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Context: The persistence and the recurrence of posterior medial knee pain (PKP) after anterior cruciate ligament reconstruction (ACLR) using hamstring tendon graft are often overlooked during rehabilitation. Design: Cross-sectional observational study. Methods: The study aimed (1) to evaluate the prevalence of these types of PKP before 4 months post-ACLR, (2) to measure their consequences on the knee flexors strength, and (3) to evaluate the role of the type of ACLR. From a cohort of patients operated on with hamstring tendon procedures, the persistent and the recurrent PKP were sought at 4 months post-ACLR. The evolution of isokinetic muscle strength recovery in PKP subjects was compared with those of nonpainful subjects. The functional deficit was measured at 6/7 months post-ACLR by a hop test. Results: Three hundred seventeen subjects (25.8 [6.0] y) were included. At 4 months post-ACLR, 2 populations were identified based on the recurrent onset of PKP (PKP+, n = 40) or the absence of knee pain (PKP−, n = 277). The prevalence of PKP was 8.3%. At the fourth month post-ACLR, the PKP+ group had a higher flexor strength deficit compared with the PKP− group (limb symmetry index at 60°/s: 67.2% [12.4%] vs 84.3% [12.6%]; P <.05). At 6/7 months, the loss of strength persisted (limb symmetry index at 60°/s: 82.3% [13.4%] vs 87.7% [12.8%]; P <.05). The hop test deficit was comparable, and no difference was shown according to the type of graft. Conclusions: Persistent and recurrent PKP during the rehabilitation period were not uncommon and were associated with a worsening of flexors strength loss on the ACLR side. [ABSTRACT FROM AUTHOR]

Background Landing with poor knee sagittal plane biomechanics has been identified as a risk factor for Anterior Cruciate Ligament (ACL) injury. However, it is unclear if the horizontal hop test battery reflects knee function and biomechanics. Hypothesis/Purpose To investigate the correlation between clinical limb symmetry index (LSI) and landing and propulsion knee biomechanics during the hop test battery using markerless motion capture. Study Design Cross-sectional biomechanics laboratory study Methods Forty-two participants with and without knee surgery (age 28.0 ± 8.0 years) performed the hop test battery which consisted of a single hop for distance, crossover hop, triple hop, and 6-m timed hop in the order listed. Eight high speed cameras were used to collect simultaneous 3D motion data and Theia 3D (Theia Markerless Inc.) was used to generate 3D body model files. Lower limb joint kinematics were calculated in Visual3D. Correlation (Spearman's ρ) was computed between clinical LSI and symmetry in peak and initial contact (IC) knee flexion angle during propulsion and landing phases of each movement. Results In the single hop, clinical LSI showed positive correlation with kinematic LSI at peak landing (ρ= 0.39, p=0.011), but no correlation at peak propulsion (ρ= -0.03, p=0.851). In the crossover hop, non-significant correlations were found in both propulsion and landing. In the triple hop, positive correlation was found at peak propulsion (ρ= 0.38, p=0.027), peak landing (ρ= 0.48 -- 0.66, p<0.001), and last landing IC (ρ= 0.45, p=0.009). In the timed hop, peak propulsion showed positive correlation (ρ= 0.51, p=0.003). Conclusions Single hop and triple hop distance symmetry reflected landing biomechanical symmetry better than propulsion symmetry. Poor scores on the hop test battery reflect asymmetrical knee landing biomechanics, emphasizing the importance of continuing to use the hop test battery as part of clinical decision making. Level of Evidence 3b [ABSTRACT FROM AUTHOR]

Background Single-legged hop tests have been widely used to assess performance-based outcomes after anterior cruciate ligament (ACL) reconstruction. Traditional single, triple, or 6-meter (6m) timed hop tests only measure distance or time as the principal variables, neglecting other variables, such as individual hop distances within a series of hops, flight time, and stance time. The development of portable instrumented pressure walkways has made it possible to collect parameters such as hop velocity, flight time, stance time, distance, and pressure outside of a laboratory setting. However, the reliability of instrumented pressure walkways in measuring spatial and temporal variables during single-legged hop tests is unknown. This study aimed to determine if the Zeno walkway can reliably measure spatiotemporal (ST) characteristics of hop tests. Study Design Cross-Sectional Study Methods Individuals (n=38) in this cross-sectional study performed single, triple, and 6m hop tests on a pressure-sensitive Zeno walkway. Twenty-one participants completed follow-up testing between one and 14 days later. Intraclass correlation coefficients (ICC(3,k)) were used to assess test-retest reliability of ST variables. The accuracy of vertical jump height and 6m hop timing were also measured. Results All ST variables demonstrated excellent test-retest reliability (ICC > 0.86) with small minimal detectable change (MDC) values during single-legged hop tests. Six-meter hop time and jump height during a bilateral drop jump were also accurately measured by the walkway. Conclusion An instrumented pressure walkway is a novel tool to reliably assess non-traditional parameters of clinically relevant hop and jump tests such as flight time, stance time, and jump height after lower extremity injury, surgery, and rehabilitation. Level of Evidence 3b [ABSTRACT FROM AUTHOR]

Anterior cruciate ligament (ACL) tears are injuries with a high incidence in athletes, and ACL reconstruction (ACLR) is a surgical treatment orthopedists perform. This study aims to compare the 6 and 12 months post-op results of single leg hop tests (SLHT) performed in multidirectional conventional semitendinosus/gracilis (ST/G) and modified all inside (MAI) ACLR techniques on both sides and the limb symmetry indexes (LSI) of both techniques. This study evaluated a retrospective cohort of 50 male athletes who applied MAI (n = 23) and traditional ACLR ST/G (n = 27) techniques. Functional knee strength of the participants on both sides was measured with different SLHTs at 6 and 12 months postoperatively. The SLHT included medial side (MSTH), triple hop (TH), medial rotation (90°) (MRH), crossover triple (CH) ve the single hop (SH) hop for distance. Both ACLR techniques showed significant improvement in mean Tegner, International Knee Documentation Committee (IKDC) and Lysholm scores preoperatively and at 6 and 12 months postoperatively (p < 0.05). For MAI and ST/G techniques, there was no significant difference in the results of SLHTs at 6 and 12 months for both the operated and non-operated sides (p < 0.05). Significance was found only in the MRH test of the non-operated side (p < 0.05). There was no significant difference in SLHT scores between the operated and non-operated sides at 6 and 12 months postoperatively (p > 0.05). There was no difference in LSI scores between techniques (p < 0.05). Our study revealed similar LSI rates in ST/G and MAI techniques at 6 and 12 months, suggesting that MAI technique can be used as a functional ACLR technique for athletes.

We aimed to report the trajectory of self‐reported outcomes up to 11 years post‐ACLR. We also explored the relationship between hop performance at 1 year and: (i) future self‐reported knee outcomes; and (ii) risk of subsequent knee events. 124 participants (43 women, mean age 31 ± 8 years) were recruited at 1 year following hamstring‐autograft ACLR. Hop performance was assessed with single‐forward and side‐hop tests. Follow‐up was completed at 3 (n = 114), 5 (n = 89) and 11 years (n = 72) post‐ACLR. Self‐reported outcomes were assessed at each follow‐up with the Knee injury Osteoarthritis Outcome Score (KOOS) pain and quality of life (QOL) subscales. Generalized linear mixed models estimated the relationship between hop performance and self‐reported outcomes. Subsequent knee events (new injury/surgery) to either knee were recorded, with the relationship between hop performance and risk of subsequent knee events analyzed with Cox proportional hazards. Self‐reported knee outcomes were stable (mean change < 10 points) across all timepoints but with major within‐sample variability. There was a modest relationship between greater hop performance at 1 year and better future KOOS‐pain (average marginal effect [AME] % improvement with + 1 cm single forward hop = 0.06% [95% CI 0.02–0.10]). A nonlinear spline relationship showed better single‐forward hop performance was associated with better KOOS‐QOL for scores < 108 cm, not present for higher hop scores > 108 cm. There were 21 index and 11 contralateral subsequent knee events. Hop performance was not related to risk of a subsequent knee event (hazard ratio index knee 0.99 [95% CI 0.98–1.02]). In conclusion, self‐reported knee pain and quality of life were generally stable across the 11‐year follow‐up period. Greater hop performance at 1‐year post‐ACLR was related to better self‐reported knee outcomes up to 11‐year follow‐up (of questionable clinical importance), but not associated with the risk of subsequent knee injury/surgery. [ABSTRACT FROM AUTHOR]

