下背痛是世界性公衛議題之一，國際著名下背痛及脊椎專家建議，不宜以屈膝雙足支撐的仰臥起坐作為訓練或檢測腹肌肌耐力的動作。其爭議可從雙足之支撐、上半身起坐範圍及動作節奏等三方面加以修正。經過修正，建議的腹肌肌耐力檢測動作為雙足無支撐的慢速仰臥半起訓練動作，此一動作可以激活更高的腹肌肌電水準、較低的屈髖肌群肌激活水準及減緩腰椎壓力，似乎較能避開下背痛的潛在風險。修正動作除了產生較佳的預防下背痛之效度，也具有蠻高的信度水準，足以作為檢測屈腹肌耐力的動作，已廣為美、加等國體適能協會所採用。為了減少大眾曝露於下背痛的風險中，建議學校教育與國家考試不宜採仰臥起坐動作，改採仰臥半起動作。

Low back pain is a persistent global problem in public health. World-renowned experts on low back pain and the spine suggest that it may not be suitable for people to perform sit-ups to exercise the abdominal muscles or test their endurance. However, the public, school physical education programs, and the national fitness-education examinations in Taiwan continue to use sit-ups as a means for exercising or testing the endurance of the abdominal muscles. This study proposed three recommendations to enable modifying and improving the leg support, range of upper body motion, and pace of sit-ups. The modified exercise, the curl-up, is suggested as a safer alternative to the sit-up for abdominal-muscle endurance testing. This exercise can activate high levels of myoelectric activity in the abdominal muscles while keeping the activation level of the hip flexor muscles low, thus alleviating lumbar stress and likely lowering the risk of low back pain. Therefore, to lower the risk of low back pain, this paper recommends that school organizations and the national fitness-education examinations use the curl-up to replace the conventional sit-up for abdominal-muscle endurance testing.