 15 s; (7) return the left leg and right arm to the
ground, and lift both the right leg and left arm off the ground for
15 s; (8) return to the basic plank position for 30 s; (9) repeat the
steps from (1) to (9) until the maintenance of the prone bridge
failed.
In this study, in regard to the sport-specific endurance plank test
that each participant repeated with identical body posture, the
distances between the left and right elbows (medial epicondyle),
the left and right feet (1st metatarsal), and the elbow and feet on
the left and right sides of the body were measured during the
familiarisation trial while the participant was comfortably per-
forming the prone bridge basic plank position on a bench. Further,
two elastic strings of w80 cm length which were attached hori-
zontally to a pair of vertical scales were placed beside the bench
during the test (Fig. 1). The two strings maintained at a distance of
10 cm were adjusted up and down until a height was reached that
was at the same level as the participant’s hip (the iliac crest was
Fig. 1. The setting of the sport-specific endurance plank test (from the view of test
administrator), with the subject remaining in the basic plank position, is shown.
 Author's personal copy
60 T.K. Tong et al. / Physical Therapy in Sport 15 (2014) 58e63
evenly in between the two strings). This setting acted as a reference
for the objective monitoring of hip displacement during the test.
The measured distances between elbows and feet, as well as the hip
height, remained constant in subsequent experimental trials.
During the test, the test administrator sat on a chair 1 m away
from the bench with the seat height adjusted to a level so that the
hip displacement of the participant could be monitored horizon-
tally. The participant was then asked to maintain the prone bridge
throughout the test with maximum effort. For each time that the
hip was beyond either of the reference lines, a warning would be
given. The test would be terminated when the hip failed to be
maintained at the required level after receiving two consecutive
warnings. The measured time to exhaustion was used to reveal
the endurance capacity of the global core muscle of the
participant.
2.4. Surface electromyographic (sEMG) measurements
For test validation, sEMG data from rectus abdominis (RA),
external oblique abdominis (EO) and erector spinae (ES) on the
right side of the body were collected during the sport-specific
endurance plank test. The locations of electrode placement were
in accordance with those previously described (Cram & Kasman,
1998). For the RA, a pair of electrodes was placed 3 cm lateral to
the umbilicus. For EO and ES, the paired electrodes were placed
midway between the anterior superior iliac spine and the rib cage,
and 2 cm lateral to the L4-L5 interspace, respectively. Prior to
measurement, the sites for electrode placement were prepared by
performing abrasion with fine sandpaper and cleaning with alcohol
swabs. The paired sEMG electrodes (PG-10S, FIAB SpA, Firenze,
Italy) were then placed parallel to the muscle fibres, 7.6 cm apart.
During the test, EMG data of the selected muscle groups were
collected synchronously using the BTS FREEEMG 300 system (BTS,
MI, Italy). The system was interfaced with a computer, and Myolab
2.2 software (BTS, MI, Italy) was used for data processing and
analysis. The sampling rate for each channel was set at 1000 Hz.
During data collection, the EMG signals were full-wave rectified,
processed using a root mean squared algorithm, and smoothed
with a 100-ms moving window. Filtering of EMG signals was per-
formed using standard band-pass filtering techniques with band-
pass filters set at cut-offs of 20 Hz and 350 Hz, respectively. The
average values of data recorded from 10th to 15th second in stage 1,
and from 5th to 10th second in stage 2e8 of each circuit during the
plank test were selected for analysis.
For normalisation, each selected muscle performed maximum
voluntary isometric contraction (MVIC) and the sEMG amplitude
for the maximum manoeuvre was recorded. The activities for each
muscle to perform MVIC against manual resistance were consistent
with those applied in the study of Schellenberg et al. (2007). After
familiarisation, the participant performed MVIC during each ac-
tivity for 5 s. The average values of the EMG data recorded from the
2nd to 4th second during the 5-s MVIC of each muscle represented
100% muscle activity. The muscle activity recorded during the plank
test was expressed by %MVIC.
2.5. Pre-fatigue core workout
Each participant consecutively performed four sets of circuit
exercises consisting of: (1) seated upper torso rotation with a 4 kg-
medicine ball, (2) static prone torso extension with a 4 kg-medicine
ball, (3) supine lower torso rotations with a 4 kg-medicine ball, (4)
sit-ups with a 10-lb dumb-bell, (5) lateral side bend with a 10-lb
dumb-bell, and (6) rotating lumbar extension with a 10-lb dumb-
bell. The duration of each exercise was 40 s followed by a 20-
s recovery. A similar exercise protocol has been shown to effectively
fatigue the core muscles (Abt, Smoliga, Brick, Jolly, Lephart, & Fu,
2007). Further, the handgrip strength, the strength of non-active
muscles in the core workout, was also assessed pre- and post-
workout to reveal if the resultant core muscle fatigue was origi-
nated from central or peripheral factors (Ozkaplan, Rhodes, Sheel, &
Taunton, 2005). The handgrip strength was measured by following
the protocol described previously (Adams & Beam, 2007).
2.6. Statistical analysis
All results were expressed as mean
SD. KolmogoroveSmirnov
normality test revealed that all the data of sEMG and plank test
performance were normally distributed.
2.6.1. Validation
The differences in muscle activity level (%MVIC) among stages 1,
2, 4, 6 and 8 during the first circuit of the specific plank test were
examined for each selected muscle by using one-way ANOVA with
repeated measurements. Paired sample t-test was used to evaluate
the change in the endurance performance of the specific plank test
and handgrip strength with pre-fatigue core workout.
2.6.2. Reliability
One-way ANOVA with repeated measurements was applied for
examining the presence of systematic bias among the trials. The
relative reliability of the test was determined by a two-way random
effects model intraclass correlation coefficient (ICC) with 95%
confidence intervals. The absolute reliability was determined by
calculating the coefficient of variation (CV) and mean bias (mean
difference between values) with 95% limits of agreement (LOA,