Purpose: The majority of anterior cruciate ligament reconstruction (ACLr) patients wish to return to sport. Clinical evaluations after ACLr often do not include physical testing, making it difficult to determine the patient's readiness to return to sport. Thus, it would be helpful to identify easily assessable factors associated with physical function in ACLr patients that could inform planning of patients' return to sport. This study sought to evaluate the associations between physical test performance in ACLr patients and known ACL injury risk factors, knee laxity and patient‐reported outcomes at 1‐year follow‐up. Methods: The cohort included isolated primary ACLr patients operated between 2009 and 2014. Patients were invited to a 1‐year visit to clarify their readiness to return to sport. A test battery was performed, including clinical evaluation, patient‐reported outcomes and three physical tests, from which the Leg Symmetry Index (LSI) was calculated. Multivariate regression analyses were performed for each of the physical tests, including known risk factors, clinical outcomes and patient‐reported outcomes. Laxity <3 mm, pivot shift = 0, Knee Injury and Osteoarthritis Outcome Score (KOOS) sport >75, International Knee Documentation Committee (IKDC) >75.9, and Single Assessment Numeric Evaluation (SANE) >92.7 were applied as cut‐off values for good versus poor status. Results: A total of 480 ACLr patients were included in the study. Laxity <3 mm had a negative impact on the single‐hop LSI, whereas a pivot shift = 0 or IKDC >75.9 had a positive impact on the single‐hop LSI. Age <20, a pivot shift grade of 0 and KOOSsport >75 were positively associated with the triple‐hop LSI. Finally, age <20 and IKDC >75.9 were positively associated with the leg extension strength LSI. Conclusions: Age, sagittal laxity, pivot shift and patient‐reported outcomes were associated with physical test performance 1 year after ACLr. However, the associations were not completely uniform and strong, so information on age, sagittal laxity, pivot shift and patient‐reported outcomes cannot replace a return‐to‐sport functional test battery in determining when it is safe to return to sport after ACLr. Level of Evidence: Level III. [ABSTRACT FROM AUTHOR]

tOBJECTIVE: To synthesize and present reference values for double-leg and single-leg jump tests in healthy athletes who play pivoting sports, and athletes with anterior cruciate ligament reconstruction (ACLR) who play pivoting sports. tDESIGN: Scoping review. tLITERATURE SEARCH: We searched PubMed, the Cochrane Library, MEDLINE, Embase, and Web of Science until April 7, 2023. tSTUDY SELECTION CRITERIA: We included reference values in 2 different categories: (1) double-leg and/or single-leg jump test outcomes in pivoting-sport athletes with ACLR at a specific time point during rehabilitation, and (2) double-leg and/or single-leg jump test outcomes in healthy pivoting-sport athletes. tDATA SYNTHESIS: We performed data synthesis for reference values from double-leg jump tests (squat jump and countermovement jump) and single-leg jump tests (vertical hop, single hop for distance, triple hop for distance, crossover hop for distance, medial triple hop for distance, lateral triple hop for distance, 6-m timed hop, side hop, drop jump, and 10-second repeated hop) that were performed according to a standardized test description. We summarized the data for type of sport, sex, sport participation level, and age group. tRESULTS: Of the 27 included studies, nine reported reference values from healthy soccer players, six from healthy basketball players, and eleven from other healthy pivoting-sport athletes. LSI dominant/ nondominant (LSI-D/ND) ranged between 97% and 106% for healthy soccer players, and between 99% and 120% for healthy basketball players. Four studies reported reference values from pivoting-sport athletes with ACLR from 7 to 10 months postsurgery. tCONCLUSION: This scoping review summarizes double-leg and single-leg jump test reference values for athletes who play common pivoting sports, [ABSTRACT FROM AUTHOR]

Background: Adequate movement control and quality can be prerequisite functions for performance of the lower extremity. The purposes of our work were 1) to explore the agreement of an efficient test battery assessing qualitative movement execution and 2) to determine its consistency with quantitative performance tests from the corresponding movement pattern. Methods: The participants were professional male association football players competing in the first German Bundesliga. They performed four movement quality tests (Single-limb balance squat, Balance forward hop, Balance side hop, Balance 90° rotation hop) and the corresponding performance tests (Y-balance test, Forward hop for distance, Side hop test, Square hop test). Qualitative tests were judged by two experienced raters; the ratings were compared to determine inter-rater agreement using Kappa statistics. The relationship with the quantitative tests was determined using Spearman's rank correlations. Results: Thirty participants (19 to 33 years old) were included in this study. We found an at least substantial level of agreement (Cohen's Kappa, 0.64-0.84) with an excellent percentage of exact (83-93%) agreement between the two raters for the movement quality tests. Our findings revealed that the quantitative test results are only slightly related to the movement quality outcomes (ρ(27) <|0.3| and P > 0.2). Conclusions: Consequently, the qualitative test results provide unique information and complement corresponding quantitative performance tests in professional football athletes. Their observational judgement of foot position, lower limb alignment and upper body control in sagittal, frontal, and transverse planes is agreeable. [ABSTRACT FROM AUTHOR]

Patellofemoral pain is a common complaint between physically active subjects. Patients with patellofemoral pain present limitations to performing daily activities. Pain could alter proprioceptive acuity and lead to movement impairment. The aim of this study was to investigate the relationship of pain and disability with proprioception acuity and physical performance in patients with patellofemoral pain. Methods: Forty-eight patients with patellofemoral pain [age 31.15 (5.91) years; 30 (62.50%) males] were recruited. Data collected included pain intensity, pain duration, disability, joint position sense (JPS) test at 20° and 60° of knee flexion, and physical performance tests (Single-Leg Triple-Hop Test and Y- Balance Test). Spearman's rank correlation coefficient (r s) and 95% confidence intervals (CI) were computed to assess the relationship between the variables. Pain intensity was correlated with Y-Balance Test posteromedial component (r s = −0.32, 95%CI = −0.55 to −0.03, p = 0.029) and the composite score (r s = −0.35, 95%CI = −0.58, −0.07, p = 0.015). Pain duration was correlated with Y-Balance Test posterolateral component (r s = −0.23, 95% CI = −0.53 to −0.01, p = 0.047). Disability was correlated with Y-Balance Test posteromedial component (r s = 0.41, 95% CI = 0.14 to 0.62, p = 0.004). Pain and disability were not correlated with JPS and the Single-Leg Triple-Hop Test. Pain and disability were related to Y-Balance Test but not to proprioceptive acuity and Single-Leg Triple-Hop Test in patients with patellofemoral pain. • The dynamic balance was related to pain and disability. • Pain and disability were not related to proprioceptive acuity. • Single-Leg Triple-Hop Test performance was not related to pain and disability. [ABSTRACT FROM AUTHOR]

Abstract Purpose The majority of anterior cruciate ligament reconstruction (ACLr) patients wish to return to sport. Clinical evaluations after ACLr often do not include physical testing, making it difficult to determine the patient's readiness to return to sport. Thus, it would be helpful to identify easily assessable factors associated with physical function in ACLr patients that could inform planning of patients' return to sport. This study sought to evaluate the associations between physical test performance in ACLr patients and known ACL injury risk factors, knee laxity and patient‐reported outcomes at 1‐year follow‐up. Methods The cohort included isolated primary ACLr patients operated between 2009 and 2014. Patients were invited to a 1‐year visit to clarify their readiness to return to sport. A test battery was performed, including clinical evaluation, patient‐reported outcomes and three physical tests, from which the Leg Symmetry Index (LSI) was calculated. Multivariate regression analyses were performed for each of the physical tests, including known risk factors, clinical outcomes and patient‐reported outcomes. Laxity 75, International Knee Documentation Committee (IKDC) >75.9, and Single Assessment Numeric Evaluation (SANE) >92.7 were applied as cut‐off values for good versus poor status. Results A total of 480 ACLr patients were included in the study. Laxity 75.9 had a positive impact on the single‐hop LSI. Age 75 were positively associated with the triple‐hop LSI. Finally, age 75.9 were positively associated with the leg extension strength LSI. Conclusions Age, sagittal laxity, pivot shift and patient‐reported outcomes were associated with physical test performance 1 year after ACLr. However, the associations were not completely uniform and strong, so information on age, sagittal laxity, pivot shift and patient‐reported outcomes cannot replace a return‐to‐sport functional test battery in determining when it is safe to return to sport after ACLr. Level of Evidence Level III.

