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One-Arm Hop Test: Reliability and Effects of Arm Dominance

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  • Athletes' Performance

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Test-retest reliability analysis and 2-factor ANOVA contrast of athletic group and limb dominance. To determine the reliability of the one-arm hop test and the effects of upper-extremity dominance on test scores for 2 athletic groups. Limited information is available regarding functional performance tests of the upper extremity that involve axial loading. Thirteen male collegiate wrestlers (mean age, 20.3 +/- 1.6 years) and 13 male collegiate football players (mean age, 20.0 +/-1.7 years) without upper-extremity pathology participated in the study. Subjects were trained to perform the one-arm hop test, starting from a one-arm push-up position and then hopping as quickly as possible onto and off of a 10.2-cm platform 5 times. Subjects returned to the test site 1 to 2 days later and were timed for 2 trials of the one-arm hop test for each upper extremity. Within-session ICC2,1 reliability values were 0.78 for the football players and 0.81 for the wrestlers. Mean absolute differences between trials were 0.64 seconds for the football players and 0.47 seconds for the wrestlers. Trial 2 performance times were significantly faster than trial 1 times for the wrestlers. Although performance time for the nondominant side was on average 4.4% slower than that of the dominant side, performance times for the dominant side were not significantly different from those of the nondominant upper extremities. The results provide preliminary evidence that the one-arm hop test may be a reliable upper-extremity functional performance test with sufficient training of the subject. Uninjured upper-extremity performance for the one-arm hop test may be useful as a basis for comparing performance of an injured contralateral upper extremity.
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One-Arm Hop Test: Reliability and Effects
of Arm Dominance
Susan A. Falsone, PT, ATC, MS
1
Michael T. Gross, PT, PhD
2
Kevin M. Guskiewicz, ATC, PhD
3
Robert A. Schneider, PT, ATC, MS
4
Study Design: Test-retest reliability analysis and 2-factor ANOVA contrast of athletic group and
limb dominance.
Objectives: To determine the reliability of the one-arm hop test and the effects of upper-extremity
dominance on test scores for 2 athletic groups.
Background: Limited information is available regarding functional performance tests of the upper
extremity that involve axial loading.
Methods and Measures: Thirteen male collegiate wrestlers (mean age, 20.3 ± 1.6 years) and 13
male collegiate football players (mean age, 20.0 ± 1.7 years) without upper-extremity pathology
participated in the study. Subjects were trained to perform the one-arm hop test, starting from a
one-arm push-up position and then hopping as quickly as possible onto and off of a 10.2-cm
platform 5 times. Subjects returned to the test site 1 to 2 days later and were timed for 2 trials of
the one-arm hop test for each upper extremity.
Results: Within-session ICC
2,1
reliability values were 0.78 for the football players and 0.81 for the
wrestlers. Mean absolute differences between trials were 0.64 seconds for the football players and
0.47 seconds for the wrestlers. Trial 2 performance times were significantly faster than trial 1 times
for the wrestlers. Although performance time for the nondominant side was on average 4.4%
slower than that of the dominant side, performance times for the dominant side were not
significantly different from those of the nondominant upper extremities.
Conclusions: The results provide preliminary evidence that the one-arm hop test may be a reliable
upper-extremity functional performance test with sufficient training of the subject. Uninjured
upper-extremity performance for the one-arm hop test may be useful as a basis for comparing
performance of an injured contralateral upper extremity. J Orthop Sports Phys Ther
2002;32:98–103.
Key Words: functional performance test, upper extremity
1
Physical therapist, Athletes’ Performance, Tempe, AZ.
2
Professor, Program in Human Movement Science, Division of Physical Therapy, University of North
Carolina at Chapel Hill, Chapel Hill, NC.
3
Assistant professor, Department of Exercise and Sport Science, University of North Carolina at Chapel
Hill, Chapel Hill, NC
4
Physical therapist and athletic trainer, Student Health Service, University of North Carolina at Chapel
Hill, Chapel Hill, NC.
Ms. Falsone completed this research in partial fulfillment for her Master’s of Science degree in the
Program in Human Movement Science at the University of North Carolina at Chapel Hill.
Approved by the Committee for the Protection of the Rights of Human Subjects at the University of North
Carolina at Chapel Hill.
