Shirado Test

Context

The Shirado Test is a static abdominal endurance test commonly used in the assessment of patients with low back pain. The value obtained from the test is not only comparable to normative data, but is also useful for reassessing the patient throughout their rehabilitation.

Video of the Test

Execution

To perform the test, the subject is placed in a supine position with the hips and knees flexed at 90°. The calves rest on a chair or stool, the arms are crossed over the chest, and the hands rest on the shoulders. The subject must lift their scapulae off the table and hold the neck in maximum flexion. They must maintain this position for as long as possible. The physical therapist records the time in seconds without encouraging the subject or informing them of the elapsed time during the test.

Clinical Value

In a 2009 study conducted on 235 healthy subjects and 17 patients with low back pain, the overall mean time for this test was 155 seconds (± 79). It should be noted that, despite being healthy subjects, some participants stopped the test due to the onset of spinal pain. Among them, many reported a rapid onset of cervical pain. It has been shown that patients with low back pain hold the position for significantly less time than healthy subjects, with a mean hold time of 41 seconds (± 23) (Fransoo et al., 2009).

The test-retest reliability of the Shirado Test is reported to be excellent (ICC > 0.95). However, no MDC appears to be available for this test in individuals with low back pain (Del Pozo-Cruz et al., 2014; Coleman et al., 2024).