Biering-Sorenson Test

Original Editor - Uchechukwu Chukwuemeka Top Contributors - Uchechukwu Chukwuemeka and Wanda van Niekerk  


The Biering-Sorenson test was first described by Hansen in 1964 as an examination of the isometric endurance of the hip and back extensor muscles. Following a study by Beiring-Sorenson, it was found to be a good assessment tool for predicting the risk of non-specific lower back pain in patients/clients. The test as described by Sorenson[1] is "measuring how many seconds the subject is able to keep the unsupported upper body (from the upper border of the iliac crest) horizontal, while placed prone with the buttocks and legs fixed to the couch by three wide canvas straps and the arms folded across the chest.”


To begin this test, an examination plinth, a stopwatch and three to four straps are needed. The starting position is the patient/client adopting a half prone lying on a plinth with the superior edge of the iliac crest at the edge of the plinth and the arms crossed over the chest. The lower limbs are strategically stabilized with straps. The patient/client is asked to maintains the upper body in a horizontal position and the timer is started. The test ends if the patient/client can maintain the said position for 4 minutes (240 seconds) or can no longer maintain the set position before 4 minutes elapses. The stop time is recorded.[2]



There is evidence available to show that this test is an accurate measure of back muscle endurance time and a predictor of the risk of low back pain.

Groups Minimal Detectable Change(MDC) in seconds[4] Interrater Reliability(ICC)[4] Test/Retest Reliability(ICC) Responsiveness(ES)[4] Standard Error of Measurement(SEM) in seconds[4]
All Subject 43.2 0.85 0.98[5][6] 0.002, 0.34[6] 15.6
Current LBP 32.1 0.88, 0.99[7] 0.93 0.02 11.6
Previous LBP 48.5 0.77 0.05 17.5
Physically active adults 48.5 0.86 0.96 15.2
Physically inactive adults 42.1 0.82 0.39 17.5
Healthy Male 20.0[5] 7.21[5]
Healthy Female 23.5[5] 8.49[5]
Healthy 48.8[7] 0.73[7] 0.80[8] 17.6[7]


A study by Adams et al.[9] in 1999 reported a predictive validity of R= -0.01 and found a relationship between fatigability and back muscle strength. The study also reported a significant association between Biering-Sorensen endurance time and self report of LBP history at baseline in adolescents (p= .006). Demoulin et al.[10] shows that maintaining the Biering–Sorenson position for less than 176 seconds, predicts low back pain within the next year and greater than 198 seconds predicts absence of low back pain. It also reported that Biering-Sorenson test does not have a ceiling effect.

Simmonds et al. (1998)[7] supports the discriminant properties of the test; it found a statistically significant difference between the performance of LBP patients and healthy participants and controls. This report was also supported by the research done by Keller et al.[8] in 2001.

Ghroubi et al. (2015)[11] reported a good divergent validity as VAS pain has a poor relationship with functional impairment indices (p > 0.05) and excellent convergent validity as Biering-Sorenson test shows a statistically significant relationship with the Borg scale (r = 0,4, p = 0,02), and the Shirado test (r = 0,59, p < 0,001).


  1. Biering–Sorensen F. Physical measurements as risk indicators for low-back trouble over a one-year period. Spine. 1984;9:106–119.
  2. Beiring-Sorenson test. 2015. Available from: (assessed 11 January 2020)
  3. Kayla Saraiva. Biering Sorensen. Available from: [last accessed 8/1/2020]
  4. 4.0 4.1 4.2 4.3 Latimer J, Maher CG, Refshauge K, Colaco I. The reliability and validity of the Biering–Sorensen test in asymptomatic subjects and subjects reporting current or previous nonspecific low back pain. Spine. 1999; 24(20): 2085-2090.
  5. 5.0 5.1 5.2 5.3 5.4 McGill SM, Childs A, Liebenson C. Endurance Times for Low Back Stabilization Exercises: Clinical Targets for Testing and Training From a Normal Database. Arch Phys Med Rehabil. 1999;80: 941-944.
  6. 6.0 6.1 Mannion AF, Connolly B, Wood K, Dolan P. The use of surface EMG power spectral analysis in the evaluation of back muscle function. Journal of Rehabilitation Research and Development. 1997;34(4):427-439
  7. 7.0 7.1 7.2 7.3 7.4 Simmonds MJ, Olson SL, Jones S, Hussein T, Lee CE, Novy D, et al. Psychometric characteristics and clinical usefulness of physical performance tests in patients with low back pain. Spine. 1998; 23(22):2412-2421.
  8. 8.0 8.1 Keller A, Hellesnes J, Brox JI. Reliability of the isokinetic trunk extensor test, Biering-Sørensen test, and Åstrand bicycle test: Assessment of intraclass correlation coefficient and critical difference in patients with chronic low back pain and healthy individuals. Spine. 2001;26(7): 771-777.
  9. Adams M, Mannion A. Dolan P. Personal Risk Factors for First-Time Low Back Pain. Spine. 1999;24(23):2497-2505.
  10. Demoulin C, Vanderthommen M, Duysens C, Crielaard CM. Spinal muscle evaluation using the sorensen test: a critical appraisal of the literature. Joint Bone Spine. 2006;73(1): 43-50.
  11. Ghroubi S, Jribi S, Jdidi J, Yahia A, Elleuch W, Chaaben M, et al. Study of the validity and reproducibility of the Biering-Sorensen test in chronic low back pain Annals of Physical and Rehabilitation Medicine. 2015; 58(1):e88