Objective To analyze the similarities and differences between four-point hand-knee position and hand-foot kneeling positions in trunk muscle activation and co-contraction, explore the possibility of hand-foot kneeling position as core stabilization exercises, so as to provide suggestions for actual training.Methods Nineteen healthy volunteers randomly performed exercises of four-point hand-knee position (4 motions) and hand-foot kneeling position (3 motions), while surface electromyography (sEMG) signals were collected from bilateral rectus abdominis, external oblique, erector spine, and multifidus muscles. The average sEMG and muscle co-contraction index (CCI) based on the sEMG signals were analyzed and compared.Results Significant differences were found in the sEMG and CCI within and between the two positions. Under four-point hand-knee position with the right hand and left leg lifting, the activation of all muscles was higher than that in the starting position. In four-point hand-knee position with the left leg lifting, the activation of ipsilateral multifidus muscle was significantly higher than that in hand-foot kneeling position. The activation degree of external oblique muscle and rectus abdominis was higher in hand-foot kneeling position with right hand lifting. A total of 28 muscle matching methods were obtained by pair-to-pair matching of 8 muscles. The starting posture in four-point hand-knee position fluctuated the least, indicating that the spine was the most stable, while the index of other exercises fluctuated in a larger range.Conclusions The possibility of hand-foot kneeling position as core stabilization exercises was proved from two aspects, namely, muscle activation and CCI. The hand-foot kneeling position and four-point hand-knee position can be used for strengthening abdominal muscles and back muscles, respectively. The four-point hand-knee position with contralateral upper and lower limbs lift is a more advanced exercise for trunk muscles, but sports injuries should be avoided.