{"id":10501,"date":"2023-04-03T06:00:09","date_gmt":"2023-04-03T05:00:09","guid":{"rendered":"https:\/\/blogs.bmj.com\/bjsm\/?p=10501"},"modified":"2023-08-31T16:43:36","modified_gmt":"2023-08-31T15:43:36","slug":"simple-hop-tests-after-acl-injury-are-prognostic-for-future-outcomes","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bjsm\/2023\/04\/03\/simple-hop-tests-after-acl-injury-are-prognostic-for-future-outcomes\/","title":{"rendered":"Simple hop tests after ACL injury are prognostic for future outcomes"},"content":{"rendered":"<p><span style=\"font-weight: 400\"><strong>Keywords<\/strong>: Rehabilitation, Anterior cruciate ligament, Hop test<\/span><\/p>\n<p><span style=\"font-weight: 400\">We recently published our systematic review in BJSM investigating the prognostic capacity of unilateral tests of lower-limb function following anterior cruciate ligament (ACL) injury and reconstruction (ACLR).<\/span><span style=\"font-weight: 400\">1<\/span><span style=\"font-weight: 400\"> The summary of <\/span><span style=\"font-weight: 400\">this study<\/span><span style=\"font-weight: 400\"> is outlined in this blog.\u00a0<\/span><\/p>\n<p><b>Why is this study important?<\/b><\/p>\n<p><span style=\"font-weight: 400\">Functional or physical performance tests, such as hop tests, are commonly used to assess recovery after anterior cruciate ligament (ACL) injury and reconstruction. Hop tests are quick and easy to administer, typically requiring only a tape measure and stopwatch. They are often performed as part of a test battery to determine rehabilitation progression and when an athlete can safely return to sport.<\/span><span style=\"font-weight: 400\">5<\/span><span style=\"font-weight: 400\"> Performance on these tests also provides prognostic value for future knee-related outcomes<\/span><span style=\"font-weight: 400\">6 7<\/span><span style=\"font-weight: 400\"> but until now data on the prognostic capacity of hop tests has not been synthesised systematically.<\/span><\/p>\n<p><b>How did the study go about this?<\/b><\/p>\n<p><span style=\"font-weight: 400\">We conducted a systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Included studies reported associations between hop tests (expressed as a limb symmetry index [LSI=index limb \u00f7 contralateral limb x 100) following ACL injury and future (\u22653 months) knee-related outcomes.<\/span><b> <\/b><span style=\"font-weight: 400\">Meta-analyses was conducted to synthesise the data, combining results from studies reporting on the same hop test and association with the same outcomes. We also assessed whether test batteries, incorporating hop tests together with strength measures, were associated with future knee-related outcomes.<\/span><\/p>\n<p><b>What did the study find?<\/b><\/p>\n<p><span style=\"font-weight: 400\">We included 42 studies (13,150 adolescents and adults, 44% female) that assessed either the single-forward hop or a repeated-forward hop (e.g., crossover, triple, 6m-timed hop, all analysed together).\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">Our meta-analyses indicated that better performance on single-forward hop and repeated-forward hop tests was associated with:\u00a0<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Twice the odds of return to pre-injury sport up to 3 years post-ACLR<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">2-4-fold the odds of better self-reported-symptoms and function up to 15 years post-ACLR<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">50% reduced odds of radiographic osteoarthritis 5-37 years post-ACLR (in relation to achieving \u226590% LSI single-forward hop test only)<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400\">Hop test performance was not related to success for an ACL-deficient knee (i.e., not having surgery after injury) or with avoiding future injury.