Safe return to sport (RTS) after anterior cruciate ligament reconstruction (ACLR) surgery is important. Core stabilization is common within rehabilitation, but its influence on hopping performance and single-leg landing kinetics among athletes post-ACLR is unclear. Twenty-four male professional athletes who had ACL reconstruction surgery (time since surgery = 11.47 ± 1.55 months) were recruited and randomly assigned to exercise (n = 12) and control (n = 12) groups. Exercise group received an 8-week core stability exercise program. Limb symmetry index (LSI) for single-leg hop for distance (SLH) and triple hop (TRH) tests, and single-leg landing kinetics (multidirectional ground reaction forces) were measured pre- and post-intervention. In post-test, the participants in exercise group were more symmetrical in SLH (P =.04, CI = 0.01–7.68) and TRH (P =.01, CI = 0.28–11.1) distances. They also improved their LSI values for vertical ground reaction force (vGRF), though not significantly (P <.05). LSI for anteroposterior (a-p) and mediolateral (m-l) GRFs remained unchanged for participants of both groups. Our findings indicate the positive effect of core exercise on decreasing between-limb asymmetries during SLH and TRH tests. Our results demonstrate that despite lack of change in kinetics, functional performance is more symmetrical following core stability training. [ABSTRACT FROM AUTHOR]

IntroductionReturn to Sport tests with functional hop tests are often used to decide when a person is ready to return to sport after an anterior cruciate ligament (ACL) injury. Poor movement quality, such as knee valgus, hip adduction and hip internal rotation is considered a risk factor for ACL injury. However, it is unclear whether existing tests adequately cover the aspect of movement quality. This study aims to investigate whether there is a relationship between the calculated limb symmetry index (LSI) of hop tests as an indication of performance and the total score of the “Quality First” assessment (movement quality). The second aim is to examine the reliability of the newly developed “Quality First” assessment for evaluating movement quality in hop tests.MethodsThe cross-sectional study recruited 34 patients with an ACL reconstruction. The vertical hop, single-leg hop for distance, and side hop tests were performed and recorded. The video recordings were assessed using the “Quality First” assessment. The Spearman correlation coefficient was calculated using the LSI and the “Quality First” total score. Intraclass correlation coefficients (ICC) and standard error of measurements (SEM) were used to calculate intra- and interrater reliability. In addition, the minimal detectable change (MDC) was determined.ResultsThe correlation test between the LSI and the “Quality First” total score showed no correlation for all three jumps (r = −0.1–0.02/p-value = 0.65–0.93). The interrater reliability of the “Quality First” assessment showed fair to good reliability (ICC2: 0.45–0.60), with SEM ranging from 1.46 to 1.73 and the MDC from 4.06 to 4.8. Intrarater reliability was good to excellent (ICC3: 0.73–0.85), with SEM values ranging from 0.89 to 1.09 and the MDC from 2.47 to 3.01.ConclusionThe quality of movement, measured with the “Quality First” assessment, indicated no correlation with the calculated LSI from jump performance, therefore movement quality should also be examined in Return to Sport tests. The “Quality First” assessment shows fair to good reliability when used by different raters. When used multiple times by the same rater, the assessment has good to excellent reliability.

Background: There are few studies examining anterior cruciate ligament reconstruction (ACLR) and RAMP lesion repair. However, no studies have investigated the level of functional performance and psychological state after ACLR and all-inside RAMP lesion repair. Hypothesis/Purpose: The aim of this study is to determine the effect of ACLR and RAMP lesion repair on psychological status. ACLR and meniscal RAMP lesion repair were hypothesized to be associated with better psychological outcomes. Study Design: This is a cohort study. Methods: Patients who underwent ACLR with semitendinosus and gracilis autografts by a single surgeon were determined retrospectively. Fifteen patients who underwent ACLR and all-inside meniscus RAMP lesion repair (ACLR-RR) and 15 patients who underwent isolated ACLR were compared. Patients were evaluated by a physiotherapist at least 9 months after surgery. The primary outcome measure was anterior cruciate ligament-return to sports after injury (ACL-RSI), and the psychological status of the patients was examined. Secondary outcomes were visual analog scale (VAS), Tegner activity score, Lysholm knee score, single hop tests, and limb symmetry index (LSI). While pain intensity at rest and during movement was evaluated with VAS, functional performance level was evaluated with the Tegner activity score, the Lysholm knee score, single hop tests, and limb symmetry index (LSI). Results: A significant difference was found in the ACL-RSI values in the ACLR-RR group compared to the isolated ACLR group (p = 0.02). The results of the groups in VAS scores at rest and during movement, Tegner activity levels, and Lysholm knee scores, in the intact and operated leg single hop tests (single leg hop, cross hop, triple hop, and six-meter hop test), and the LSI values in the single leg hop tests showed no significant difference. Conclusions: This study revealed different psychological outcomes and similar functional levels for ACLR and all-inside meniscus RAMP repair compared with isolated ACLR. It was observed that the psychological status of patients with RAMP lesions should also be evaluated. [ABSTRACT FROM AUTHOR]

Introduction: Hop tests are used to assess knee function but outcomes often reflect rather performance than movement quality, which is crucial for proper knee function.1 Objectives: The movement quality scoring tool "Quality First", focusing on movement related risk factors for knee injury, was developed and quality criteria were assessed. Moreover, movement quality was correlated with performance and a comparison of real-time versus slow-motion analysis was executed. Study Design: Cross-sectional study in a clinical setting. Methods: 34 participants performed various hop tests and 2D-videos were evaluated using "Quality First". Content validity was assessed from the perspective of professionals, for interpretability, classical test theory was employed. Cron-bach's α was calculated to evaluate internal consistency. Intraclass correlation coefficients (ICC2,3), standard error of measurements (SEM) and minimal detectable changes (MDC) were analyzed to assess reliability. Hop performance (Limb- Symmetry-Index, LSI) was correlated with the "Quality First" total score (Spearman) and Bland- Altman analysis was performed for method comparison (slow-motion, real-time). Results: Content validity resulted in the final inclusion of single-leg hop for distance, vertical hop, and side hop test covering sagittal, vertical, and transversal plane. "Quality First" consists finally of 15 items on a 4-point scale and obtained a sufficient Cronbach's α. The interrater reliability showed ICC2s from 0.45-0.60, with SEMs ranging from 1.46-1.73 and MDCs from 4.06-4.80. Intrarater reliability revealed ICC3s from 0.73-0.85 with SEMs ranging from 0.89-1.09 and MDCs from 2.47-3.01. No correlations between LSIs and "Quality First" were found (r=-0.1-0.02, p=0.65-0.93). Bland-Altman analysis revealed no systematic mean differences between real-time and slow-motion except for the vertical hop (0.8 points). Conclusion: "Quality First" can be a promising and time-efficient tool to assess movement quality showing fair to good interrater- and good to excellent intrarater-reliability. Patient progress of movement quality in hop tests should be monitored in addition to performance. [ABSTRACT FROM AUTHOR]

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IntroductionCurrent approaches fail to adequately identify sport readiness after anterior cruciate ligament (ACL) rehabilitation. Altered landing biomechanics after ACL reconstruction are associated with increased risk of a noncontact ACL reinjury. There is a lack of objective factors to screen for deficient movement patterns. Therefore, the aim of this study was to investigate content validity, interpretability, and internal consistency for the newly developed “Quality First” assessment to evaluate movement quality during hop tests in patients after ACL rehabilitation.MethodParticipants in this cross-sectional study were recruited in collaboration with the Altius Swiss Sportmed Center in Rheinfelden, Switzerland. After a successful ACL reconstruction, the movement quality of 50 hop test batteries was evaluated between 6 and 24 months postoperatively with the “Quality First” assessment. Content validity was assessed from the perspective of professionals. To check the interpretability, classical test theory was employed. Cronbach's α was calculated to evaluate internal consistency.ResultsContent validity resulted in the inclusion of three different hop tests (single-leg hop for distance, vertical hop, and side hop). The “Quality First” assessment is enabled to evaluate movement quality in the sagittal, vertical, and the transversal plane. After the exclusion process, the “Quality First” assessment was free from floor and ceiling effects and obtained a sufficient Cronbach's α. The final version consists of 15 items, rated on a 4-point scale.DiscussionBy means of further validations, the “Quality First” assessment could offer a possibility to evaluate movement quality after ACL rehabilitation during hop tests.

