Τρίτη 16 Φεβρουαρίου 2016

Single Limb Hop Tests

Link to instrument: PubMed Article
Acronym:
Purpose:
To review the measurement properties of physical performance tests (PPTs) of the knee as each pertain to athletes, and to determine the relationship between PPTs and injury in athletes age 12 years to adult.
Description:
  • One leg single hop for distance - hop forward on one leg as far as possible
  • One leg triple hop for distance - hop forward three times on one leg as far as possible
  • 6 m timed hop - hop on one leg as quickly as possible for 6m
  • Crossover hop for distance - hop forward as far as possible three times, each time crossing over a line
  • Triple jump - in a continuous manner, complete three phases of movement: hop, step, and jump, as far as possible
  • Single leg vertical jump - jump as high as possible off of one leg
  • Lateral Hop - using dominant leg, hop as far as possible laterally (landing on same leg)
  • Medial Hop - using dominant leg, hop as far as possible medially (landing on same leg)
  • Figure 8 Hop – subjects hop in figure 8 over 5 m distance for time (2 consecutive laps)
  • Up-down hop – subjects hop up onto a 20 cm high step and back down 10 times as fast as they can
  • Side hop – subjects hop transversely (more than 30 cm) for ten hops as quickly as possible
  • Stair hop – subjects hop up and down 3 steps, then they turn around and repeat
  • Vertical hop – single hop for maximum height on a force plate
Area of Assessment: Balance Non-Vestibular, Coordination, Functional Mobility, Occupational Performance, Strength
Body Part: Lower Extremity
ICF Domain: Body Structure, Body Function, Activity, Participation
Domain: Motor, Sensory
Assessment Type: Performance Measure
Length of Test: 06 to 30 Minutes
Time to Administer:
Approximately 10-20 Minutes
Number of Items: 6
Equipment Required:
Vertex, Tape Measure, Marker, Stopwatch
Training Required:
No formal training or licensing required.
Type of training required: No Training
Cost: Free
Actual Cost:
No Cost
Age Range: Adolescent: 13-17 years, Adult: 18-64 years, Elderly adult: 65+
Diagnosis: Knee Dysfunction, Movement Disorders, Pain
Populations Tested:
• Athletes
• Hegedus et al
o Recreational athletes ages 12-adult (no limit)
• Kea et al.
o Twenty-seven non-impaired professional or elite amateur hockey players
• Munro & Herrington
o Twenty-two recreational athletes
• Ross et al
o Eighteen physically active young adult male cadets enrolled at the U.S. Air Force Academy (average age 20.2 +/- 1.2 years)
• Post-ACL reconstruction
• Hopper et al
o Nineteen subjects presenting at 12 months post ACL reconstruction
• Logerstedt et al.
o 120 subjects with ACL reconstruction.
• Petschnig et al.
 55 male subjects with ACL reconstruction (group B: N=30, mean age=27.8+/- 9 years; group C: N=25, mean age=29.9+/- 5.8 years)
• Reinke et al
o Sixty-nine subjects participated between 24 and 39 months after ACL reconstruction
• Other
• Booher et al
o Eighteen subjects (4 males and 14 females)
• Fitzgerald et al
o via Borsa et al
 50 subjects with ACL deficiency
o via Carter et al
 50 subjects with ACL deficiency
o via Eastlack et al
 50 subjects with ACL deficiency
o via Kennedy et al
 29 subjects with ACL deficiency
o via Risberg et al
 50 subjects with ACL reconstruction
o via Sernert
 50 subjects with ACL reconstruction
o via Wilk et al
 50 subjects with ACL reconstruction
• Grindem et al.
o 91 nonoperatively treated patients with an ACL injury
• Itoh et al.
o 50 patients with chronic ACL-deficient knees with a mean age of 23.1 years.
• Noyes et al.
o Sixty seven patients with "ACL deficient knees" or a chronic ACL rupture and of 97 normal patients with no injury
Standard Error of Measurement (SEM):

Single Leg Hop for Distance

      Munro & Herrington

    Male: 7.87(% leg length x 100)

    Female: 7.93 (% leg length x 100)

      Ross et al

    4.61 cm

 

Triple Hop

      Munro & Herrington

    Male: 17.17 (% leg length x 100)

     Female: 23.18 (% leg length x 100)

      Ross et al

    11.17 cm

 

6 m Timed Hop

      Munro & Herrington

    Male: 0.084 s

    Female: 0.076 s

      Ross et al

    0.06 s

 

Cross Over Hop

      Munro & Herrington

    Male: 21.16 (% leg length x 100)