Send correspondence to Michael T. Gross, CB #7135, University of North Carolina at Chapel Hill,
Chapel Hill, NC 27599-7135. E-mail: mtgross@med.unc.edu
R
ecently, the effects of
weight-bearing exer-
cises for upper-
extremity joint insta-
bility have been under
examination.
1,8,9,15,25,27
Sports
such as gymnastics, football,
wrestling, and rowing involve an
axial load imposed on the hands.
For sports such as these, it is
difficult to determine when
athletes are ready for sport-specific
drills following injury and prior
to returning to competition.
Many conventional physical
examination techniques are per-
formed without imposing axial
loads on the hands, such as range
of motion, manual muscle testing,
joint position tests, and isokinetic
testing of shoulder joint muscula-
ture. For the athlete who com-
petes with axial loads imposed on
the upper extremities, these ex-
amination techniques may not
provide information sufficiently
accurate to determine return-to-
play status. Athletes such as wres-
tlers, gymnasts, and football play-
ers may benefit from performance
testing that involves upper-
extremity axial loading. Dynamic
functional performance testing
using axial loading evaluates the
patient in functional situations
under varying degrees of stress,
allowing a clinician to measure
the patient’s performance objec-
tively.
13
98 Journal of Orthopaedic & Sports Physical Therapy
Journal of Orthopaedic & Sports Physical Therapy
Official Publication of the Orthopaedic and Sports Physical Therapy Sections of the American Physical Therapy Association
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Functional performance testing has been widely
advocated for clinical assessments that follow lower-
extremity injuries.
4,5,8,14,16,20
Although these tests
have been described by many investigators, few au-
thors have reported reliability for their
measurements.
24,17,18,2022,25,27
There is limited
information on functional performance testing of
the upper extremity. Wilson et al
29
have described a
functional test for the hemiparetic upper extremity
that involves activities of daily living. Ubinger et al
25
used a FASTEX device (Cybex, Ronkonkoma, NY) to
test the ability of ‘‘physically active’’ subjects to bal-
ance in a single-arm push-up position. Neither group
of investigators reported the reliability of their test
results.
25,29
These studies did not involve tasks that
required forceful propulsive axial loading of the up-
per extremity (ie, pushing away from a support sur-
face or other object), or tasks that required strenu-
ous deceleration loading of the upper extremity (ie,
falling onto an outstretched upper extremity). We
were unable to identify any literature, other than the
study by Ubinger et al,
25
that describes a weight-
bearing functional performance test for the upper
extremity.
The one-arm hop test in this research study
is a functional performance test designed by the
University of North Carolina Sports Medicine staff
for preseason screening examinations. The one-arm
hop test requires the athlete to be in a one-arm
push-up position on the floor. The athlete then
uses his arm to hop onto a 10.2-cm step and back
onto the floor. The time required to perform 5
repetitions of this movement as quickly as possible is
recorded. The one-arm hop test requires concentric
and eccentric muscle strength and control while
the distal portion of the upper extremity has a con-
siderable external load placed upon it. Similar de-
mands are placed upon the upper extremities of
wrestlers and football players while they participate
in their sport. The test was developed to simulate
functional axial-loading movements of the upper ex-
tremity and to assist in making return-to-play deci-
sions.
Many unanswered questions exist regarding the
one-arm hop test. The reliability of the test and the
effects of upper-extremity dominance on test perfor-
mance have not been documented. Clinicians often
use test performance of the contralateral extremity
as a basis for comparing test results for the upper
extremity concerned (eg, undergoing rehabilitation).
Such comparisons for the one-arm hop test would be
valid if test scores between dominant and
nondominant upper extremities were similar. The
purpose of this study was to assess the reliability of
the one-arm hop test and to determine the effects of
upper-extremity dominance on test performance for
2 athletic groups.
METHODS
Subjects
Thirteen wrestlers and 13 football players (4 line-
backers, 4 offensive linemen, and 5 defensive line-
men) without current upper-extremity pathology
were tested. An additional football player enrolled in
the study did not meet the criteria for acceptable
testing (described later). Subjects reported through a
written questionnaire that they had no upper-
extremity injury currently limiting their athletic par-
ticipation and no history of upper-extremity trauma
or injury having limited their activity for more than
2 consecutive days during a period of 6 weeks prior
to testing. Each subject signed a statement of in-
formed consent prior to participation, and the study
was approved by the Committee for the Protection of
the Rights of Human Subjects at the University of
North Carolina at Chapel Hill.