Background and Objectives: Anterior cruciate ligament (ACL) ruptures are common injuries, and ACL reconstruction (ACLR) is among the most common surgical procedures in sports surgery. Our research aims to compare the 6-month post-operative results of the modified all-inside (MAI) ACLR technique, single leg hop tests (SLHT), and Y balance tests applied in different directions on the operated and non-operated sides. Materials and Methods: A retrospective cohort of 22 male recreational athletes who underwent MAI ACLR techniques performed by the same surgeon were evaluated. The functional knee strengths of the participants on the operated and non-operated sides were evaluated with five different tests of SLHTs: single hop for distance (SH), triple hop for distance (TH), crossover triple hop for distance (CH), medial side triple hop for distance (MSTH), and medial rotation (90°) with hop for distance (MRH). Their dynamic balance was evaluated with the Y balance Test. Results: Compared to pre-operative levels, there was a significant improvement in the mean Lysholm, Tegner, and IKDC scores during the post-operative period (p < 0.05). There was a difference between SH, THD, CHD, MSTH, and MRH on the operated and non-operative sides (p < 0.05). There was no difference between Y balance scores on the operated and non-operative sides, and there were no differences between LSI scores resulting from SLHTs (p > 0.05). There were no significant relationships between YBT (composite scores) and SH, TH, CH, MSTH, and MRH distances in the healthy leg (p > 0.05), but a significant correlation with only CH in the ACL leg (p < 0.05). Conclusions: Our research shows that sixth-month post-operative SLHT findings were lower on the ACL side compared to the healthy side in patients tested with the MAI ACLR technique. However, when these scores are evaluated in terms of balance, it can be seen that both sides reveal similar findings. The similarity of LSIs in SLHTs applied in different directions, and balance scores of ACL and healthy sides revealed that the MAI technique is also an ACLR technique that can be used in athletes from a functional point of view. [ABSTRACT FROM AUTHOR]

Repair for total Achilles tendon ruptures is sometimes delayed, despite the recommendation for early repair.To investigate patient recovery scores, and ankle strength and function according to the timing of Achilles tendon rupture repair.We conducted a retrospective analysis by categorizing repair: emergency (ER, n = 38), late (LR, n = 16), and very late (VLR, n = 13). Patients were evaluated based on the Achilles Tendon Total Rupture Score (ATRS), dorsiflexion range of motion, ankle strength, hop tests, and balance.All groups showed consistent improvement in the ATRS, heel-raise, plantarflexion strength, hop tests, and balance up to 6 and 9 months post-surgery. At 3 months, the ER and LR groups had significantly better values in the ATRS, heel raise, plantarflexion strength, and single-hop test compared with the VLR group (p < 0.05); by 12 months, there were no significant between-group differences (p > 0.05). The ER group outperformed the VLR group in the crossover hop test, and in posteromedial and lateral balance at 12 months (p < 0.05).Twelve months after Achilles tendon rupture repair, VLR induced similar improvement in the ATRS, and ankle strength and function compared to ER and LR. Therefore, despite being very late, the repair was significantly effective in improving ankle function. [ABSTRACT FROM AUTHOR]

Background The study aims to identify the correlation of ankle dorsiflexion range-of-motion (ADROM) (with its related gastrocnemius and soleus extensibility) with lower-limb kinetic chain function and hop test performance in young healthy recreational athletes. Methods Twenty-one young male healthy recreational athletes were tested for ADROM, gastrocnemius and soleus extensibility, lower-limb kinetic chain function with the closed kinetic chain lower extremity stability test (CKCLEST) and hop test performance with the single-leg hop for distance test (SHDT) and side hop test (SHT). Results There was a positive significant (rho = 0.514, 95% CI [0.092–0.779], P 0.05). Conclusion The CKCLEST is positively and significantly correlated with SHT and weight-bearing ADROM with knee flexion (and its related soleus extensibility) which suggests comparability among them. Open-chain ADROM has a negligible and non-significant correlation with the readings of this study performance-based tests suggesting that it is probably not an essential construct of their execution. To the best of our knowledge, this study is the first to investigate these correlations.

Background: There are currently no well-established criteria to guide return to sports (RTS) after anterior cruciate ligament reconstruction (ACLR). In this study, a new test battery consisting of subjective and objective tests, especially multiplanar knee kinematics assessment, was developed to aid RTS decision making after ACLR.Methods: This study was conducted with 30 patients who were assessed a mean of 9.2 ± 0.5 months after ACLR. All patients underwent complete evaluations of both lower limbs with four objective assessments [isokinetic, hop, knee laxity, and 6–degree of freedom (6DOF, angle: flexion-extension, varus-valgus, internal-external rotation; translation: anteroposterior, proximodistal, mediolateral) knee kinematics tests] and two subjective assessments [International Knee Documentation Committee (IKDC) and Anterior Cruciate Ligament Return to Sport after Injury (ACL-RSI) questionnaires]. Limb symmetry indices (LSIs) of knee strength, hop distance, and range of motion (ROM) of knee kinematics were calculated. LSI ≥90%, IKDC scale score within the 15th percentile for healthy adults, and ACL-RSI score >56 were defined as RTS criteria.Results: Significant differences between affected and contralateral knees were observed in the quadriceps strength (p < 0.001), hamstring strength (p = 0.001), single hop distance (p < 0.001), triple hop distance (p < 0.001), and rotational ROM (p = 0.01). Only four patients fulfilled the overall RTS criteria. The percentages of patients fulfilling individual criteria were: quadriceps strength, 40%; hamstring strength, 40%; single hop distance, 30%; triple hop distance, 36.7%; knee ligament laxity, 80%; flexion-extension, 23.3%; varus-valgus rotation, 20%; internal-external rotation, 66.7%; anteroposterior translation, 20%; proximodistal translation, 33.3%; mediolateral translation, 26.7%; IKDC scale score, 53.3%; and ACL-RSI score, 33.3%.Conclusion: At an average of 9 months after ACLR, objectively and subjectively measured knee functional performance was generally unsatisfactory especially the recovery of knee kinematics, which is an important prerequisite for RTS.