1.96  SD of differences between values). Due to the presence of
heteroscedasticity in the data, the variables were logarithmically
transformed prior to calculations of the measurement bias ratio
*/O ratio LOA.
All tests for statistical significance were standardised at an alpha
level of P < 0.05. Post-hoc comparisons (least significance differ-
ence) were employed when the main effects of ANOVA were
significant.
3. Results
3.1. Validation
3.1.1. sEMG
Fig. 2 is the sEMG of the RA, EO and ES of one typical subject
recorded during the sport-specific endurance plank test. It dem-
onstrates that the selected muscles were loaded continuously
during the test while the loading of the muscles for holding the
basic plank position were varied with additional limb actions.
Table 1 shows the %MVIC in the three selected muscles during the
first circuit of the specific plank test at stages 1, 2, 4, 6, and 8. One-
way ANOVA test revealed that the main effects of RA (F(4,28) ¼ 12.1),
EO (F(4,28) ¼ 9.36) and ES (F(4,28) ¼ 6.05) across the stages were
significant (P < 0.05). For all muscles, %MVIC in stage 6 and 8 were
greater than those in stage 1 (P < 0.05). The values of %MVIC of all
muscles in stage 2 and 4 were also greater than those in stage 1
with significant differences (P < 0.05) found in RA and EO in stage 4,
and in RA and ES in stage 2. The difference in ES in stage 4 and in EO
in stage 2 approached significance (P ¼ 0.07). For RA and ES, the %
MVIC in stage 6 was greater than those in stage 2 and 4 (P < 0.05).
The %MVIC of RA in stage 8 was also greater than that in stage 2
(P < 0.05). For EO, the %MVIC in stage 6 was greater than those in
stage 2 (P < 0.05), and the %MVIC in stage 8 was less than that in
stage 6 (P < 0.05).
 Author's personal copy

T.K. Tong et al. / Physical Therapy in Sport 15 (2014) 58e63 61

Fig. 2. Surface electromyographic recordings from the rectus abdominis (RA), external oblique (EO) and erector spinae (ES) in a representative subject throughout the sport-specific
endurance plank test are shown.