Testing Procedure
Testing procedures took place over 2 days for each
subject. On the first day, subjects completed a ques-
tionnaire pertaining to past and present upper-
extremity injuries and current athletic participation
status. Descriptive data measured and recorded for
all subjects included age, height, weight, upper-
extremity dominance (defined as the hand reported
to be preferred for throwing a ball), percentage of
body fat, sport, and sport position.
Skinfold thickness was measured at the chest, ab-
domen, and thigh using Lange skinfold calipers
(Cambridge Medical Instruments, Ossining, NY).
24
Chest measurements were taken on a diagonal fold
halfway between the axilla and the nipple. Abdomen
measurements were taken on a vertical fold 2.5 cm
to the right of the umbilicus. The thigh measure-
ment was taken using a vertical fold on the front of
the thigh, midway between the hip and the knee.
Percentage of body fat estimates were then deter-
mined using tabled data for men under 40 years of
age.
12
The subjects warmed up on the Schwinn Air-Dyne
(Boulder, CO) for 4 minutes at 30 revolutions per
minute (RPM), using only their upper extremities,
and then performed 10 standard 2-hand push-ups. A
5-minute rest period followed. Each subject then per-
formed the procedures to get familiar with the one-
arm hop test. The subject first watched an instruc-
tional video depicting the one-arm hop test. After
instruction, subjects practiced the one-arm hop test
for each upper extremity. Verbal cues were given dur-
ing this practice session if necessary. Each subject
practiced the one-arm hop test by assuming a one-
arm push-up position with his back flat, his feet and
shoulders apart, and his weight-bearing upper ex-
J Orthop Sports Phys Ther Volume 32 Number 3 March 2002 99
RESEARCH REPORT
tremity positioned perpendicular to the floor (Figure
1). The subject placed his nonweight-bearing hand
on the posterior aspect of the low back. A 10.2-cm
step (‘‘The Step,’’ Sports Step Group, Marietta, GA)
was placed immediately lateral to the subjects test
hand (Figure 1). The step has a rubber upper sur-
face and the test was performed on a carpeted floor
to help prevent slipping. After the subject was in the
proper start position, the investigator said, ‘‘Ready,
set, go,’’ to signal the beginning of the trial. The
subject used the weight-bearing arm to hop onto the
step and landed on the rubber portion of the step
with the entire hand. The subject then used the
weight-bearing arm to hop off of the step and return
his hand to the start position next to the step. Sub-
jects repeated this movement 5 times as quickly as
possible. If the subject performed the test with im-
proper technique, he rested for 1 minute, and then
performed another practice test. An acceptable test
was defined as a test in which the subject fully
hopped onto the rubber portion of the step, did not
use the other hand, did not touch down with a knee,
and kept his back flat and his feet in the same posi-
tion. Subjects continued to practice the test until
they demonstrated 1 trial using acceptable technique.
After a 1-minute rest, the same maneuver was then
performed with the contralateral upper extremity.
The order for practicing dominant and
nondominant upper extremities was randomized.
The investigators did not record the number of prac-
tice trials needed by each subject to demonstrate
proper technique.
Each subject returned 12 days after the first test
day for data collection for the one-arm hop test. Sub-
jects performed the same 4-minute warm-up on the
Schwinn Air-Dyne at 30 RPM, followed by 10 stan-
dard push-ups. The subject again watched the in-
structional video depicting the one-arm hop test.
FIGURE 1. Anterior view of subject positioned for the one-arm hop
test.
Subjects performed the one-arm hop test with their
dominant and nondominant upper extremities in
random order, with a 1-minute rest between the test-
ing for each upper extremity. Timing with a standard
stopwatch began when the subjects hand left the
floor on the first hop and stopped when the hand
landed back onto the floor after the fifth hop. The
time taken to perform the test for each upper ex-
tremity was recorded to the nearest one-hundredth
of a second. The subject rested for 5 minutes, and
then performed the test a second time using the
same order of dominant-nondominant upper-
extremity testing as the first testing sequence, with a
1-minute rest between the testing for each upper ex-
tremity. Data from trial 2 were compared with trial 1
data to assess test-retest reliability. Only data from
the first trials were used to assess the effects of arm
dominance on test performance. This reflects the
type of single-trial testing that might occur in the
clinic. Therefore, each subject was represented only
once in the data analysis.
