Advertisement

Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 14, Issue 8, pp 778–788 | Cite as

A test battery for evaluating hop performance in patients with an ACL injury and patients who have undergone ACL reconstruction

  • Alexander Gustavsson
  • Camille Neeter
  • Pia Thomeé
  • Karin Grävare Silbernagel
  • Jesper Augustsson
  • Roland Thomeé
  • Jon Karlsson
Sports Medicine

Abstract

The purpose of this study was to develop a test battery of hop tests with high ability to discriminate (i.e. high test–retest reliability, sensitivity, specificity and accuracy) between the hop performance of the injured and the uninjured side in patients with an ACL injury and in patients who have undergone ACL reconstruction. Five hop tests were analysed: three maximum single hop tests and two hop tests while developing fatigue. Fifteen healthy subjects performed the five hop tests on three separate occasions in a test–retest design. Thirty patients, mean 11 months after an ACL injury and 35 patients, mean 6 months after ACL reconstruction were tested. ICC values ranged from 0.85 to 0.97 for the five hop tests, indicating that all the tests had high test–retest reliability. Sixty-seven percent to 100% of the healthy subjects had normal symmetry (i.e. <10% side-to-side difference) in the five hop tests. Abnormal symmetry in the five hop tests ranged from 43 to 77% for patients with an ACL injury and from 51 to 86% for patients who had undergone ACL reconstruction respectively. The three tests with the highest ability to discriminate hop performance were chosen for the test battery; they were the vertical jump, the hop for distance and the side hop. The test battery revealed a high level of sensitivity and accuracy in patients with an ACL injury (87 and 84%) and in patients who had undergone ACL reconstruction (91 and 88%), when at least one of the three tests was classified as abnormal. To summarise, the test battery consisting of both maximum single hop performances: the vertical jump and the hop for distance and hop performance while developing fatigue: the side hop, produced high test–retest reliability, sensitivity and accuracy. Further, the test battery produced higher values compared with any of the three hop tests individually revealing that only one out of ten patients had restored hop performance 11 months after an ACL injury and 6 months after ACL reconstruction. It is concluded that this test battery showed a high ability to discriminate between the hop performance of the injured and the uninjured side both in patients with an ACL injury and in patients who have undergone ACL reconstruction.

Keywords

Anterior cruciate ligament Knee Rehabilitation Hop test 

Notes

Acknowledgments

This study was supported by grants from the Swedish Centre for Research in Sports and Research and The Local Research and Development Council for Gothenburg and Southern Bohuslän Sweden.