3.1.2. Pre-fatigue core workout
Paired sample t-test revealed that the plank test performance was
reduced significantly with pre-fatigue core workout (260.6
89.8 vs.
181.8
87.8 s, t(7) ¼ 5.16, P < 0.05), while the change in handgrip
strength (391.3
76.2 vs. 391.3
51.4 N, t(7) ¼ 0.001, P > 0.05) was not
significant.
7.86
4.95% when trial 1 and 2 were considered while the value
decreased to 2.0
1.56% when the last two trials were counted.
Similar to the CV, the measurement bias ratio and 95% ratio LOA
between trial 1 and 2 was 0.89 */O 1.15. The ratios enhanced to
0.99 */O 1.07 when trials 2 and 3 were counted.
4. Discussion

3.2. Reliability
This study examined the validity and reliability of the sport-
specific endurance plank test, which was designed in an attempt
One-way ANOVA with repeated measurements revealed that
to advance the core test originally developed by Mackenzie (2005)
the main effect of the plank test performance across the three trials
as a surrogate measure of global core muscle endurance in athletes.
(Fig. 3) was significant (F(2,38) ¼ 35.9, P < 0.05). Post-hoc compar-
The current sEMG data validated the claims that the performance of
isons showed that the performance in the 1st trial (173.85
49.1 s)
prone bridge (plank) during the new test recruits trunk flexors as
was lower than (P < 0.05) that in the 2nd and 3rd trials
well as the lumbar extensors; the plank manoeuvre interspersed
(194.6
57.5 s, 197.1
58.2 s, P < 0.05). No significant difference
with the alternate lift up of arms and legs imposes extra loading
was found between the 2nd and 3rd trials (P > 0.05).
upon these muscles. Construct validity of the new test was also
ICC for the plank test performance across the three trials was
suggested by its ability to discriminate the changes in the global
0.97 (95% confidence interval: 0.94e0.99), reflecting substantial
relative reliability. For the ICC between the 1st and 2nd trials, the
value decreased to 0.96 (95% confidence interval: 0.91e0.99). In
contrast, it increased to 0.99 (95% confidence interval: 0.98e0.99)
when the 2nd and 3rd trials were counted. For absolute reliability,
the CV across the three trials was 6.86
4.22%. It increased to

Table 1
Percentage of maximum voluntary isometric contraction (%MVIC) in the rectus
abdominis (RA), external oblique (EO) and erector spinae (ES) at stages 1, 2, 4, 6 and
8 of the sport-specific endurance plank test (n ¼ 8).

%MVIC (%)

Stage 1 Stage 2 Stage 4 Stage 6 Stage 8

RA 32.7
10.8 47.7
13.5* 50.0
17.9* 73.7
22.3*ab 63.2
8.2*a
EO 31.7
8.5 42.8
11.9 56.6
17.7* 68.6
14.1*a 55.2
7.4*ac
ES 3.3
1.2 4.7
1.3* 4.6
2.9 6.3
2.1*ab 5.1
2.2*

Notes: Values are expressed as Mean
SD.