    Female: 19.73 (% leg length x 100)

      Ross et al

    17.74 cm

 

Lateral Hop

      Kea et al

    Mean after 2 occasions: 4 cm

 

Medial Hop

      Kea et al

Mean after 2 occasions: 5 cm
Minimal Detectable Change (MDC):

Single Leg Hop for Distance

      Munro & Herrington

    Male: 21.81 (% leg length x 100)

    Female: 21.98 (% leg length x 100)

 

Triple Hop

      Munro & Herrington

    Male: 47.59 (% leg length x 100)

    Female: 64.25 (% leg length x 100)

 

6 m Timed Hop

      Munro & Herrington

    Male: 0.233 s

    Female: 0.211 s

 

Cross Over Hop

      Munro & Herrington

    Male: 58.65 (% leg length x 100)

    Female: 54.69 (% leg length x 100)

 

Lateral Hop

      Kea et al

    95% MDC: 11.1 cm

 

Medial Hop

      Kea et al

95% MDC: 13.9 cm
Minimally Clinically Important Difference (MCID):
Not Established
Cut-Off Scores:

Single Leg Hop for Distance

      Grindem et al

    Less than 85% on limb symmetry score was classified as having self-reported knee function below normal ranges

      Hopper et al (ACL)

    Difference in limb performance >15% is classified as abnormal.

      Ito et al. (ACL deficient knees)

    ≤ 0.20m difference between limbs is classified as normal.

      Logerstedt et al

    An optimum cut off score 89.3% of LSI was found.

      Munro & Herrington (healthy recreational athletes)

    100% of subjects had a limb symmetry index (LSI) > 90%

    73% of subjects had a LSI > 95%

      Noyes et al (ACL deficient knees)

    Less than 85% on limb symmetry score is classified as abnormal ( )

      Petschnig et al (ACL)

    Group A had a 97.4% LSI with a SD of 3.4

    Group B had a 73.0% LSI with a SD of 9.9

    Group C had a 88.4% LSI with a SD of 8.4

 

Triple Hop

      Grindem et al

    Less than 85% on limb symmetry score were classified as having self-reported knee function below normal ranges

      Logerstedt et al

                     An optimum score of 95.2% of LSI was found to be optimal

      Munro & Herrington (healthy recreational athletes)

    100% of subjects had a LSI > 90%

    68% of subjects had a LSI > 95%

      Noyes et al (ACL deficient knees)

    Less than 85% on limb symmetry score is classified as abnormal (

      Petschnig et al (ACL)

    Group A had a 98.3% LSI with a SD of 4.1

    Group B had a 71.0% LSI with a SD of 12.9

    Group C had a 89.5% LSI with a SD of 12.0

 

6 m Timed Hop

      Grindem et al

    Less than 85% on limb symmetry score were classified as having self-reported knee function below normal ranges

      Logerstedt et al

    A LSI of 87.7% of LSI was found to be optimum

      Munro & Herrington (healthy recreational athletes)

    100% of subjects had a LSI > 90%

    86% of subjects had a LSI > 95%

      Noyes et al (ACL deficient knees)

    Less than 85% on limb symmetry score is classified as abnormal ( )

 

Cross Over Hop

      Grindem et al

    Less than 85% on limb symmetry score were classified as having self-reported knee function below normal ranges

      Logerstedt et al.

    A LSI of 94.9% was found to be optimum

      Munro & Herrington (healthy recreational athletes)

    100% of subjects had a LSI > 90%

    64% of subjects had a LSI > 95%

      Noyes et al (ACL deficient knees)

    Less than 85% on limb symmetry score is classified as abnormal ( )

 

Vertical Hop

      Petschnig et al (ACL)

    Group A had a 95.2% LSI with a SD of 8.5

    Group B had a 46.3% LSI with a SD of 12.9

    Group C had a 74.9% LSI with a SD of 13.3

 

Figure-eight hop test 

      Ito et al. (ACL deficient knees)

    ≤ 0.81s difference between limbs.

 

Up-down Hop Test

      Ito et al. (ACL deficient knees)

    ≤ 0.72s difference between limbs.

