Using Normative Data and Unilateral Hopping Tests to Reduce Ambiguity in Return-to-Play Decisions

Area of Science:

• Sports Medicine
• Rehabilitation Science
• Biomechanics

Background:

• Return to sport (RTS) decisions after lower extremity injury are often based on achieving limb symmetry on hopping tests.
• The specific target limb symmetry index (LSI) value required for safe RTS remains unclear.
• Identifying predictive variables for LSI can aid clinicians in objective RTS assessments.

Purpose of the Study:

• To identify variables that predict limb symmetry index (LSI) values on six unilateral hopping tests in healthy, physically active adults.
• To provide clinicians with objective measures for return to sport decisions.

Main Methods:

• Cross-sectional study involving 275 healthy, physically active adults (recreational athletes, student-athletes, ROTC cadets).
• Participants completed three speed (6-m crossover-hop, side-hop, figure-8 hop) and three distance (triple-crossover-hop, lateral-hop, medial-hop) functional performance tests on both limbs.
• Two multiple regression models were used to identify predictors of LSI values for each test.

Main Results:

• Predictive models successfully identified limb symmetry predictors for 10 out of 12 regressions.
• Unilateral limb performance was the strongest predictor of LSI, significant in 11 of 12 models.
• Sex and body mass index were significant predictors for the side hop and figure-8 hop, respectively.

Conclusions:

• Significant predictor variables were identified to help clinicians determine patient-specific LSI values for return to sport.
• Individualizing RTS decisions based on these predictors can reduce subjectivity.
• This approach supports a safer and more timely return to competition for athletes post-injury.