Leg Lowering Test

Original Editor - Khloud Shreif
Top Contributors - Khloud Shreif, Lucinda hampton and Kim Jackson

Introduction[edit | edit source]

Leg Lowering Test.gif

Double leg lowering test (DLLT) general test to assess the core muscles. This test is important to conduct as poor abdominal muscle strength can cause poor posture leading to lower back pain.[1]

The curl up test is used to assess the strength of the lower muscle fibres of the abdominal muscles. The DLLT is more challenging test than curl-up and examines the muscles as they work eccentrically during lowering the limbs[2][3].

Purpose[edit | edit source]

Torso-rectus-abdominis-transversus-abdominis.png

The purpose of the test to assess abdominal muscles and the ability of muscles to maintain the posterior pelvic tilting position against the load (lowering both lower limbs from the vertical position). Hip flexors and abdominal muscles work eccentrically together to control the lowering of the limb. As the legs lower there is an increase in the resistance to hold the pelvis in position.

The muscles that play a major role in the effort to maintain the position of the low back and pelvis during the leg-lowering movement are the rectus abdominis muscle, and moderate work for the external oblique, internal oblique, and transversus abdominis[4]

Image 2: Rectus Abdominalis shown.

Procedure[edit | edit source]

  • The subject lays supine, the arms are held across the chest and the head rested on the floor.
  • The tester places their finger tips underneath the subject's lower back. Alternatively a blood pressure cuff or pressure biofeedback unit can be used and inflated to 40 mmHg.
  • Both legs are raised to a 90-degree angle (vertically) while keeping the upper body flat on the floor.
  • The subject may bend their knees first to move to the starting position, before straightening the knee joint.
  • The subject aims to sustain the pressure on the tester's fingers or cuff under the lower back by contracting the abdominals as the legs are lowered.
  • During the test, if the pressure on your hand or the cuff is decreased, stop the test and the angle is measured.

The score is the angle of the legs in degrees from the floor. Below is a guide to scoring for this test

Angle Rating
90 very poor, starting position
75 poor
60 below average
45 average
30 above average
15 good
0 excellent, legs horizontal

[1]

This excellent 3 minute video shows the test.

[5]

Evidence[edit | edit source]

  1. Spearman's correlation coefficient (ρ) between core strength test and DLL test was found to be 0.24. The median for DLL test was 4 and pressure reduction on the pressure biofeedback unit was 9 mmHg. Study found that there is weak positive correlation between the core strength test and DLL test[6].
  2. A prospective descriptive study carried on to investigate the kinematic movement of the pelvis during DLLT on a sample consist of 17 young fit adults, divided into two groups, the first group instructed to do the test while trying to control the pelvis, and the second group descends without trying to control the pelvis tilting. The study concluded, there was a natural tendency for anterior pelvic tilting that increase through the range, anterior pelvic tilt 1° for 3.6° of lower limb lowering from early DLLT[7].

References[edit | edit source]

  1. 1.0 1.1 Top end sports Straight Leg Lift Abdominal Strength Test Available: https://www.topendsports.com/testing/tests/abdominal-strength.htm (accessed 4.1.2022)
  2. Krause DA, Youdas JW, Hollman JH, Smith J. Abdominal muscle performance as measured by the double leg-lowering test. Archives of physical medicine and rehabilitation. 2005 Jul 1;86(7):1345-8.
  3. O'Sullivan PB, Phyty GD, Twomey LT, Allison GT. Evaluation of specific stabilizing exercise in the treatment of chronic low back pain with radiologic diagnosis of spondylolysis or spondylolisthesis. Spine. 1997 Dec 15;22(24):2959-67.
  4. Haladay DE, Denegar CR, Miller SJ, Challis J. Electromyographic and kinetic analysis of two abdominal muscle performance tests. Physiotherapy theory and practice. 2015 Nov 17;31(8):587-93.
  5. Lauren Green. Double Leg Lowering Test - A Core Stability Assessment. Available from: http://www.youtube.com/watch?v=tvGf9MwdLCE[last accessed 25/1/2021]
  6. Rathod SR, Vyas NJ, Sorani DM. Relationship between double leg lowering test and core strength test of the lumbar spine in normal healthy individuals. Journal of Mahatma Gandhi Institute of Medical Sciences. 2021 Jan 1;26(1):23. Available: https://www.jmgims.co.in/article.asp?issn=0971-9903;year=2021;volume=26;issue=1;spage=23;epage=27;aulast=Rathod(accessed 4.1.2022)
  7. Zannotti CM, Bohannon RW, Tiberio D, Dewberry MJ, Murray R. Kinematics of the double-leg-lowering test for abdominal muscle strength. Journal of Orthopaedic & Sports Physical Therapy. 2002 Sep;32(9):432-6.