<\/span><\/p>\n<p><span style=\"font-weight: 400\">For test batteries incorporating hop tests together with strength and biomechanical measures:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Achieving \u226590% LSI on all criteria is associated with increased likelihood of returning to sport\u00a0<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Achieving \u226590% LSI on all criteria is not associated with avoiding subsequent knee injury\u00a0<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400\">Our results need to be interpreted with caution as they are associated with very low certainty evidence; 65% of included studies had high risk of bias.<\/span><\/p>\n<p><b>Key clinical take homes:\u00a0<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Hop tests can inform clinicians and patients of potential future outcomes after ACL injury and reconstruction.\u00a0<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Our results encourage the continued use of hop tests during ACL rehabilitation and as part of return to sport testing, though best-available evidence suggests that achieving adequate performance does not automatically reduce subsequent knee injury risk.\u00a0<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">The prognostic capacity of individual hop tests and hop test batteries should be harnessed by clinicians to empower and motivate patients along their ACL rehabilitation journey. They provide instant feedback and their important impact on future outcomes can be utilised to enhance motivation and adherence to rehabilitation.\u00a0<\/span><\/li>\n<\/ul>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-10502\" src=\"https:\/\/blogs.bmj.com\/bjsm\/files\/2023\/04\/Screenshot-2023-04-01-at-14.10.48-211x300.png\" alt=\"\" width=\"425\" height=\"604\" srcset=\"https:\/\/blogs.bmj.com\/bjsm\/files\/2023\/04\/Screenshot-2023-04-01-at-14.10.48-211x300.png 211w, https:\/\/blogs.bmj.com\/bjsm\/files\/2023\/04\/Screenshot-2023-04-01-at-14.10.48-768x1090.png 768w, https:\/\/blogs.bmj.com\/bjsm\/files\/2023\/04\/Screenshot-2023-04-01-at-14.10.48-640x909.png 640w, https:\/\/blogs.bmj.com\/bjsm\/files\/2023\/04\/Screenshot-2023-04-01-at-14.10.48.png 858w\" sizes=\"auto, (max-width: 425px) 100vw, 425px\" \/><\/p>\n<p><b>References<\/b><\/p>\n<ol>\n<li><span style=\"font-weight: 400\"> West TJ, Bruder AM, Crossley KM, et al. Unilateral tests of lower-limb function as prognostic indicators of future knee-related outcomes following anterior cruciate ligament injury: a systematic review and meta-analysis of 13 150 adolescents and adults. <\/span><i><span style=\"font-weight: 400\">British Journal of Sports Medicine<\/span><\/i><span style=\"font-weight: 400\"> 2023:bjsports-2022-105736. doi: 10.1136\/bjsports-2022-105736<\/span><\/li>\n<li><span style=\"font-weight: 400\"> Grindem H, Snyder-Mackler L, Moksnes H, et al. Simple decision rules can reduce reinjury risk by 84% after ACL reconstruction: the Delaware-Oslo ACL cohort study. <\/span><i><span style=\"font-weight: 400\">Br J Sports Med<\/span><\/i><span style=\"font-weight: 400\"> 2016;50(13):804. doi: 10.1136\/bjsports-2016-096031<\/span><\/li>\n<li><span style=\"font-weight: 400\"> Ardern CL, Taylor NF, Feller JA, et al. Sports participation 2 years after anterior cruciate ligament reconstruction in athletes who had not returned to sport at 1 year: a prospective follow-up of physical function and psychological factors in 122 athletes. <\/span><i><span style=\"font-weight: 400\">Am J Sports Med<\/span><\/i><span style=\"font-weight: 400\"> 2015;43(4):848-56. doi: 10.1177\/0363546514563282 [published Online First: 2015\/01\/15]<\/span><\/li>\n<li><span style=\"font-weight: 400\"> Davies WT, Myer GD, Read PJ. Is It Time We Better Understood the Tests We are Using for Return to Sport Decision Making Following ACL Reconstruction? A Critical Review of the Hop Tests. <\/span><i><span style=\"font-weight: 400\">Sports Med<\/span><\/i><span style=\"font-weight: 400\"> 2020;50(3):485-95. doi: 10.1007\/s40279-019-01221-7<\/span><\/li>\n<li><span style=\"font-weight: 400\"> van Melick N, van Cingel RE, Brooijmans F, et al. Evidence-based clinical practice update: practice guidelines for anterior cruciate ligament rehabilitation based on a systematic review and multidisciplinary consensus. <\/span><i><span style=\"font-weight: 400\">Br J Sports