Are Single Limb Hopping Scores the Same When Performed in a Physical Education Class Versus a Laboratory Setting in Uninjured Adolescents? Implications for Future Rehabilitation Guidelines for Adolescents With Knee Injuries
Main Article Content
Abstract
This study compared the performance of adolescents (11-13 years old) in two environments with five single-limb hopping tasks. The purpose was to assess the reproducibility and responsiveness of single-limb hop tests in two environments (gymnasium and laboratory) for uninjured adolescents, and determine whether there are differences in baseline measures between males and females. Thirty-four participants (12 ± 0.3 years) were randomly assigned the gymnasium during a regularly scheduled physical education class or the laboratory and completed five single-limb hop tasks. Two weeks later, participants completed the tasks in the other location. The performances were evaluated for reproducibility (intra-class correlation coefficients [ICC], and standard errors of measurement [SEM]), and responsiveness (Bland-Altman analyses [BA], and smallest real difference [SRD]). Limb symmetry indices (LSI) were also calculated for each task. Two-way mixed ANOVAs examined location and sex differences. All hops were reproducible (ICC = 0.62-0.88) with SEMs ranging between 6.7-13.0% of the mean of the group. BA showed location differences for the triple hop on the dominant limb (d = -13.3 cm, p=0.03). SRDs ranged between 18.5-35.9% of the mean of the group for all hops. Males scored higher (percent difference (%D) = 9.9-21.4%, p<0.05) for all hops except the anterior hop on both limbs, the 6-meter timed hop and lateral hop on the non-dominant limb. LSIs were 93.5-102.6% and 94.4-101.7% for all hopping task for females and males, respectively. In conclusion, this battery of single-limb hop tests offer a reliable method for clinicians and researchers to assess the functional capacity of uninjured adolescents in various environments.
Metrics
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors retain the copyright of their manuscripts, and all Open Access articles are distributed under the terms of the Creative Commons Attribution License (CC-BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided that the original work is properly cited.
References
Abrams, G. D., Harris, J. D., Gupta, A. K., McCormick, F. M., Bush-Joseph, C. A., Verma, N. N., Cole, B. J., & Bach, B. R., Jr. (2014). Functional Performance Testing After Anterior Cruciate Ligament Reconstruction. Orthopaedic Journal of Sports Medicine, 2(1), 232596711351830. https://doi.org/10.1177/2325967113518305
Atkinson, G., & Nevill, A. M. (1998). Statistical Methods For Assessing Measurement Error (Reliability) in Variables Relevant to Sports Medicine. Sports Medicine, 26(4), 217–238. https://doi.org/10.2165/00007256-199826040-00002
Barber, S. D., Noyes, F. R., Mangine, R. E., McCloskey, J. W., & Hartman, W. (1990). Quantitative assessment of functional limitations in normal and anterior cruciate ligament-deficient knees. Clinical Orthopaedics and Related Research, 255, 204–214. https://pubmed.ncbi.nlm.nih.gov/2347154/
Barber-Westin, S. D., & Noyes, F. R. (2011). Factors Used to Determine Return to Unrestricted Sports Activities After Anterior Cruciate Ligament Reconstruction. Arthroscopy: The Journal of Arthroscopic and Related Surgery, 27(12), 1697–1705. https://doi.org/10.1016/j.arthro.2011.09.009
Beckerman, H., Roebroeck, M. E., Lankhorst, G. J., Becher, J. G., Bezemer, P. D., & Verbeek, A. L. M. (2001). Quality of Life Research, 10(7), 571–578. https://doi.org/10.1023/a:1013138911638
Bel, M. J. D., Kemp, L. G., Girard, C. I., Rossignol, J., Goulet, S. F., Bourgon, J.-F., Carsen, S., & Benoit, D. L. (2020). Translation and Validation of the Hospital for Special Surgery Pediatric Functional Activity Brief Scale for French Paediatric Populations. Physiotherapy Canada, 72(4), 348–354. https://doi.org/10.3138/ptc-2019-0033
Bland, J. M., & Altman, D. G. (1986). Statistical methods for assessing agreement between two methods of clinical measurement. The Lancet, 327(8476), 307–310. https://doi.org/10.1016/s0140-6736(86)90837-8