If a subject performed a trial with any of the previ-
ously identified performance errors, he was given a
5-minute rest period and another trial. If the subject
could not complete a successful trial in 2 attempts,
he was disqualified from the study. If a subject re-
ported pain during the test or immediately following
testing procedures, his data were excluded from the
study.
Data Analysis
Independent t-tests were used to assess differences
between the two groups with regard to age, height,
mass, and percentage of body fat. An intraclass cor-
relation coefficient (ICC
2,1
)
23
and mean absolute dif-
ference values were computed to assess test-retest
reliability of the two trials of the one-arm hop test
for each subject group. Absolute difference values
were also computed as a percentage difference be-
tween trials:
trial 1trial 2
× 100%
trial 1
Absolute differences were normalized as a percent-
age of the trial 1 data, which were used to assess the
effects of upper-extremity dominance. Differences
between the two trials for each subject group also
were assessed using paired t-tests. A 2-way ANOVA
with repeated measures on 1 factor (subjects upper
extremity) was conducted to assess the effects of
upper-extremity dominance on one-arm hop test
scores for each subject group. An alpha level of 0.05
was used for the t-tests and the ANOVA.
Differences between dominant-upper-extremity per-
formance and nondominant-upper-extremity perfor-
mance were also assessed by computing differences
100 J Orthop Sports Phys Ther Volume 32 Number 3 March 2002
between limb performance, and were expressed as a
percentage of dominant-upper-extremity perfor-
mance:
dominantnondominant
× 100%
dominant
All analyses were conducted using SAS Statistical
Software (Cary, NC).
RESULTS
Descriptive statistics for the two subject groups ap-
pear in the Table. The two subject groups were simi-
lar with regard to age and percentage of body fat.
The football players, however, were significantly taller
and had significantly more mass than the wrestlers.
Eleven of the wrestlers were right-upper-extremity
dominant and 2 were left-upper-extremity dominant.
Eleven of the football players were right-upper-
extremity dominant and 2 were left-upper-extremity
dominant. All of the wrestlers performed the one-
arm hop test correctly on the second test day. Three
of the football players performed the one-arm hop
test with errors on their first attempt and had to re-
peat the first data collection trial. One football
player experienced shoulder pain when he per-
formed the one-arm hop test and was dismissed from
the study.
The test-retest reliability results for the two trials of
the one-arm hop test were ICC
2,1
= 0.81 for the wres-
tlers, and ICC
2,1
= 0.78 for the football players. The
mean absolute difference between the two test trials
was 0.47 0.45 seconds for the wrestlers, and 0.64
0.69 seconds for the football players. These mean
values corresponded to an average of 9% change in
performance for the wrestlers, and an average of
11% change in performance for the football players.
Descriptive statistics for the first and second trials for
each subject group appear in Figure 2. Paired t-test
results indicate that the wrestlers mean trial 1 time
(4.72 ± 1.10 seconds) for the one-arm hop test was
significantly greater than (t = 4.31, df = 25, P 0.05)
the mean trial 2 time (4.29 ± 0.87 seconds). The
football players mean trial 1 time (5.69 ± 1.31 sec-
onds) for the one-arm hop test was not significantly
different (t = 1.37, df = 25) from their mean trial 2
time (5.44 ± 1.49 seconds).
Descriptive statistics for one-arm hop test scores by
subject group and upper-extremity dominance are
graphically represented in Figure 3. The ANOVA re-
sults indicate that subject group and upper-extremity
dominance did not interact significantly to affect
one-arm hop test scores (F = 0.63; df = 1,24). One-
arm hop test scores did not differ significantly be-
tween dominant and nondominant upper extremities
(F = 1.92; df = 1,24). Performance time for the
nondominant side was on average 4.4% slower than
for the dominant side. Differences between domi-
nant and nondominant upper extremities ranged
from the nondominant upper extremity being 32.8%
slower to 23.8% faster than the dominant upper ex-
tremity. The 95% confidence interval results indicate
that clinicians might expect nondominant-upper-
extremity performance to range from 1.1% faster to
9.8% slower than dominant-upper-extremity perfor-
mance.
DISCUSSION
The range of one-arm hop test performance for
the wrestlers (2.95 to 7.07 seconds) and the football
players (3.24 to 9.95 seconds) represents a fairly re-
stricted range of scores. Additionally, a manual stop-
watch was used to record the time taken by subjects
to perform the one-arm hop test. For the two test-
retest trials, the stopwatch was started and stopped a
total of 4 times. Considering the human error in-
volved in manipulating the stopwatch and the re-
stricted range of measurements, the ICC and the ab-
solute difference values compare favorably with
previous reports of reliability for lower-extremity
functional tests.