Linear complexity test included in the NIST test suite only checks whether or not the observed linear complexity is close to the expected linear complexity. To take full advantage of the information of the linear complexity profile, we propose two randomness tests including a jump test based on the jump complexity, i. e., the number of changes in the linear complexity profile of a sequence, and a hop test checking the sum of jump heights at intervals. By using an iterative algorithm we calculate some necessary statistical measures of a random sequence of length M, and combining with hypothesis test we determine whether a given binary sequence is random or not. Moreover, we provide the explicit formulae of the expectation and the variance of the statistical measure of the hop test. The computational complexity of the jump test and the hop test is the same as that of the linear complexity test. Additionally, we provide a type of sample which, having passed all tests in the NIST test suite, is rejected by the jump test and hop test. So the proposed tests deserve to be considered. [ABSTRACT FROM AUTHOR]

Background: Jumps are predominant components in football (soccer). Interlimb functional difference in single-leg jump performance is a risk factor for lower extremities injuries. Screening uninjured athletes is essential to design prevention strategies and implement individual training interventions. The aims of this cross-sectional study were (1) to provide age-specific mean values and limb symmetry index (LSI) in young football players, (2) to detect age effect on LSI and interlimb functional differences and (3) to investigate the association of age with single-leg functional performance and LSI. Methods: A total of 146 male football players (age 14.2 ± 2.3) performed the countermovement jump, jump for distance, side hop and speedy jump tests. Descriptive statistics, mean values (dominant/non-dominant) and LSI were provided according to age groups (U11–U19). Two-way mixed analysis of variance (ANOVA), one-way ANOVA and Pearson's correlation were used for the statistical analysis. Results: Participants showed on average perfect LSI (103.8 ± 14.2%) amongst all tests and age groups. Interlimb functional differences occurred in three out of four tests (p < 0.05), without age interaction (p > 0.05). Age effect was positively associated with single-leg functional performance (p < 0.05), but not with LSI (p > 0.05), in all tests and age groups. Conclusion: An LSI ≥100% in single-leg jump tests is proposed as a benchmark in young football players, but interlimb performance differences may occur without age interaction. Nevertheless, the growth process plays a crucial role in the development of functional capacities: older players may show a higher single-leg jump performance, but not a higher LSI, than younger players. In football practice, preventive intervention is advisable to counteract interlimb performance differences, for which unilateral strength, power and plyometric training is recommended. [ABSTRACT FROM AUTHOR]

Background: After anterior cruciate ligament reconstruction (ACLR), a battery of strength and hop tests is frequently used to determine the readiness of an athlete to successfully return to sports. However, the anterior cruciate ligament reinjury rate remains alarmingly high. Purpose: To evaluate the lower limb function of athletes after ACLR at the time when they had been cleared to return to sports (RTS). We aimed to evaluate if passing discharge criteria ensures restoration of normal lower limb biomechanics in terms of kinematics, kinetics, work, and percentage work contribution during a triple hop for distance. Study Design: Controlled laboratory study. Methods: Integrated 3-dimensional motion analysis was performed in 24 male athletes after ACLR when cleared to RTS and 23 healthy male controls during the triple-hop test. The criteria for RTS were (1) clearance by the surgeon and the physical therapist, (2) completion of a sports-specific on-field rehabilitation program, and (3) limb symmetry index >90% after quadriceps strength and hop battery tests. Lower limb and trunk kinematics, as well as knee joint moments and work, were calculated. Between-limb differences (within athletes after ACLR) and between-group differences (between ACLR and control groups) were evaluated using mixed linear models. Results: Although achieving 97% limb symmetry in distance hopped and displaying almost 80% symmetry for knee work absorption in the second rebound and third landing, the ACLR cohorts demonstrated only 51% and 66% limb symmetry for knee work generation in the first and second rebound phases, respectively. During both work generation phases of the triple hop, the relative contribution of the involved knee was significantly smaller, with a prominent compensation from the hip joint (P <.001, for all phases) as compared with the uninvolved limb and the controls. In addition, patients deployed a whole body compensatory strategy to account for the between-limb differences in knee function, mainly at the hip, pelvis, and trunk. Conclusion: Symmetry in the triple hop for distance masked important deficits in the knee joint work. These differences were more prominent during work generation (concentric-propulsive) than work absorption (eccentric-landing). Clinical Relevance: Symmetry in hop distance during the triple hop test masked significant asymmetries in knee function after ACLR and might not be the appropriate outcome to use as a discharge criterion. Differences between limbs in athletes after ACLR were more prominent during the power generation than the absorption phase. [ABSTRACT FROM AUTHOR]

Patients with anterior cruciate ligament reconstruction (ACLR) are often psychologically and physically under‐prepared for sports participation. This study compared readiness to return to sport based on completion of advanced training after ACLR. Patients with ACLR who self‐selected participation in a 6‐week group‐format advanced training program (TRAINING) were compared to age‐ and sex‐matched patients who did not participate (NoTRAINING). Each group had 23 participants (14 females). Advanced training consisted of plyometric, strengthening, and agility exercises. Baseline and follow‐up testing included psychological measures (Anterior Cruciate Ligament Return to Sport after Injury [ACL‐RSI]; Tampa Scale for Kinesiophobia [TSK‐11]; Knee Activity Self‐Efficacy [KASE]; and fear intensity for the primary fear‐evoking task or situation) and a hop test battery. Return to sport criteria were ACL‐RSI score ≥70 points and limb symmetry index ≥90% on all hop tests. At follow‐up, KASE score was higher in TRAINING than NoTRAINING (92.7 vs. 89.1 points; respectively), but ACL‐RSI, TSK‐11 and fear intensity scores were not significantly different between groups. Return to sport criteria passing rate was not significantly different between groups at baseline (TRAINING: 13%, NoTRAINING: 30%) or follow‐up (TRAINING: 52%, NoTRAINING: 43%); however, the distribution of criteria met at follow‐up differed with more patients in TRAINING than NoTRAINING meeting hop test criteria (30% vs. 4%, respectively) and more patients in NoTRAINING than TRAINING failing to meet any criteria (25% vs. 0%, respectively). Advanced training after ACLR facilitated readiness for sport participation by improving confidence and hop performance, but may not have a preferential effect on fear. [ABSTRACT FROM AUTHOR]

Introduction There are several postoperative evaluation methods for anterior cruciate ligament reconstruction (ACLR), and patient-reported outcome measurement (PROM) is one of the most important for evaluating postoperative clinical results. However, conventional PROMs have a high risk of a ceiling effect at one and two years postoperatively and do not accurately reflect functional improvement over time. Therefore, a longitudinal evaluation using PROM with a low risk of ceiling effect is necessary. The forgotten joint score-12 (FJS) was developed for clinical evaluation after arthroplasty. It is considered an evaluation method after arthroplasty with a low risk of demonstrating a ceiling effect. However, few studies have used the FJS as an evaluation method after ACLR, particularly those tracking changes over time. This study aimed to longitudinally evaluate FJS at one and two years after ACLR. Methods This is a retrospective observational study of postoperative patients using existing data and a questionnaire-based survey. This study included patients who underwent primary double-bundle ACLR between August 2017 and August 2021. We compared the FJS, knee injury and osteoarthritis outcome score (KOOS), and Lysholm knee scale (LKS) scores at one and two years post-surgery using the Wilcoxon signed-rank test. The ceiling effect for each PROM was calculated at one and two years post-surgery. A ceiling was defined as obtaining a perfect score in PROMs, and the risk of demonstrating a ceiling effect was the percentage of perfect scores among all cases. The risk of demonstrating a ceiling effect for each PROM was compared using the McNemar test. To identify factors influencing FJS one-year post-ACLR across all cases, multivariate linear regression analysis was conducted for the FJS.  Results Finally, 87 patients were included in this study. Fifty-six participants were women, and 31 were men, with an average age of 28.5 ± 11.8 years at the time of surgery and a BMI of 23.2 ± 3.7 kg/m 2 . Fifty-eight patients with meniscus injuries requiring treatment were observed. A total of 54 patients were used to compare the results at one and two years, while 87 patients were included in the multivariate analysis for FJS at one year. The median of FJS at one and two years post-surgery were 90.6 and 95.8, respectively. The FJS showed a statistically significant improvement from one to two years (p = 0.033). Question #12 in FJS showed a significant improvement from the first to the second year postoperatively (1.74 ± 1.46 vs 1.15 ± 1.25 at one year vs two years, respectively; p = 0.0016). FJS had a lower risk of demonstrating a ceiling effect than KOOS ADL at one and two years (FJS vs KOOS ADL; at first year: 20.4% and 48.1%, p < 0.001; at second year: 33.3% and 63.0%, p = 0.0013). There was no difference compared to the other PROMs. According to the multivariate linear regression analysis, predictive factors for higher FJS scores at one year post-surgery were younger age and limb symmetry index of single-leg hop test(SLH-LSI) on the affected side that was close to that of the healthy side (SLH-LSI > 0.9). Conclusions The FJS continued to improve over two years after ACLR. The FJS post-ACLR was higher in younger individuals and those with SLH-LSI of 0.9 or higher., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. The Institutional Review Board of Chiba University issued approval M10379. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Sakamoto et al.)