References

  1. 1.
    Barber SD, Noyes FR, Mangine RE, McCloskey JW, Hartman W (1990) Quantitative assessment of functional limitations in normal and anterior cruciate ligament-deficient knees. Clin Orthop 255:204–214PubMedGoogle Scholar
  2. 2.
    Eastlack ME, Axe MJ, Snyder-Mackler L (1999) Laxity, instability, and functional outcome after ACL injury: copers versus noncopers. Med Sci Sports Exerc 31:210–215CrossRefPubMedGoogle Scholar
  3. 3.
    Fitzgerald GK, Axe MJ, Snyder-Mackler L (2000) A decision-making scheme for returning patients to high-level activity with nonoperative treatment after cruciate ligament rupture. Knee Surg Sports Traumatol Arthrosc 8:76–82CrossRefPubMedGoogle Scholar
  4. 4.
    Itoh H, Kurosaka M, Yoshiya S, Ichihashi N, Mizuno K (1998) Evaluation of functional deficits determined by four different hop tests in patients with anterior cruciate ligament deficiency. Knee Surg Sports Traumatol Arthrosc 6:241–245CrossRefPubMedGoogle Scholar
  5. 5.
    Noyes FR, Barber SD, Mangine RE (1991) Abnormal lower limb symmetry determined by function hop tests after anterior cruciate ligament rupture. Am J Sports Med 19:513–518PubMedCrossRefGoogle Scholar
  6. 6.
    Rudolph KS, Axe MJ, Snyder-Mackler L (2000) Dynamic stability after ACL injury: who can hop? Knee Surg Sports Traumatol Arthrosc 8:262–269CrossRefPubMedGoogle Scholar
  7. 7.
    Tegner Y, Lysholm J, Lysholm M, Gillquist J (1986) A performance test to monitor rehabilitation and evaluate anterior cruciate ligament injuries. Am J Sports Med 14:156–159PubMedCrossRefGoogle Scholar
  8. 8.
    Augustsson J (2004) Ability of a new hop test to determine functional deficits after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 12:350–356CrossRefPubMedGoogle Scholar
  9. 9.
    Jerre R, Ejerhed L, Wallmon A, Kartus J, Brandsson S, Karlsson J (2001) Functional outcome of anterior cruciate ligament reconstruction in recreational and competitive athletes. Scand J Med Sci Sports 11:342–346CrossRefPubMedGoogle Scholar
  10. 10.
    Juris PM, Phillips EM, Dalpe C, Edwards C, Gotlin RS, Kane DJ (1997) A dynamic test of lower extremity function following anterior cruciate ligament reconstruction and rehabilitation. J Orthop Sports Phys Ther 26:184–191PubMedGoogle Scholar
  11. 11.
    Keays SL, Bullock-Saxton J, Keays AC, Newcombe P (2001) Muscle strength and function before and after anterior cruciate ligament reconstruction using semitendinosus and gracilis. The Knee 8:229–234CrossRefPubMedGoogle Scholar
  12. 12.
    Liu-Ambrose T, Taunton JE, MacIntyre D, McConkey P, Khan KM (2003) The effects of proprioceptive or strength training on the neuromuscular function of the ACL reconstructed knee: a randomized clinical trail. Scand J Med Sci Sports 13:115–123CrossRefPubMedGoogle Scholar
  13. 13.
    Pantano KJ, Irrgang JJ, Burdett R, Delitto A, Harner C, Fu FH (2000) A pilot study on the relationship between physical impairment and activity restriction in persons with anterior cruciate ligament reconstruction at long-term follow-up. Knee Surg Sports Traumatol Arthrosc 9:369–378CrossRefGoogle Scholar
  14. 14.
    Paterno MV, Greenberger HB (1996) The test–retest reliability of a one legged hop for distance in young adults with and without ACL reconstruction. Isokinet Exerc Sci 6:1–6Google Scholar
  15. 15.
    Petschnig R, Baron R, Albrecht M (1998) The relationship between isokinetic quadriceps strength test and hop tests for distance and one-legged vertical jump test following anterior cruciate ligament reconstruction. J Orthop Sports Phys Ther 28:23–31PubMedGoogle Scholar
  16. 16.
    Risberg MA, Ekeland A (1994) Assessment of functional tests after anterior cruciate ligament surgery. J Orthop Sports Phys Ther 19:212–217PubMedGoogle Scholar
  17. 17.
    Ross MD, Irrgang JJ, Denegar CR, McCloy CM, Unangst ET (2002) The relationship between participation restrictions and selected clinical measures following anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 10:10–19CrossRefPubMedGoogle Scholar
  18. 18.
    Sernert N, Kartus J, Köhler K, Stener S, Larsson J, Eriksson B, Karlsson J (1999) Analysis of subjective, objective and functional examination tests after anterior cruciate ligament reconstruction. A follow up of 527 patients. Knee Surg Sports Traumatol Arthrosc 7:160–165CrossRefPubMedGoogle Scholar