 

Side hop test

      Ito et al. (ACL deficient knees)

≤ 0.78s difference between limbs.
Normative Data:
Test-retest Reliability:

Single Hop for Distance

      Booher et al.  0.77 - 0.99 ICC

      Munro & Herrington

    Males 0.80 ICC

    Females 0.80 ICC

      Ross et al

    ICC 0.92

 

Triple Hop

      Munro & Herrington

    Males 0.92 ICC

    Females 0.8 ICC

      Ross et al

    ICC 0.97

 

6 m Timed Hop

      Booher et al.  0.77 - 0.99 ICC

      Hopper et al (ACL)

    Reconstructed 0.96 ICC

    Uninjured 0.95 ICC

      Munro & Herrington

    Males 0.6 ICC

    Females 0.84 ICC

      Ross et al

    ICC 0.92

 

Cross Over Hop

      Hopper et al (ACL)

    Reconstructed 0.98 ICC

    Uninjured 0.95 ICC

      Munro & Herrington

    Males 0.86 ICC

    Females 0.87 ICC

      Ross et al

    ICC 0.93

 

Stair Hop

      Hopper et al (ACL)

    Reconstructed 0.96 ICC

    Uninjured 0.96 ICC

Vertical Hop

      Hopper et al (ACL)

    Reconstructed 0.94 ICC

    Uninjured 0.92 ICC

      Petschnig et al (ACL)

    Group A (healthy males) 0.89 ICC (indicates good reliability)

Lateral Hop

      Kea et al

    0.95 ICC

 

Medial Hop

      Kea et al

    0.93 ICC

 

30 m Agility Hop

Booher et al.  0.77 - 0.99 ICC
Interrater/Intrarater Reliability:

Vertical Hop

      Hegedus et al (Knee injury)

Inter-rater reliability:0.75
Internal Consistency:
Note Established
Criterion Validity (Predictive/Concurrent):

Single Hop for Distance

      Petschnig et al (ACL)

    Specificity for the single hop test was 98 (false-positive rate=2). The sensitivity for group B was 93 (false-negative rate=7) and 28 (false-positive rate=73) for group C.

 

Triple Hop

      Petschnig et al (ACL)

    Specificity for the triple hop test was 96 (false-positive rate=4). The sensitivity for group B was 90 (false-negative rate=10) and 16 (false-positive rate=84) for group C.

 

6 m Timed Hop

      Logerstedt et al.

     The 6m timed hop had the strongest predictor validity of the four hop tests (single hop for distance, crossover hop, triple hop, and 6m timed hop).  Patients with decreased knee function were over five times more likely to be below the optimum cutoff score of 87.7% (rounded to 88%) compared to subjects with acceptable knee function, quantified by the IKDC 2000.

 

Cross Over Hop

      Logerstedt et al.

    The cross over hop had high predictive validity, similar to the 6m timed hop test.  Subjects were 4x's as likely to have impaired knee function when below the cutoff score, compared to subjects with acceptable knee function.

 

Vertical Hop

      Hegedus et al (Knee injury)

    Evidence quality for criterion validity was mixed with one study of poor and one of good quality

      Petschnig et al (ACL)

    Specificity for the vertical jump was 96 (false-positive rate=4). The sensitivity for group B was 100 (false-negative rate=0) and 72 (false-positive rate=28) for group C.

    One-legged vertical jump is sensitive enough to detect functional limitations for the lower limb following knee ligament reconstruction. Sensitivity of the vertical jump decreases when both legs are used, as people may be compensating with the uninvolved leg.

 

Lower limb symmetry (chronic ACL tear)

      Noyes et al

    The study used a combination of hop tests (single hop and timed hop) to determine the predictability of chronic ACL tear. Using any two tests together (also including triple hop and cross over hop) was found to be a better predictor of ACL dysfunction (62% performed abnormally on at least one) than one test alone (half of the participants failed each test alone). The study concluded that one-legged function tests (single hop, timed hop) had low sensitivity (52, 49). However high specificity (97, 94) and low false positive rates (3, 6) indicated that these tests can be used to help confirm abnormal limb symmetry.

Construct Validity (Convergent/Discriminant):

Single Leg Hop for Distance

      Hegedus et al (Knee injury)

    The quality rating of construct validity for the hop test is generally positive when examining discriminant validity and generally negative when describing convergent validity.

 

Single Leg Hop and Triple Leg Hop Test

      Reinke et al

    The strongest relationship was found to be a moderate, positive correlation between the IKDC scores and the single hop test (o.3) and triple hop test (0.4). The KOOS Sports and Recreation subscore was weakly correlated with the triple hop test (0.2) and single hop test (0.2). For the KOOS Knee Related Quality of Life, only the correlation with the triple-hop ratio was significant and it had a moderate rho value of 0.31.

Content Validity:
Not Established
Face Validity:
Not Established
Floor/Ceiling Effects:
Not Established
Responsiveness:

Hegedus et al

      Five studies reported on the responsiveness of five PPTs at the knee, however only one study demonstrated good methodological quality.

