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  • Mick Hughes

Return To Sport Test: The Hop Test Battery.

I've previously posted about the single leg hop test and its role in the decision-making process regearding return to sport following lower limb injury. Now, I'll cover the 4 hop test battery that is commonly used in return to sport testing following ACL surgery (SEE picture above).

2 recent studies (Kyritsis et al., 2016 & Grindem et al, 2016) show that athletes were significantly more likely to sustain a 2nd ACL injury when all discharge criteria were NOT met; which included the 4 following hop tests:

- single hop (>10% difference between limbs), - triple hop (>10% difference between limbs), - triple crossover hop (>10% difference between limbs),

- 6m timed hop (>10% difference between limb limbs)

*NB: Other discharge criteria included isokinetic quads & hamstring strength testing, agility T-Test and completing sport-specific conditioning and training.

Further to these 2 studies, another recent trial showed that performing these 4 hop tests of the uninvolved limb in patients awaiting ACL surgery (PRE-OP) is superior to predicting 2nd ACL injuries than strength & hop tests at >6 months POST-OP (Wellsandt et al, 2017). 

Take home messages

1) If you're not using functional tests such as hop tests in the return to sport decision making process for ACLR patients, you need to start ASAP. It really should be considered a non-negotiable for both athlete and treating physio. It takes the guessing game out of the equation, and objectively shows functional deficits between limbs. They're not 100% perfect, but it certainly is better than allowing your patient to return to sport because it's been 12 months since their op.

2) PRE-OP physio is NOT A WASTE OF TIME. Getting strong and establishing baseline measures when the patient/athlete is at their fittest (and strongest), appears to be more accurate in determining readiness to return to sport, than testing the patient/athlete >6 months post-op when they've deconditioned following surgery.  

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