Copyright of Rigakuryoho Kagaku is the property of International Press Editing Center Incorporation and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: To evaluate and compare changes in quadriceps and hamstring strength and single-leg-hop (SLH) test performance over the first 24 postoperative months in patients who underwent anterior cruciate ligament reconstruction (ACLR) with bone-patellar tendon-bone (BPTB) or hamstring tendon (HT) autografts and followed either a standard or an accelerated rehabilitation protocol. Methods: A total of 160 patients undergoing ACLR were randomised in four groups depending on the graft that was used and the rehabilitation protocol (40 BPTB/standard rehab, 40 BPTB/accelerated rehab, 40 HT/standard rehab, 40 HT/accelerated rehab). Isokinetic concentric quadriceps and hamstring strength at 90°/s and the SLH test performance were assessed preoperatively and 4,6,8,12 and 24 months postoperatively. The results were reported as the limb symmetry index (LSI) at the same time point. Linear mixed models were used to compare the groups at the different time points. Results: An average quadriceps strength LSI of 78.4% was found preoperatively. After ACLR, the LSI first decreased at 4 months and then increased from 6 to 24 months, reaching an overall value of 92.7% at the latest follow-up. The BPTB group showed a significantly decreased LSI at 4, 6, 8 and 12 months compared with the HT group. No significant differences between the graft groups were found at 24 months. An average hamstring strength LSI of 84.6% was found preoperatively. After ACLR, the LSI increased from 4 to 24 months in the BTPB group. In the HT group, the LSI first decreased at 4 months and then increased from 6 to 24 months. An LSI of 97.1% and 89.1% was found at the latest follow-up for the BPTB and the HT group, respectively. The HT group showed a significantly decreased LSI at all follow-ups compared with the BPTB group. An average SLH test LSI of 81% was found preoperatively. After ACLR, the LSI increased from 4 to 24 months, reaching 97.6% overall at the latest follow-up. The BPTB group showed a significantly decreased LSI only at 4 months postoperatively compared with the HT group. No significant differences in any of the three tests were found between the standard and accelerated rehabilitation groups for either of the graft groups at any time point. Conclusion: Muscle strength and SLH test performance recovered progressively after ACLR overall, but they did not all fully recover, as the injured leg performed on average less than 100% compared with the uninjured leg even 24 months postoperatively. After ACLR, inferior quadriceps strength and a poorer SLH test performance were found at 4, 6, 8 and 12 months and at 4 months, respectively, for the BTPB group compared with the HT group. Persistent, inferior hamstring strength was found at all postoperative follow-ups in the HT group. Rehabilitation, standard or accelerated, had no significant impact on the recovery of muscle strength and SLH test performance after ACLR in any of the graft groups. Level of Evidence: Level I. [ABSTRACT FROM AUTHOR]

Background A comprehensive battery of tests are used to inform return to play decisions following anterior cruciate ligament (ACL) reconstruction. Performance measures contribute to patient function, but it is not clear if achieving symmetrical performance on strength and hop tests is sufficient or if a patient also needs to meet minimum unilateral thresholds. Hypothesis/Purpose To determine the association of quadriceps strength and single-leg forward hop performance with patient-reported function, as measured by the IKDC Subjective Knee Form (IKDC), during late-stage ACL rehabilitation. A secondary purpose was to determine which clinical tests were the most difficult for participants to pass. Study Design Descriptive Laboratory Study Methods Forty-eight individuals with a history of ACL-R (32 female, 16 male; mean±SD age=18.0±2.7 y; height=172.4±7.6 cm; mass=69.6±11.4 kg; time since surgery=7.7±1.8 months; IKDC=86.8±10.6) completed the IKDC survey, quadriceps isometric strength, and single-leg forward hop performance. The relationship between IKDC scores and performance measures (LSI and involved limb) was determined using stepwise linear regression. Frequency counts were used to determine whether participants met clinical thresholds (IKDC 90%, quadriceps and single-leg forward hop LSI 90%, quadriceps peak torque 3.0 Nm/kg, and single-leg forward hop 80% height for females and 90% height for males). Results Quadriceps LSI and involved limb peak torque explained 39% of the variance in IKDC scores while measures of single-leg forward hop performance did not add to the predictive model. Nearly 90% of participants could not meet established clinical thresholds on all five tests and quadriceps strength (LSI and peak torque) was the most common unmet criteria (71% of participants). Conclusions During late-stage ACL rehabilitation deficits in quadriceps strength contribute more to patient function and are greater in magnitude compared to hop test performance. Level of evidence Cross-Sectional Study, Level 3 [ABSTRACT FROM AUTHOR]

Background Many sporting activities demand multidirectional skills and movements, emphasizing the importance of various fitness components such as functional stability, strength, power, endurance, and range of motion. These aspects must be thoroughly assessed before athletes can return to sports safely following an injury. Although the single-leg hop test (SHT) is widely used as the gold standard for evaluating joint stability, it has limitations in assessing multidirectional movements. Therefore, further research is necessary to explore whether increasing the dynamicity of the hop test in different directions enhances its sensitivity in assessing knee joint stability across all four directions. The objective of this study was to investigate the applicability of a new functional assessment tool, the quadrant hop test (QHT), for evaluating lower limb functional stability. Methodology One hundred nineteen amateur sportsmen who are in the age group of 18-25 years with a limb symmetry index of the lower limb calculated through SHT of >80% were included. All the participants performed the SHT, a triple hop test (THT), a crossover hop test (CHT), and the QHT on two different days, with two investigators assessing the QHT on different days and then recording the measurements of Hop distance. Results The mean difference between SHT, THT, and CHT with QHT was 4.59%, with a moderate correlation between all the hop tests. The Cronbach's alpha revealed good intra-rater (0.917) and inter-rater reliability (0.912) of the QHT. Conclusion The QHT proves to be a reliable and valid measure for assessing the functional stability of the lower limb and is 4.59% more sensitive than SHT, THT, and CHT in assessing knee stability and in return to sports criteria., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Vijayakumar et al.)

Copyright of Rigakuryoho Kagaku is the property of International Press Editing Center Incorporation and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Side differences in the limb symmetry index during hop tests have been rarely investigated in uninjured athletes. Unknown differences can result in false interpretation of hop tests and affect return to sport decision. Hypothesis was that un-injured athletes in Judo and Taekwondo have side differences in hop test and that asymmetries can be predicted based on the athletes fighting display. Differences, risk relationships were analyzed using the chi-squared test and the odds ratio. A two-tailed p value of<0.05 was considered statistically significant. 115 athletes from the national teams were included (mean age 18.4 years; range 13–27 years). 93, 97.4 and 98.3% did not have symmetric hop distance for three hop tests. Up to a quarter did not reach a limb symmetry index of>90. Moreover, 57.4% (n=66) reached longer jumping distance with the standing leg. Ignoring such pre-existent side differences in evaluation of hop tests and not knowing which limb was dominant prior the injury, can lead to premature or delayed return to sports in the rehabilitation process. Therefore, it might be helpful to refer to individual jump lengths for each limb in case of injury by using hop tests in pre-season screening in professional athletes in Judo and Taekwondo. [ABSTRACT FROM AUTHOR]