Med<\/span><\/i><span style=\"font-weight: 400\"> 2016;50(24):1506-15. doi: 10.1136\/bjsports-2015-095898 [published Online First: 2016\/08\/20]<\/span><\/li>\n<li><span style=\"font-weight: 400\"> Logerstedt D, Grindem H, Lynch A, et al. Single-legged hop tests as predictors of self-reported knee function after anterior cruciate ligament reconstruction: the Delaware-Oslo ACL cohort study. <\/span><i><span style=\"font-weight: 400\">Am J Sports Med<\/span><\/i><span style=\"font-weight: 400\"> 2012;40(10):2348-56. doi: 10.1177\/0363546512457551 [published Online First: 2012\/08\/29]<\/span><\/li>\n<li><span style=\"font-weight: 400\"> Wellsandt E, Axe MJ, Snyder-Mackler L. Poor Performance on Single-Legged Hop Tests Associated With Development of Posttraumatic Knee Osteoarthritis After Anterior Cruciate Ligament Injury. <\/span><i><span style=\"font-weight: 400\">Orthop J Sports Med<\/span><\/i><span style=\"font-weight: 400\"> 2018;6(11):2325967118810775. doi: 10.1177\/2325967118810775 [published Online First: 2018\/12\/07]<\/span><\/li>\n<\/ol>\n<p><strong>Author and Affiliations:<\/strong><\/p>\n<p><span style=\"font-weight: 400\">Thomas West\u00a0<\/span><span style=\"font-weight: 400\">1,2<\/span><span style=\"font-weight: 400\">, Dr Andrea Bruder\u00a0<\/span><span style=\"font-weight: 400\">1,2<\/span><span style=\"font-weight: 400\">, Professor Kay Crossley\u00a0<\/span><span style=\"font-weight: 400\">1,2<\/span><span style=\"font-weight: 400\">, Dr Adam Culvenor\u00a0<\/span><span style=\"font-weight: 400\">1,2<\/span><span style=\"font-weight: 400\">\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">1 &#8211;\u00a0<\/span><span style=\"font-weight: 400\">La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Bundoora, Victoria, Australia<\/span><\/p>\n<p><span style=\"font-weight: 400\">2 &#8211;\u00a0<\/span><span style=\"font-weight: 400\">Australian IOC Research Centre, La Trobe University, Bundoora, Victoria, Australia<\/span><\/p>\n<p><span style=\"font-weight: 400\">Twitter: <a href=\"https:\/\/twitter.com\/tsewmot\">@tsewmot<\/a> <a href=\"https:\/\/twitter.com\/AndreaBruder\">@AndreaBruder<\/a> <a href=\"https:\/\/twitter.com\/agculvenor\">@Agculvenor<\/a> <a href=\"https:\/\/twitter.com\/kaymcrossley\">@kaymcrossley<\/a><\/span><!--TrendMD v2.4.8--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Keywords: Rehabilitation, Anterior cruciate ligament, Hop test We recently published our systematic review in BJSM investigating the prognostic capacity of unilateral tests of lower-limb function following anterior cruciate ligament (ACL) injury and reconstruction (ACLR).1 The summary of this study is outlined in this blog.\u00a0 Why is this study important? Functional or physical performance tests, such [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bjsm\/2023\/04\/03\/simple-hop-tests-after-acl-injury-are-prognostic-for-future-outcomes\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":463,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[16068,16069],"class_list":["post-10501","post","type-post","status-publish","format-standard","hentry","category-uncategorized","tag-featured","tag-featured-list"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Simple hop tests after ACL injury are prognostic for future outcomes - BJSM blog - social media&#039;s leading SEM voice<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bjsm\/2023\/04\/03\/simple-hop-tests-after-acl-injury-are-prognostic-for-future-outcomes\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Simple hop tests after ACL injury are prognostic for future outcomes - BJSM blog - social media&#039;s leading SEM voice\" \/>\n<meta property=\"og:description\" content=\"Keywords: Rehabilitation, Anterior cruciate ligament, Hop test We recently published our systematic review in BJSM investigating the prognostic capacity of unilateral tests of lower-limb function following anterior cruciate ligament (ACL) injury and reconstruction (ACLR).1 The summary of this study is outlined in this blog.\u00a0 Why is this study important? 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