 

Kea et al

      Effect size for lateral hop test = 0.15

      Effect size for medial hop test = 0.26

 

Munro & Herrington

Effect sizes comparing males and females were high for all tests, ranging from 1.08-2.00, with the exception of the timed hop which had an effect size of 0.47. Therefore, genders were separated for analysis.
Considerations:
PPTs are a wide array of tests which are not well established. Caution should be used when making clinical decisions based on the results of these tests. Clinicians should use additional valid and reliable tests along with the PPTs before making clinical decisions.
Bibliography:

Booher, L., Hench, K., Worrell, T., & Stikeleather, J. (1993). Reliability of Three Single-Leg Hop Tests. Journal of Sport Rehabilitation, 2(3), 165-170.

 

Fitzgerald, K.G., Lephart S. M., Hwang J.H., Wainner M. R. S. "Hop Tests as Predictors of Dynamic Knee Stability." Journal of Orthopaedic and Sports Physical Therapy 31.10 (2001): 588-597.

 

Grindem, H., Logerstedt, D., Eitzen, I., Moksnes, H., Axe, M. J., Snyder-Mackler, L., ... & Risberg, M. A. (2011). Single-legged hop tests as predictors of self-reported knee function in nonoperatively treated individuals with anterior cruciate ligament injury. The American Journal of Sports Medicine, 39(11), 2347-2354.

 

Hegedus EJMcDonough SBleakley CCook CEBaxter GD. Clinician-friendly lower extremity physical performance measures in athletes: a systematic review of measurement properties and correlation with injury, part 1. The tests for knee function including the hop tests. Br J Sports Med. 2015 May;49(10):642-648. doi: 10.1136/bjsports-2014-094094. Epub 2014 Dec 10.

 

Hopper, D. M., Goh, S. C., Wentworth, L. A., Chan, D. Y., Chau, J. H., Wootton, G. J., ... & Boyle, J. J. (2002). Test–retest reliability of knee rating scales and functional hop tests one year following anterior cruciate ligament reconstruction.Physical Therapy in Sport, 3(1), 10-18.

 

Itoh, H., Kurosaka, M., Yoshiya, S., Ichihashi, N., & Mizuno, K. (1998). Evaluation of functional deficits determined by four different hop tests in patients with anterior cruciate ligament deficiency. Knee Surgery, Sports Traumatology, Arthroscopy, 6, 241-245.

 

Kea, J., Kramer, J., Forwell, L., & Birmingham, T. (2001). Hip Abduction-Adduction Strength and One-Leg Hop Tests: Test-Retest Reliability and Relationship to Function in Elite Ice Hockey Players. J Orthop Sports Phys Ther Journal of Orthopaedic & Sports Physical Therapy, 31(8), 446-455.

 

Logerstedt D, Grindhem H, Lynch A, Eitzen I, Engebretsen L, Risberg MA, Axe MJ, Snyder-Mackler L.  Single-legged hop tests as predictors of self-reported knee function after anterior cruciate ligament reconstruction: the Delaware-Oslo ACL cohort study,  The American Journal of Sports Medicine.  2012 Oct; 40(10), 2348-56.

 

Munro, Allen & Herrington, Lee. Between Session Reliability of Four Hop Tests and the Agility T-Test. Journal of Strength and Conditioning Research. 2011. 25(5), 1470-77.

 

Noyes, F. R., Barber, S. D., & Mangine, R. E. (1991). Abnormal lower limb symmetry determined by function hop tests after anterior cruciate ligament rupture. The American Journal of Sports Medicine, 19 (5), 513-518. 4xvvnsg

 

Petschnig, R., Baron, R., & Albrecht, M. (1998). The relationship between isokinetic quadriceps strength test and hop tests for distance and one-legged vertical jump test following anterior cruciate ligament reconstruction. Journal of Orthopaedic & Sports Physical Therapy, 28(1), 23-31.

 

Reinke, Emily K, et al. "Hop Tests correlate with IKDC and KOOS at Minimum of 2 years after Primary ACL Reconstruction." Knee surgery, sports traumatology, arthroscopy: official journal of the ESSKA 19.11 (2o11): 1806-1816. PMV. Web. 9 July 2015.

 

Ross, M.D., B. Langford, and P.J. Whelan. Test-retest reliability of 4 single leg horizontal hop tests. Journal of Strength and Conditioning Research. 16(4):617-622. 2002.

Year published: 1991
Instrument in PDF Format: Yes


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