After lower extremity injury, only half of the injured athletes return to their pre-injury sports level. Even though functional performance tests are often used to make return to sport decisions, it is unknown whether functional performance is associated with return to performance after such injuries. The aim of this systematic review was to identify, critically appraise, and analyze studies that investigated the association of functional performance tests with return to performance after lower extremity injuries in athletes participating in high-impact sports. MEDLINE, Embase, Web of Science, and CINAHL were systematically searched for relevant studies. Articles were independently screened by two authors and data were obtained from each included study using a data extraction form. Two authors independently scored methodological quality using the Quality In Prognosis Studies tool. A qualitative best evidence synthesis was conducted. Eight studies reported the association of functional performance with return to performance after lower extremity injuries, involving 1,246 athletes after anterior or posterior cruciate ligament reconstruction. No studies were found on the association of functional performance with return to performance for lower extremity injuries other than after anterior or posterior cruciate ligament reconstruction. All included studies had a high risk of bias. Two studies found significant but small associations for selected hop tests after anterior cruciate ligament reconstruction. Low evidence of association between functional performance and return to performance was present after anterior cruciate ligament reconstruction for the triple hop for distance, the 6-meter timed hop, the side hop in female athletes, and for the combination of the single and crossover hop for distance. In athletes after posterior cruciate ligament reconstruction, the vertical jump showed a significant but small association with return to performance. There is no high-quality evidence that functional performance is associated with return to performance after lower extremity injuries in athletes practicing high-impact sports. Low quality evidence suggests small associations after anterior and posterior cruciate ligament reconstruction. No evidence exists for lower extremity injuries other than after anterior or posterior cruciate ligament reconstruction. Therefore, research on functional performance associated with return to performance is recommended in high-quality prospective cohort studies including athletes with any type of lower extremity injury. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate the effect of static or dynamic stretching training program on hamstrings eccentric peak torque and functional performance. Forty-five active healthy men were randomly allocated into 3 groups (n = 15 per group): no stretching (control), static stretching (3 sets of 30 seconds), and dynamic stretching (3 sets of 30 repetitions). Static and dynamic stretching protocols on the hamstring muscles were performed 3 times a week until complete 10 sessions. Isokinetic knee flexor eccentric peak torque (608$s21), triple hop distance, and modified 20-m sprint time were assessed in a random order before and after stretching training. A mixed-design analysis of variance was performed, with an alpha level of 0.05. There was a significant decrease of eccentric peak torque (p ≤ 0.0001, -15.4 ± 10.4%, within-group effect size: 1.03) after static stretching training. The static stretching training reduced eccentric torque when compared with no stretching (27.6 ± 21.7%, betweengroup effect size: 0.50) and dynamic stretching (27.8 ± 29.8%, between-group effect size: 0.51). Moreover, the reached distance on triple hop test was also reduced after static stretching protocol (p = 0.009, 23.7 ± 4.1%, withingroup effect size: 0.29). These findings suggest that static stretching training is sufficient to produce meaningful reductions on hamstrings eccentric torque and functional performance. Based on the results of this study, caution should be taken when prescribing of static stretching training in isolation when the purpose is to improve performance, and indirectly, to prevent hamstring strain injuries due to its possible negative effects on hopping performance and knee flexor eccentric torque. [ABSTRACT FROM AUTHOR]

The main aim of this study was to determine the test–retest reliability of an experimental functional test battery: Y-balance test (YBT), single-leg countermovement jump (SLCMJ), single-leg hop for distance (SLH), side-hop (SH), speedy-jump (SJ), agility-T (AT), and lower extremity functional test (LEFT). Secondary aims were (1) to determine the mean range for the limb symmetry index (LSI) and (2) to detect significant differences in performance between test–retest sessions. Twenty-two healthy adults (14 males, 8 females; age 23.3 ± 3.9) were tested by the same rater during two different sessions (T1–T2), with a seven-day interval, under the same conditions. Reliability analysis showed good-to-excellent reliability (0.89 < ICC < 0.97; 0.80 < α < 0.98) for the test battery. LSI ranged from 95.9 ± 6.7% (SH-T1) to 104.4 ± 12.5% (SLCMJ-T2). Repeated measures ANOVA detected significant performance differences between sessions in the LEFT (p = 0.009) and for non-dominant sides in the SLH (p = 0.015), SH (p = 0.007), and SJ (p = 0.011). The high reliability of the test battery suggests a potential use in clinical sports practice. The LSI range of ≥95% was proposed as a benchmark for healthy adults. Learning effect seems to have played a crucial role in the T2 improvements of the non-dominant side for hop performances (SLH, SH, SJ) and speed performance (LEFT).

Introduction: Return to Sport tests with functional hop tests are often used to decide when a person is ready to return to sport after an anterior cruciate ligament (ACL) injury. Poor movement quality, such as knee valgus, hip adduction and hip internal rotation is considered a risk factor for ACL injury. However, it is unclear whether existing tests adequately cover the aspect of movement quality. This study aims to investigate whether there is a relationship between the calculated limb symmetry index (LSI) of hop tests as an indication of performance and the total score of the "Quality First" assessment (movement quality). The second aim is to examine the reliability of the newly developed "Quality First" assessment for evaluating movement quality in hop tests., Methods: The cross-sectional study recruited 34 patients with an ACL reconstruction. The vertical hop, single-leg hop for distance, and side hop tests were performed and recorded. The video recordings were assessed using the "Quality First" assessment. The Spearman correlation coefficient was calculated using the LSI and the "Quality First" total score. Intraclass correlation coefficients (ICC) and standard error of measurements (SEM) were used to calculate intra- and interrater reliability. In addition, the minimal detectable change (MDC) was determined., Results: The correlation test between the LSI and the "Quality First" total score showed no correlation for all three jumps ( r  = -0.1-0.02/ p -value = 0.65-0.93). The interrater reliability of the "Quality First" assessment showed fair to good reliability (ICC 2 : 0.45-0.60), with SEM ranging from 1.46 to 1.73 and the MDC from 4.06 to 4.8. Intrarater reliability was good to excellent (ICC 3 : 0.73-0.85), with SEM values ranging from 0.89 to 1.09 and the MDC from 2.47 to 3.01., Conclusion: The quality of movement, measured with the "Quality First" assessment, indicated no correlation with the calculated LSI from jump performance, therefore movement quality should also be examined in Return to Sport tests. The "Quality First" assessment shows fair to good reliability when used by different raters. When used multiple times by the same rater, the assessment has good to excellent reliability., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2024 Weber, Müller, Mathieu-Kälin, Caminada, Häberli and Baur.)

Objective: The purpose of this systematic review with meta-analysis was to determine the effectiveness of functional performance tests (FPTs) in differentiating between individuals with chronic ankle instability (CAI) and healthy controls. Data Sources: The National Library of Medicine Catalog (PubMed), the Cumulative Index for Nursing and Allied Health Literature (CINAHL), and the SPORTDiscus, from inception to June 2017 were searched. Search terms consisted of: "Functional Performance Test*" OR "Dynamic Balance Test*" OR "Postural Stability Test*" OR "Star Excursion Balance Test*" OR "Hop Test*" AND "Ankle Instability" OR "Ankle Sprain." Included articles assessed differences in FPTs in patients with CAI compared with a control group. Main Results: Included studies were assessed for methodological quality and level of evidence. Individual and mean effect sizes were also calculated for FPTs from the included articles. Twenty-nine studies met the criteria and were analyzed. The most common FPTs were timed-hop tests, side-hop, multiple-hop test, single-hop for distance, foot-lift test, and the Star Excursion Balance Tests (SEBTs). The side-hop (g = -1.056, P = 0.009, n = 7), timed-hop tests (g = -0.958, P = 0.002, n = 9), multiple-hop test (g = 1.399, P < 0.001, n = 3), and foot-lift tests (g = -0.761, P = 0.020, n = 3) demonstrated the best utility with large mean effect sizes, whereas the SEBT anteromedial (g = 0.326, P = 0.022, n = 7), medial (g = 0.369, P = 0.006, n = 7), and posteromedial (g = 0.374, P < 0.001, n 5 13) directions had moderate effects. Conclusions: The side-hop, timed-hopping, multiple-hop, and foot-lift seem the best FPTs to evaluate individuals with CAI. There was a large degree of heterogeneity and inconsistent reporting, potentially limiting the clinical implementation of these FPTs. These tests are cheap, effective, alternatives compared with instrumented measures. [ABSTRACT FROM AUTHOR]

