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Prone Instability Test

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Original Editor - Jennifer Babb and Valerie Ross

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Valerie Ross, Jennifer Babb and Rachael Lowe  



To test for the likelihood of a patient with low back pain responding to a stabilization exercise program.


The patient lies prone with the body on the examining table and legs over the edge and feet resting on the floor. While the patient rests in this position with the trunk muscles relaxed, the examiner applies posterior to anterior pressure to an individual spinous process of the lumbar spine. Any provocation of pain is reported. Then the patient lifts the legs off the floor (the patient may hold table to maintain position) and posterior to anterior compression is applied again to the lumbar spine while the trunk musculature is contracted.

The test is considered positive if pain is present in the resting position but subsides in the second position, suggesting lumbo-pelvic instability. The muscle activation is capable of stabilizing the spinal segment.

Test Position 1
Test Position 2


Reference standard success with stabilization exercise program.

Sensitivity = .72 - LR = .48

Specificity = .58 + LR = 1.7


Interrater Reliability of Clinical Examination Measures for Identification of Lumbar Segmental Instability

Spinal palpation for lumbar segmental mobility and pain provocation: an interexaminer reliability study.

Recent Related Research (from Pubmed)


References will automatically be added here, see adding references tutorial.
  1. 1.0 1.1 Flynn T, Cleland J, Whitman J. User's Guide to the Musculoskeletal Examination: Fundamentals for the Evidence-based Clinician. Buckner, Kentucky: Evidence in Motion; 2008.
  2. Dutton, M. Orthopaedic Examination, Evaluation, and Intervention. New York: The McGraw-Hill Companies, Inc.; 2008.
  3. Hicks G, FritzJ, Delitto A, McGill S. Preliminary development of a clinical prediction rule for determining which patients with low back pain will respond to a stabilization exercise program. Arch Phys Med Rehabil 2005;86:1753-1762.

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