scholarly journals Hop Testing Provides a Reliable and Valid Outcome Measure During Rehabilitation After Anterior Cruciate Ligament Reconstruction

2007 ◽  
Vol 87 (3) ◽  
pp. 337-349 ◽  
Author(s):  
Andrea Reid ◽  
Trevor B Birmingham ◽  
Paul W Stratford ◽  
Greg K Alcock ◽  
J Robert Giffin

Background and Purpose Although various hop tests have been proposed as performance-based outcome measures following anterior cruciate ligament (ACL) reconstruction, limited reports of their measurement properties exist. The purpose of this study was to investigate the reliability and longitudinal validity of data obtained from hop tests during rehabilitation after ACL reconstruction. Subjects Forty-two patients, 15 to 45 years of age, who had undergone ACL reconstruction participated in the study. Methods and Measures The study design was prospective and observational with repeated measures. The subjects performed a series of 4 hop tests on 3 separate occasions within the 16th week following surgery and on a fourth occasion 6 weeks later. The tests were a single hop for distance, a 6-m timed hop, a triple hop for distance, and crossover hops for distance. Performance on the ACL-reconstructed limb was expressed as a percentage of the performance on the nonoperative limb, termed the “limb symmetry index.” Subjects also completed the Lower Extremity Functional Scale and a global rating of change questionnaire. Results Intraclass correlation coefficients for limb symmetry index values ranged from .82 to .93. Standard errors of measurement were 3.04% to 5.59%. Minimal detectable changes, at the 90% confidence level, were 7.05% to 12.96%. Changes in hop test scores on the operative limb were statistically greater than changes on the nonoperative limb. Pearson correlations (r) between change in hop performances and self-reported measures ranged from .26 to .58. Discussion and Conclusion The results show that the described series of hop tests provide a reliable and valid performance-based outcome measure for patients undergoing rehabilitation following ACL reconstruction. These findings support the use and facilitate the interpretation of hop tests for research and clinical practice.

2018 ◽  
Vol 6 (8) ◽  
pp. 232596711878804 ◽  
Author(s):  
Kate E. Webster ◽  
Julian A. Feller

Background: Return to sport (RTS) after anterior cruciate ligament (ACL) reconstruction is a topic of current interest. The high reinjury rates reported in younger athletes may be due in part to an early RTS. Purpose: To determine the proportion of athletes who return to level I (jumping, hard pivoting, and cutting) sport at less than 1 year after ACL reconstruction and compare return rates by age and sex. A secondary purpose was to examine whether RTS is associated with some commonly used outcome criteria. Methods: A cohort of 1440 athletes (992 males, 448 females) satisfied criteria for inclusion in this study (primary ACL reconstruction, normal contralateral knee, no additional surgery within the first year after the reconstruction, and participation in level I sport on a weekly basis prior to injury). The proportion of athletes in this sample who had resumed level I sport by 12 months after surgery was recorded, along with measurements of knee function (single-legged hop symmetry), laxity (KT-1000 arthrometer), and self-reported outcomes (International Knee Documentation Committee [IKDC] subjective score). Limb symmetry index scores of 90 or higher, side-to-side difference in anterior knee laxity of 2 mm or less, and IKDC scores of 95 or higher were considered indicators of satisfactory recovery from surgery. Results: Rates of return to level I sport were significantly higher for athletes aged 25 years and younger (48% return rate) compared with older athletes (26-35 years, 32% return rate [ P < .0001]; ≥36 years, 19% return rate [ P < .001]). Male athletes who were in the ≤25-year and 26- to 35-year age brackets had significantly higher return rates than female athletes (52% vs 39% and 37% vs 18%, respectively), whereas no sex-based differences in RTS were seen after 36 years of age. A significantly higher proportion of younger patients met the selected indicators of a satisfactory recovery. Regardless of age, athletes had twice the odds of RTS if they had limb symmetry index scores of 90 or higher ( P ≤ .0001) and 3 times the odds of RTS if they had IKDC scores of 95 or higher ( P < .0001). Conclusion: Almost half of younger athletes (aged ≤25 years) in the current cohort returned to level I sports within 12 months after ACL reconstruction. Younger athletes were also more likely to meet criteria that indicate a satisfactory functional recovery and that have been used to indicate readiness to RTS. There may be a role for adjusting thresholds for these criteria based on age.


2018 ◽  
Vol 6 (6_suppl3) ◽  
pp. 2325967118S0004
Author(s):  
F García-Bol ◽  
V Posada-Franco ◽  
A Roldán-Valero ◽  
R Del Caño-Espinel

