A CRITICAL ANALYSIS OF LIMB SYMMETRY INDICES OF HOP TESTS IN ATHLETES AFTER ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION: A CASE CONTROL STUDY

Review written by Mick Hughes info

BACKGROUND & OBJECTIVE

For a patient to be cleared to return to sport (especially cutting and pivoting sports) after ACL reconstruction (ACLR), it is becoming clear that they need to be discharged by passing appropriate strength and functional tests; specifically, quadriceps strength limb symmetry index (LSI) >90% and achieving >90% LSI on a battery of hop tests. For those unaware, LSI is calculated by: LSI = injured limb/uninjured limb x 100

Concerns however have been raised over using the uninjured limb as the reference point, as it has been found that abnormal movement patterns and neuromuscular deficits exist bilaterally after ACL injury. Thus, LSI may over-estimate the patient’s ability to perform high functioning demands following ACLR. The objectives of this study were to compare the results of 3 different hop tests in ACLR patients and compare these results to normative data of healthy high school and college soccer and basketball athletes.

METHODS

52 patients (38M – mean age 23.9/14F – mean age 21.7) who had undergone ACLR were included and were compared to normative hop test data of 188 healthy high school and college athletes (age range 17-33). The hop tests were:

  1. Single Leg Hop (SLH)
  2. Triple Leg Hop (TLH)
  3. Side Hop (SH)

For all the 3 hop tests, LSI was calculated by taking the mean score of 3 hops on the injured limb/mean score of 3 hops on the uninjured limb.

RESULTS

The most interesting finding to come out of this study was that 83% and 86.8% of ACLR patients passed the 90% LSI cut-off for the SLH and TLH respectively. However, when compared to normative data of age and sex matched

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