Associations between Distance and Loading Symmetry during Return to Sport Hop Testing

Purpose Hop tests are widely used to quantify recovery from anterior cruciate ligament reconstruction (ACLR) surgery. However, there is evidence that simply measuring hop distance may not be indicative of the quality of movement or representative of potential limitations in hopping mechanics, particularly during landing. The first purpose of the present study was to compare hop distance and loading symmetry between ACLR athletes and healthy uninjured recreational athletes. The second was to determine the association between hop distance and loading symmetry. Methods Twenty-five ACLR patients and 30 healthy controls completed the single hop, triple hop, and crossover hop test on each limb while the loadsol®, a single-sensor force insole, collected impact forces (100 Hz). A limb symmetry index was calculated for hop distance, peak impact force, loading rate, and impulse from the final landing of each trial. LSIs were compared between groups using Mann-Whitney U-Tests and distance and loading LSIs were compared using Spearman rank correlations. Results ACLR patients had reduced symmetry in hop distance and loading relative to healthy controls for every hop test and outcome measure (p

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