Unilateral vs. bilateral hamstring strength assessments: comparing reliability and inter-limb asymmetries in female...

The aims in the present study were to assess reliability for two unilateral and two bilateral field-based hamstring assessments and compare magnitude, direction and agreement of inter-limb asymmetry between tests and sessions. Twenty-nine female soccer players (age: 21.1 ± 4.5 years; height: 169.7 ± 5.8 cm; body mass: 66.2 ± 6.4 kg) performed three repetitions per leg of unilateral isometric 30° and 90° knee flexion (KF) tasks, and three repetitions total for a bilateral 90° isometric KF and Nordic hamstring exercise. Absolute reliability of most methods were acceptable (<10%). Relative reliability within-session was fair to excellent (ICC≥0.784; lower bound 95%CI ≥0.623). Greater variability in between-session relative reliability was observed during the unilateral tests, demonstrating poor to good (ICC = 0.698-0.798; lower bound 95%CI = 0.274-0.638). Bilateral assessments demonstrated similar ranges of poor to excellent (ICC = 0.679-0.963; lower bound 95%CI = 0.231-0.790). Agreement between-session for inter-limb asymmetry identification was slight and fair in the unilateral tests, with moderate to substantial agreement demonstrated in the bilateral. Being the most reliable within- and between-sessions, demonstrating substantial agreement in asymmetry between-sessions, the NHE would be most appropriate to identify inter-limb asymmetry and assess chronic changes in hamstring strength.