Borotikar, B. S., Newcomer, R., Koppes, R., & McLean, S. G. (2008). Combined effects of fatigue and decision making on female lower limb landing postures: Central and peripheral contributions to ACL injury risk. Clinical Biomechanics, 23(1), 81–92. https://doi.org/10.1016/j.clinbiomech.2007.08.008
Brown, T. N., Palmieri-Smith, R. M., & McLean, S. G. (2009). Sex and limb differences in hip and knee kinematics and kinetics during anticipated and unanticipated jump landings: implications for anterior cruciate ligament injury. British Journal of Sports Medicine, 43(13), 1049–1056. https://doi.org/10.1136/bjsm.2008.055954
Cristiani, R., Mikkelsen, C., Edman, G., Forssblad, M., Engström, B., & Stålman, A. (2019). Age, gender, quadriceps strength and hop test performance are the most important factors affecting the achievement of a patient-acceptable symptom state after ACL reconstruction. Knee Surgery, Sports Traumatology, Arthroscopy, 28(2), 369–380. https://doi.org/10.1007/s00167-019-05576-2
Davies, G. J., McCarty, E., Provencher, M., & Manske, R. C. (2017). ACL Return to Sport Guidelines and Criteria. Current Reviews in Musculoskeletal Medicine, 10(3), 307–314. https://doi.org/10.1007/s12178-017-9420-9
de Vet, H. C. W., Terwee, C. B., Knol, D. L., & Bouter, L. M. (2006). When to use agreement versus reliability measures. Journal of Clinical Epidemiology, 59(10), 1033–1039. https://doi.org/10.1016/j.jclinepi.2005.10.015
Deaner, R. O., Geary, D. C., Puts, D. A., Ham, S. A., Kruger, J., Fles, E., Winegard, B., & Grandis, T. (2012). A Sex Difference in the Predisposition for Physical Competition: Males Play Sports Much More than Females Even in the Contemporary U.S. PLoS ONE, 7(11), e49168. https://doi.org/10.1371/journal.pone.0049168
Dingenen, B., Truijen, J., Bellemans, J., & Gokeler, A. (2019). Test–retest reliability and discriminative ability of forward, medial and rotational single-leg hop tests. The Knee, 26(5), 978–987. https://doi.org/10.1016/j.knee.2019.06.010
Fabricant, P. D., Robles, A., Downey-Zayas, T., Do, H. T., Marx, R. G., Widmann, R. F., & Green, D. W. (2013). Development and Validation of a Pediatric Sports Activity Rating Scale. The American Journal of Sports Medicine, 41(10), 2421–2429. https://doi.org/10.1177/0363546513496548
Fernandez, W. G., Yard, E. E., & Comstock, R. D. (2007). Epidemiology of Lower Extremity Injuries among U.S. High School Athletes. Academic Emergency Medicine, 14(7), 641–645. https://doi.org/10.1197/j.aem.2007.03.1354
Fleiss, J. L. (2011). The design and analysis of clinical experiments. (Vol. 73).
Girard, C. I., Warren, C. E., Romanchuk, N. J., Del Bel, M. J., Carsen, S., Chan, A. D. C., & Benoit, D. L. (2020). Decision Tree Learning Algorithm for Classifying Knee Injury Status Using Return-to-Activity Criteria. In 2020 42nd Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC). 2020 42nd Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC) in conjunction with the 43rd Annual Conference of the Canadian Medical and Biological Engineering Society. IEEE. https://doi.org/10.1109/embc44109.2020.9176010
Guyatt, G., Walter, S., & Norman, G. (1987). Measuring change over time: Assessing the usefulness of evaluative instruments. Journal of Chronic Diseases, 40(2), 171–178. https://doi.org/10.1016/0021-9681(87)90069-5
Hootman, J. M., Dick, R., & Agel, J. (2007). Epidemiology of Collegiate Injuries for 15 Sports: Summary and Recommendations for Injury Prevention Initiatives. Journal of Athletic Training, 42(2), 311–319. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1941297/
Johnson, M. R., & Stoneman, P. D. (2007). Comparison of a Lateral Hop Test Versus a Forward Hop Test for Functional Evaluation of Lateral Ankle Sprains. The Journal of Foot and Ankle Surgery, 46(3), 162–174. https://doi.org/10.1053/j.jfas.2006.12.007
Kivlan, B. R., & Martin, R. L. (2012). Functional performance testing of the hip in athletes: a systematic review for reliability and validity. International Journal of Sports Physical Therapy, 7(4), 410–412. https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/22893860/
LaBella, C. R., Hennrikus, W., Hewett, T. E., Brenner, J. S., Brookes, M. A., Demorest, R. A., Halstead, M. E., Kelly, A. K. W., Koutures, C. G., LaBella, C. R., LaBotz, M., Loud, K. J., Martin, S. S., Moffatt, K. A., Schwend, R. M., Gordon, J. E., Otsuka, N. Y., Raney, E. M., Shaw, B. A., …. (2014). Anterior Cruciate Ligament Injuries: Diagnosis, Treatment, and Prevention. Pediatrics, 133(5), e1437–e1450. https://doi.org/10.1542/peds.2014-0623