  19. 19.
    Wilk KE, Romaniello WT, Soscia SM, Arrigo CA, Andrews JR (1994) The relationship between subjective knee scores, isokinetic testing, and functional testing in the ACL-reconstructed knee. J Orthop Sports Phys Ther 20:60–71PubMedGoogle Scholar
  20. 20.
    Risberg MA, Holm I, Ekeland A (1995) Reliability of functional knee tests in normal athletes. Scand J Med Sci Sports 5:24–28PubMedCrossRefGoogle Scholar
  21. 21.
    Östenberg A, Roos E, Ekdahl C, Roos H (1998) Isokinetic knee extensor strength and functional performance in healthy female soccer players. Scand J Med Sci Sports 8:257–264PubMedGoogle Scholar
  22. 22.
    Dugan SA, Frontera WR (2000) Muscle fatigue and muscle injury. Phys Med Rehabil Clin N Am 11:385–403PubMedGoogle Scholar
  23. 23.
    Feagin JA Jr, Lambert KL, Cunningham RR, Anderson LM, Riegel J, King PH, Van Genderen L (1987) Consideration of the anterior cruciate ligament injury in skiing. Clin Orthop 216:13–18PubMedGoogle Scholar
  24. 24.
    Östenberg A, Roos H (2000) Injury risk factors in female European football. A prospective study of 123 players during one season. Scand J Med Sci Sports 10:279–285CrossRefPubMedGoogle Scholar
  25. 25.
    Tegner Y, Lysholm J (1985) Rating system in the evaluation of knee ligament injuries. Clin Orthop 198:43–49PubMedGoogle Scholar
  26. 26.
    Grimby G (1986) Physical activity and muscle training in the elderly. Acta Med Scand 711(Suppl.):233–237Google Scholar
  27. 27.
    Shrout PE, Fleiss JL (1979) Intraclass Correlations: uses in assessing rater reliability. Psychol Bull 86:420–428CrossRefPubMedGoogle Scholar
  28. 28.
    Dahlberg G (1940) Statistical methods for medical and biological students. Allen and Unwin, LondonGoogle Scholar
  29. 29.
    Altman DG (1991) Practical statistics for medical research. Chapman & Hall, London, pp 410–411Google Scholar
  30. 30.
    Portney LG, Watkins MP (2000) Foundations of clinical research: applications to practice, 2nd edn. Prentice-Hall, New Jersey, pp 494–495Google Scholar
  31. 31.
    Wilson GJ, Newton RU, Murphy AJ, Humphries BJ (1993) The optimal training load for the development of athletic performance. Med Sci Sports Exerc 11:1279–1286Google Scholar
  32. 32.
    Manske RC, Smith B, Wyatt F (2003) Test–retest reliability of lower extremity functional tests after a closed kinetic chain isokinetic testing bout. J Sports Rehabil 12:119–132Google Scholar
  33. 33.
    MacDonald PB, Hedden D, Pacin O, Huebert D (1995) Effects of an accelerated rehabilitation program after anterior cruciate ligament reconstruction with combined semitendinosus-gracilis autograft and a ligament augmentation device. Am J Sports Med 23:588–592PubMedCrossRefGoogle Scholar
  34. 34.
    Shelbourne KD, Nitz PA (1991) The O’Donoghue triad revisited. Combined knee injuries involving anterior cruciate and medial collateral ligament tears. Am J Sports Med 19:474–477PubMedCrossRefGoogle Scholar
  35. 35.
    De Carlo M, Shelbourne KD, Oneacre K (1999) Rehabilitation program for both knees when the contralateral autogenous patellar tendon graft is used for primary anterior cruciate ligament reconstruction: a case study. J Orthop Sports Phys Ther 29:144–153PubMedGoogle Scholar
  36. 36.
    Howell S, Taylor M (1996) Brace-free rehabilitation, with early return to activity, for knees reconstructed with a double-looped semitendinosus and gracilis graft. J Bone Joint Surg Am 78:814–825PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Alexander Gustavsson
    • 1
    • 2
    • 3
  • Camille Neeter
    • 1
    • 2
  • Pia Thomeé
    • 1
    • 2
  • Karin Grävare Silbernagel
    • 1
    • 2
  • Jesper Augustsson
    • 1
    • 2
  • Roland Thomeé
    • 1
    • 2
  • Jon Karlsson
    • 1
  1. 1.Department of Orthopaedics, Sahlgrenska University Hospital Göteborg UniversityGöteborgSweden
  2. 2.Sportrehab – Physical Therapy and Sports Medicine ClinicGöteborgSweden
  3. 3.Department of Orthopaedics, Lundberg Laboratory for Human Muscle Function and Movement Analysis Sahlgrenska University HospitalGöteborgSweden

Personalised recommendations