Hop Tests (unipodal horizontal jumps) have been recommended as one of the reliable assessment tests when allowing a return to competition for a sportsperson after an anterior cruciate ligament injury1,2,3,4. Currently, comparison is made of the results with the contralateral limb through the symmetry index, a method which might not provide sufficient security upon the return to competitive sport5. Hop tests can be used in preseason to gain reference values prior to a possible injury. The objective of this review is to analise the scientific literature such as the F-Marc6 (reference manual of FIFA) to confirm whether include said tests in preseason for football teams. A search was conducted in the Pubmed y Cochrane databases (17/04/17) with the search terms “Hop Test”, “Football”, “Soccer”, and “Preseason”. Articles in English and Spanish were both accepted. Articles excluded were those that did not make reference to the knee, to football, and those that did not conduct tests during preseason. From a total of 33 articles, 4 with these search criteria were included, 5 articles were added trough the bibliography of other studies, and the F-Marc manual was analised. 4 of the articles used the hop tests in preseason for some type of study, of which 3 were used as part of a prospective assessment for the season. On the other hand, the F-Marc does not consider Hop Tests as an assessment test. Hop tests were not found to be used in preseason as reference values prior to possible future injuries, data which could be beneficial for a safe return to sport. Harris J, Abrams G, Bach B, Williams D, Heidloff D, Bush-Joseph C, Verma N, Forsythe B, Cole B. Return to Sport After ACL Reconstruction. ORTHOPEDICS. 2014; 37: e103-e108. Barber-Westin SD, Noyes FR. Factors used to determine return to unrestricted sports activities after anterior cruciate ligament reconstruction. Arthroscopy. 2011 Dec;27(12):1697-705. Thomeé R, Kaplan Y, Kvist J, Myklebust G, Risberg MA, Theisen D, Tsepis E, Werner S, Wondrasch B, Witvrouw E. Muscle strength and hop performance criteria prior to return to sports after ACL reconstruction. Knee Surg Sports Traumatol Arthrosc. 2011 Nov;19(11):1798-805. Bolgla LA, Keskula DR. Reliability of lower extremity functional performance tests. J Orthop Sports Phys Ther. 1997 Sep;26(3):138-42. Wellsandt E, Failla MJ, Snyder-Mackler L. Limb Symmetry Indexes Can Overestimate Knee Function After Anterior Cruciate Ligament Injury. J Orthop Sports Phys Ther. 2017 Mar 29:1-18. F-MARC. Football Medicine Manual. 2nd Edition. Available from: http://f-marc.com . 2017.


2020 ◽  
Vol 8 (4_suppl3) ◽  
pp. 2325967120S0015
Author(s):  
Jie J Yao ◽  
Jordan Snetselaar ◽  
Gregory A. Schmale ◽  
Michael Saper

Background: Safe return to sport (RTS) after anterior cruciate ligament (ACL) reconstruction is difficult to determine in adolescent patients. Return of strength and dynamic knee stability can be assessed with functional single-leg hop testing as part of a formal RTS assessment. However, it is unclear whether performance during single-leg hop testing can predict future ACL graft rupture. Hypothesis/Purpose: To investigate differences in single-leg hop testing between adolescent patients who experienced a graft rupture after ACL reconstruction and those that did not. Methods: A retrospective review of adolescent patients whom underwent primary ACL reconstruction with a hamstring (HS) autograft identified 16 patients (10 girls, 6 boys) with single-leg hop testing data prior to graft failure. A nearest neighbor match algorithm was used to age-, sex-, surgeon-, and graft-match 16 patients without graft rupture. All patients followed a standardized rehabilitation protocol following surgery. As part of a formal RTS test, assessment of function and dynamic strength/stability was performed using 4 different single-leg hop tests: single hop for distance, triple hop for distance, triple crossover hop for distance, and timed hop. The recovery of muscle strength was defined by a limb symmetry index (LSI) ≥ 90%. Bivariate analyses were performed to compare the two groups. Results: The mean age of the entire cohort at the time of surgery was 14.6 ± 1.5 years. Patients completed their RTS test at 29.0 ± 5.4 weeks. There were no statistically significant differences in demographics, graft size, or time to RTS test between groups. There were no statistically significant differences in LSIs on the single hop (p=0.90), triple hop (p=0.36), crossover hop (p=0.41), or timed hop (p=0.48). The mean LSIs on each of the four hop tests were 92.3 ± 14.7, 95.1 ± 6.1, 95.8 ± 7.1, and 98.6 ± 7.9, respectively. Passing rates were similar between groups (p=0.54). Conclusion: Performance on single-leg hop tests 6 months after surgery is not predictive of graft rupture following ACL reconstruction with HS autograft in adolescent patients. Further investigation of alternative RTS measures and different time frames for testing in this high-risk population is needed.


2020 ◽  
pp. 1-10
Author(s):  
Damien Murphy ◽  
Quinette A. Louw ◽  
Colum Moloney ◽  
Dominique Leibbrandt ◽  
Amanda M. Clifford

Purpose: Anterior cruciate ligament (ACL) injuries are among the most severe injuries in the Gaelic Athletic Association. Hop tests measure functional performance after ACL reconstruction as they replicate the key requirements for a match situation. However, research examining functional recovery of ACL-reconstructed Gaelic athletes is lacking. The objective of this study is to determine if athletes restore normal hop symmetry after ACL reconstruction and to examine if bilateral deficiencies persist in hop performance following return to sport. Methods: A cross-sectional design was used to evaluate hop performance of 30 ACL-reconstructed Gaelic athletes who had returned to competition and 30 uninjured controls in a battery of hop tests including a single, 6-m, triple, and triple-crossover hop test. Results: In each test, the mean symmetry score of the ACL reconstruction group was above the cutoff for normal performance of 90% adopted by this study (98%, 99%, 97%, and 99% for the single, 6-m, triple, and triple-crossover hop, respectively). No significant differences in absolute hop scores emerged between involved and control limbs, with the exception of the single-hop test where healthy dominant limbs hopped significantly further than ACL-reconstructed dominant limbs (P = .02). No significant deficits were identified on the noninvolved side. Conclusions: The majority of ACL-reconstructed Gaelic athletes demonstrate normal levels of hop symmetry after returning to competition. Suboptimal hop performance can persist on the involved side compared with control limbs. Targeted rehabilitation may be warranted after returning to competition to restore performance to levels of healthy uninjured athletes.


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