*Significant different from stage 1, P < 0.05.
a
Significant different from stage 2, P < 0.05.
b
Significant different from stage 4, P < 0.05. Fig. 3. The time to exhaustion in performing the sport-specific endurance plank test in
c
Significant different from stage 6, P < 0.05. three repeated trials is shown. *Significant difference from 1st trial (P < 0.05).
 Author's personal copy
62 T.K. Tong et al. / Physical Therapy in Sport 15 (2014) 58e63
core muscle endurance subsequent to a pre-fatigue core workout.
For test-retest reliability, the test was also shown to be reliable (CV),
especially if the first of the three trials were used as a familiariza-
tion trial (CV).
4.1. Validation
During stages 1 and 8 of the endurance plank test, participants
maintained the basic plank position by performing the prone
bridge on their elbows and toes with their spine in neutral align-
ment. The %MVIC data in Table 1 show that the static bridging
exercise, in agreement with previous findings, did load the RA, EO
and ES, while the challenges to the RA and EO were markedly
greater than those to the ES (Ekstrom, Donatelli, & Carp, 2007;
Schellenberg et al., 2007). Nevertheless, the loading imposed on the
RA and EO in stage 1, around 30% MVIC, was moderate. Such loading
was considered to be most beneficial for endurance or motor
control training (Schellenberg et al., 2007). As the test continued to
stage 8 with participants returning to the basic plank position,
higher muscle activity levels were observed. In comparison to stage
1, the %MVIC of RA increased for more than 90%. More than 70% and
50% increases in %MVIC were also observed in the EO and ES,
respectively. The performance of the same prone bridge with
marked increase in the %MVIC of the selected muscles showed that
the tensions of the muscles in stage 8 were maintained with
augmented motor unit recruitments. Although the extent of acti-
vation of other core stabilisers, such as the lumbar multifidus and
transversus abdominus, had not been examined, the current find-
ings might have already provided an indication of the changes in
the activity levels of trunk flexors and extensors in general. One can
infer from these findings that the loads originating from the sup-
port of the prone bridge that the core muscles counteracted during
the test were sufficient to induce muscle fatigue and, in turn,
challenge the endurance of the muscles to exhaustion within a few
minutes.
In stages 2 and 4, when participants lifted up either one arm or
leg while maintaining a basic plank position, the %MVIC of the
selected trunk muscles augmented in comparison to those in stage
1 (Table 1). When the arm and leg on different sides of the body
were lifted up simultaneously in stage 6, the %MVIC of the trunk
muscles was further augmented. The augmentation of the activa-
tion levels of the trunk muscles should not be wholly attributed to
the time course effect of supporting the prone bridge, as no sig-
nificant difference in %MVIC of the muscles was observed between
stages 2 and 4. Furthermore, the %MVIC of the trunk muscles ten-
ded to decrease from the levels achieved in stage 6 when the basic
plank position was resumed in stage 8. It was reasonable to claim
that the specific limb actions in stages 2, 4 and 6 were effectively to
impose extra loading to the trunk muscles while the prone bridge
was being performed. Although we cannot rule out the presence of
potential interferences mediated from different sources such as
crosstalk, which might have contaminated the sEMG data, linear
relationships between the EMG signal amplitude and increasing
force output during isometric contractions have been demon-
strated previously in the selected trunk muscles (Marras & Davis,
2001). In fact, the traditional plank test, which involves solely
sustaining a prone bridge to exhaustion, is generally considered as
an effective means for quantifying trunk-stabiliser endurance in the
rehabilitation sector (Schellenberg et al., 2007). The greater de-
mand of core muscle tension in the new test relative to that in the
traditional test favours its use in the evaluation of the core muscle
endurance of athletes, as the challenges to core stability during
sporting activities are much greater than those to spinal stability
during daily tasks (Leetun, Ireland, Willson, Ballantyne, & Davis,
2004). Moreover, most of the challenges to core muscles in sports
settings are mediated from the integration of highly dynamic and
loaded movements of the extremities (Hibbs et al., 2008). The plank
manoeuvre of the new test interspersed with the alternate lift up of
arms and legs could assess the core muscle function of athletes in a
functional dimension.
To examine further the construct validity of the new test, the
time to exhaustion during the test with and without a pre-fatigue
core workout was compared. It was noted that the performance of