Side-to-side asymmetry of lower-limb motor-performance is associated with increased noncontact injury risk in agility-sports. Side-to-side symmetry-analyses using single-leg balance and hop tests has not been reported for community-level adult netball players. The purpose of this study was to perform preseason side-to-side symmetry-analyses using eyes-closed-balance (ECB), triple-hop-for-distance (THD), single-hop-for-distance (SHD), and vertical-hop (VH) tests. Cross-sectional; Community-level adult netball club. Twenty-three female players (age 28.7 ± 6.2yr; height 171.6 ± 7.0 cm; mass 68.2 ± 9.8 kg). Right-left group-level comparisons (paired t -test) and individual-level comparisons (absolute-asymmetry (%)). A limb symmetry index was calculated for each test and a clinically-significant absolute-asymmetry defined as >10%. Clinically-significant absolute-asymmetry prevalence (%) was computed for each test. There were no right-left significant differences for any test. Maximum absolute-asymmetries for the ECB, THD, SHD, and VH were 93.3%, 15.2%, 16.7%, and 60.3%, respectively. The prevalence of clinically-significant absolute-asymmetries for the ECB, THD, SHD, and VH was 91.3%, 8.7%, 8.7%, and 52.2%, respectively. Group-level comparisons with statistical tests fail to expose the extent of clinically-significant absolute-asymmetries. Most players demonstrated preseason clinically-significant absolute-asymmetries for the ECB and VH tests. Preseason clinically-significant absolute-asymmetries that may predispose increased lower-limb noncontact injury risk are widespread in a community-level adult netball club. • Group-level statistics fail to expose preseason clinically-significant asymmetries. • Most players had clinically-significant asymmetry for the eyes-closed-balance test. • Most players had clinically-significant asymmetry for the vertical-hop test. • Clinically-significant asymmetry is widespread in a community-level adult netball [ABSTRACT FROM AUTHOR]

Purpose: To assess the reliability of neurocognitive and functional performance tests in athletes with and without functional ankle instability (FAI). Methods: In this methodological study, 20 athletes with unilateral functional ankle instability (mean age [SD]: 23.40[2.58] y; mean height[SD]: 1.77[0.11] m; mean weight[SD]: 67.00[13.18] kg) and 20 uninjured athletes (mean age[SD]: 23.05[2.72] y; mean height: 1.77[0.13] m; mean weight: 66.35[12.21] kg) matched by sex, sports type and level, age, limb dominance, height, and weight were sampled by convenient method from Karaj volleyball and basketball super league members. Functional performance tests (FPTs) included the star excursion balance test (SEBT), figure-of-8, side, square, and single hop tests. Neurocognitive function was assessed with the Deary-Liewald reaction task (DLRT) including simple and choice reaction times and error rate. The intraclass correlation coefficient (ICC) and standard error of measurement (SEM) tests were calculated using SPSS software version 16. Results: There were no statistically significant differences between 2 groups with regard to age (P=0.641), weight (P=0.872), height (P=0.989), and duration of physical activity (P=0.94). Generally, high to very high level of reliability were determined with ICC ranging from 0.74 to 0.99, and 0.91 to 0.99 and SEM ranging from 0.03 to 0.69, and 0.00 to 0.03 for hop tests and SEBT, respectively. Furthermore, ICC values ranged from 0.78 to 0.96 and SEM values from 0.24 to 23.77 for neurocognitive test. Conclusion: Reliability of the FPTs was found to be high to very high in this study. SEBT seems to be a highly reliable and applicable test to use in clinical and research practice. Although not as reliable as the SEBT, hop test seems also to be a reliable tool to assess the dynamic performance of patients with FAI. The results suggest that DLRT has an acceptable reliability for the measurement of neurocognitive function in patients with FAI

Cryotherapy is widely used in sports and rehabilitation to aid recovery and injury management. The purpose was to examine if a low temperature computer controlled continuous knee cooling protocol (10°C) for one hour and a moderate continuous knee cooling protocol (18°C) for one hour affected neuromuscular activity and functional performance tests. We used a randomized controlled study design. Twenty healthy male subjects (age = 24 ± 3 years) were included and randomized into 2 groups (10°C and 18°C). On day one, participants performed a maximal voluntary contraction of the quadriceps (MVC), single leg hop for distance (SLHD), and crossover hop for time (COHT) with both legs before and after cooling of their right leg. At day two, the same tests were performed with both legs before and after cooling of the left leg. Participants exposed to the 10°C-protocol showed a significant decrease in SLHD and COHT performance. For the 18°C-group, no significant changes in SLHD and COHT outcomes were noted. In both groups, EMG frequency during MVC decreased, but no significant increases were found in EMG amplitude. Continuous knee cooling at 18°C for one hour does not affect functional hop performance, though adaptations at the muscle level (EMG frequency decrease) can be observed. Applying a similar cooling protocol with 10°C results in a significant decrease in functional hop performance and EMG frequency. EMG amplitude remained unaffected. This infers that changes at muscle level due to local temperature manipulations may not always be detrimental to functional performance. [ABSTRACT FROM AUTHOR]

This study aimed to compare the concentric and eccentric activity and the temporal order of peak activity of the hip and knee muscles between women with patellofemoral pain (PFP) and healthy women during the single leg triple hop test (SLTHT). Electromyographic (EMG) and Kinematic data were collected from 14 healthy women (CG) and 14 women diagnosed with PFP (PFG) during a single session of the single leg triple hop test. Integral surface electromyography (iEMG) data of the hip and knee muscles in eccentric and concentric phases and the length of time that each muscle needed to reach the maximal peak of muscle activity were calculated. The iEMG in the eccentric phase was significantly higher (p < 0.05) than the concentric phase, for the gluteus maximus and gluteus medius muscles (CG and PFG) and for the vastus lateralis muscle (PFG). The vastus lateralis muscle was the first muscle to reach the highest peak of activity in the PFG, and the third to reach this peak in the CG. In the present study, the activity of the vastus lateralis muscle during the eccentric phase of the jump was greater than concentric phase, as a temporal anticipation of its peak in activity among women with PFP. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Kinesio taping consists of the attachment of a thin elastic tape over specific muscles, the thickness of which is similar to that of the epidermis. OBJECTIVE: The aim of the present study was to compare the effect of Kinesio taping and placebo taping on muscle torque, muscle activity and jumping performance soccer players. METHODS: Thirty athletes were randomly allocated to two groups (Group A: Kinesio taping and Group B: placebo taping). The participants were instructed to perform the Hop test's and were submitted to an isokinetic evaluation of the knee extensors as well as an electromyographic evaluation of the retus femoris muscle of the dominant lower limb. Next, Kinesio taping was performed for the activation of the rectus femoris muscle in Group A and placebo taping was performed in Group B. The participants were reevaluated 30 minutes after taping and 24 hours after the first evaluation using the same tests. Intra-group and inter-group comparisons were made considering the three evaluation times. RESULTS: No statistically significant differences were found between groups at any evaluation time regarding the Hop test's, root mean square of the electromyographic signal or peak torque of the knee extensors of the dominant lower limb (p > 0.05). CONCLUSION: Kinesio taping for the activation of the rectus femoris muscle has no effect on peak muscle torque, muscle activity or jumping performance among soccer players. [ABSTRACT FROM AUTHOR]

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Copyright of Retos: Nuevas Perspectivas de Educación Física, Deporte y Recreación is the property of Federacion Espanola de Asociaciones de Docentes de Educacion Fisica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The purpose of the study is to evaluate the discriminative validity of the multiple hop test (MHT) for chronic ankle instability (CAI). The dynamic postural control of 51 CAI subjects and 52 uninjured controls was assessed using the MHT. To evaluate dynamic postural control, the type and number of balance errors were analysed and the time to complete the MHT was measured. Between-group differences of time scores and balance errors, identified as being change-in-support strategy errors (CSS) or fixed-support strategy errors (FSS), were assessed. The area under curve of the outcomes was determined and likelihood ratios (LRs) were calculated based upon their most optimal cut off point. When compared to uninjured controls, CAI subjects needed significantly more time to perform the test (p<0.001) and made significantly more CSS errors (p<0.001). When 1 positive outcome (time score or CSS errors) was considered as a criterion, the LR+ was 2 and the LR- 0.08. In the case of 2 positive outcomes (time score and CSS errors), the LR+ was 7.1 and the LR- 0.49. CAI subjects have an impaired dynamic postural control and rely on a different postural strategy to restore balance. The MHT has good discriminative validity for CAI. [ABSTRACT FROM AUTHOR]