Lai, K., & Kelley, K. (2011). Accuracy in parameter estimation for targeted effects in structural equation modeling: Sample size planning for narrow confidence intervals. Psychological Methods, 16(2), 127–148. https://doi.org/10.1037/a0021764
Lexell, J. E., & Downham, D. Y. (2005). How to Assess the Reliability of Measurements in Rehabilitation. American Journal of Physical Medicine and Rehabilitation, 84(9), 719–723. https://doi.org/10.1097/01.phm.0000176452.17771.20
Marshall, W. A., & Tanner, J. M. (1969). Variations in pattern of pubertal changes in girls. Archives of Disease in Childhood, 44(235), 291–303. https://doi.org/10.1136/adc.44.235.291
Marshall, W. A., & Tanner, J. M. (1970). Variations in the Pattern of Pubertal Changes in Boys. Archives of Disease in Childhood, 45(239), 13–23. https://doi.org/10.1136/adc.45.239.13
Mattacola, C. G., Perrin, D. H., Gansneder, J. M., Gieck, J. H., Saliba, E. N., & McCue, F. C. (2002). Strength, functional outcome, and postural stability after anterior cruciate ligament reconstruction. Journal of Athletic Training, 47, 262–268. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC164354/
Mulrey, C. R., Shultz, S. J., Ford, K. R., Nguyen, A.-D., & Taylor, J. B. (2020). Methods of Identifying Limb Dominance in Adolescent Female Basketball Players: Implications for Clinical and Biomechanical Research. Clinical Journal of Sport Medicine, 30(3), 279–281. https://doi.org/10.1097/jsm.0000000000000589
Munro, A. G., & Herrington, L. C. (2011). Between-Session Reliability of Four Hop Tests and the Agility T-Test. Journal of Strength and Conditioning Research, 25(5), 1470–1477. https://doi.org/10.1519/JSC.0b013e3181d83335
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. https://doi.org/10.1177/036354659101900518
Ross, M. D., Langford, B., & Whelen, P. J. (2002). Test-Retest Reliability of 4 Single-Leg Horizontal Hop Tests. The Journal of Strength and Conditioning Research, 16(4), 617. https://doi.org/10.1519/1533-4287(2002)016<0617:trrosl>2.0.co;2
Salmon, L., Russell, V., Musgrove, T., Pinczewski, L., & Refshauge, K. (2005). Incidence and Risk Factors for Graft Rupture and Contralateral Rupture After Anterior Cruciate Ligament Reconstruction. Arthroscopy: The Journal of Arthroscopic and Related Surgery, 21(8), 948–957. https://doi.org/10.1016/j.arthro.2005.04.110
Schmitt, L. C., Paterno, M. V., Ford, K. R., Myer, G. D., & Hewett, T. E. (2015). Strength Asymmetry and Landing Mechanics at Return to Sport after Anterior Cruciate Ligament Reconstruction. Medicine and Science in Sports and Exercise, 47(7), 1426–1434. https://doi.org/10.1249/mss.0000000000000560
Sharma, N., Sharma, A., & Singh Sandhu, J. (2011). Functional Performance Testing in Athletes with Functional Ankle Instability. Asian Journal of Sports Medicine, 2(4). https://doi.org/10.5812/asjsm.34741
The National Federation of State High School Association. (2019). 2018-19 High School Athletic Participation Survery.
Toole, A. R., Ithurburn, M. P., Rauh, M. J., Hewett, T. E., Paterno, M. V., & Schmitt, L. C. (2017). Young Athletes After Anterior Cruciate Ligament Reconstruction Cleared for Sports Participation: How Many Actually Meet Recommended Return-to-Sport Criteria Cutoffs? Journal of Orthopaedic and Sports Physical Therapy, 1–27. https://doi.org/10.2519/jospt.2017.7227
van Grinsven, S., van Cingel, R. E. H., Holla, C. J. M., & van Loon, C. J. M. (2010). Evidence-based rehabilitation following anterior cruciate ligament reconstruction. Knee Surgery, Sports Traumatology, Arthroscopy, 18(8), 1128–1144. https://doi.org/10.1007/s00167-009-1027-2
van Melick, N., Meddeler, B. M., Hoogeboom, T. J., Nijhuis-van der Sanden, M. W. G., & van Cingel, R. E. H. (2017). How to determine leg dominance: The agreement between self-reported and observed performance in healthy adults. PLOS ONE, 12(12), e0189876. https://doi.org/10.1371/journal.pone.0189876
Werner, B. C., Yang, S., Looney, A. M., & Gwathmey, F. W. (2016). Trends in Pediatric and Adolescent Anterior Cruciate Ligament Injury and Reconstruction. Journal of Pediatric Orthopaedics, 36(5), 447–452. https://doi.org/10.1097/bpo.0000000000000482