the new test was reduced w30% with the preceded core muscle
fatigue workout. The impaired performance should not be attrib-
uted to central factors as the handgrip strength, which is the
strength of selected muscles which were not likely to be recruited
during the core exercises, was well maintained subsequent to the
workout. Such findings suggest that the new test is a valid tool to
assess the intra-individual change in global core muscle endurance
resulting from exercise-induced undue fatigue in the muscles. In
spite of knowing that the tension demands of selected anterolateral
trunk flexors were markedly greater than that of the trunk extensors
during the test, we do not know clearly the complicated interactions
among various core muscle groups in determining the sustainability
of the test. In this case, the new test would only be valid to assess
athletes’ global core muscle endurance. The use of the test for
assessing the functional change of individual core muscle is limited.
4.2. Reliability
In this study, the reliability of the sport-specific endurance plank
test was revealed by the reproducibility of the test performance in a
sample of repeated measurements, and the degree to which the
repeated measures varied. In the three repeated trials, the ICC for
the endurance plank test was 0.97, indicating a reasonable relative
reliability. However, an approximately 12% increase in performance
(w20 s) in the second trial in comparison to that in the first trial
was noted, although the difference in the performance (w1%) be-
tween the second and third trials was relatively minor (Fig. 3). The
marked systematic bias indicated the existence of learning effects
in participants performing the test (Cowley & Swensen, 2008).
Nevertheless, the serious bias only appeared in between the first
two trials, which indicated that the possible learning effects in
performing the test were diminished to a greater extent after the
first attempt. In fact, when the performance of the first trial was
ignored in counting the reliability, the ICC increased to 0.99.
To examine further the degree to which the performance of the
repeated tests varied, absolute reliability was assessed. In line with
the captioned findings of the relative reliability, the CV of 7.86%
across the first two repeated trials was reduced to 2.0% when the
variances in the testing performance between the second and third
trials were considered. This means that with a preceded trial of the
endurance plank test to exhaustion, 68% of the difference between
subsequent repeated tests lies within 2% of the mean of the data
(Bland & Altman, 1986). For the measurement bias ratio and 95%
ratio LOA, significant enhancement in the ratios between the sec-
ond and third trials (0.99 */O 1.07) in comparison to those occur-
ring between the first and second trials (0.89 */O 1.15) was
observed. The findings of the ratios indicate that for the perfor-
mance of the test on the first attempt, about 95% of cases may differ
from that on the second attempt by 22% below to 2% above. Sub-
sequent to the first attempt, the difference would be narrowed
greatly to the range of 8% below to 5% above when the perfor-
mances on the second and third attempts are compared (Bland &
Altman, 1986). The smallest detectable difference (SDD) based on
the testing results of the second and third trials (Roebroeck,
Harlaar, & Lankhorst, 1993), the SDD (95% CI) of 5.85 s of the
testing performance indicates adequate sensitivity of the new test
to detect the actual change in core muscle endurance for 3%. Such
 Author's personal copy
T.K. Tong et al. / Physical Therapy in Sport 15 (2014) 58e63
findings implied that the endurance plank test could possess
excellent test-retest reliability and acceptable measurement error if
there is at least one familiarisation trial with an identical testing
protocol carried out prior to data collection.
5. Conclusion
The current findings of sEMG and pre-fatigue core workout
demonstrated that the sport-specific endurance plank test is a valid
and practical method for assessing the endurance capacity of the
global core muscle of athletes in a functional manner. With the
presence of simple restriction in prone bridge formation and hip
displacement during the test, reliable measurement data could be
obtained. As there was a trial prior to data collection which allowed
the participants who are new to the plank exercise to familiarise
themselves with the testing protocol, the test reliability excels
further.
Conflict of interest statement
None declared.
Ethical statement
All participants gave written informed consent to participate in
the captioned study and the research was approved by the Com-
mittee on the Use of Human and Animal Subjects in Teaching and
Research of Hong Kong Baptist University.
Funding
None declared.
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