7,10,11,19
Descriptive statistics for the two trials of the test
and the paired t-tests, however, indicate that for the
wrestlers, times for trial 2 were significantly faster
than those for trial 1. On average, times for trial 2
were 0.42 seconds less than times for trial 1. This
difference corresponds to an average change in per-
formance of 9% for the wrestlers and 11% for the
football players. We did not record the number of
practice trials performed by each subject. The con-
trast between first- and second-trial performance
times for the subjects, however, suggests that perfor-
mance times may not have stabilized. Investigators
TABLE. Descriptive statistics for subject groups (values are means standard deviations).
Athletic Groups Age (y) Height (cm)
#
Mass (kg)
Body Fat (%)
Wrestlers (n = 13) 20.3 1.6 174.3 5.5 77.2 12.2 9.5 2.2
Football Players (n = 13) 20.0 1.7 191.9 3.2 117.2 14.0 9.0 3.6
#
Football players significantly taller than wrestlers (t = 9.90, P 0.05)
Mass of football players significantly greater than wrestlers’ mass (t = 7.76, P 0.05)
J Orthop Sports Phys Ther Volume 32 Number 3 March 2002 101
RESEARCH REPORT
FIGURE 2. Mean one-arm hop test-retest results for two trials
performed by wrestlers and football players. Trial 1 and trial 2 times
did not differ significantly for the football players, but trial 2 times
were significantly faster (P 0.05) than trial 1 times for the
wrestlers.
FIGURE 3. Mean one-arm hop test results for dominant and
nondominant upper extremities of wrestlers and football players.
Performance times for the dominant upper extremities were not
significantly different than times for the nondominant upper extremi-
ties.
and clinicians who use the one-arm hop test may
wish to have subjects or patients practice the task
until a level of consistency has been demonstrated
(eg, with a maximum difference between successive
scores of no more than 5%).
The second major objective of this study was to
determine the effects of upper-extremity dominance
on one-arm hop test performance. The ANOVA re-
sults showed no significant difference in one-arm
hop test scores attributable to upper-extremity domi-
nance. Conclusions regarding the effects of limb
dominance must be tempered by the possibility that
performance times may not have stabilized. The de-
scriptive statistics, however, indicate that
nondominant-upper-extremity performance times
were on average only 4.4% slower than dominant-
upper-extremity performance times. The confidence
interval results also show that there were comparable
performance times between dominant- and
nondominant-upper-extremity performance for the
one-arm hop test.
A clinical application for results of the effects of
limb dominance may be the use of test performance
of an uninjured upper extremity for postinjury reha-
bilitation contrasts. If no preinjury data exist for the
injured upper extremity, clinicians may use the unin-
jured extremity as a baseline for performance. The
range of differences between dominant- and
nondominant-upper-extremity performance does,
however, include outliers in both directions, as
dominant-limb performance has been observed to be
both appreciably faster and slower than
nondominant-limb performance. Clinicians might
consider, therefore, gathering test data for both
limbs during preseason screening procedures and at
regular intervals during the sport season.
The one-arm hop test may not fully represent all
upper-extremity axial-loading activities for athletes
who participate in sports that require this type of
upper-extremity function. This study involved an ini-
tial effort to standardize and assess the reliability of
the one-arm hop test. An initial practice session may
be helpful to familiarize athletes with the proper pro-
cedure for performing the test. Future research
might be directed at analyzing the amount of prac-
tice needed to obtain more stable observations of
the test. The one-arm hop test in a preseason screen-
ing might also serve the dual purpose of teaching
athletes this functional performance test, while pro-
viding preinjury baseline scores for the test.
In the present study, ensuring proper performance
of the one-arm hop test was important. The video
helped to standardize the instructions given to each
subject and to provide visual cues for the test re-
quirements. In all cases, verbal feedback was neces-
sary to remind the subject to keep his feet shoulder
width apart and his back flat. Additional motion
analysis of this movement may be helpful to identify
common substitutions and ways to correct them.
Finally, the subjects in this study were considered
healthy, collegiate varsity athletes with no significant
upper-extremity pathology at the time of testing.
Threats to the external validity of the results include
sample representation of the population, sample size,
and the extent to which the test simulates axial loads
0
1
2
3
4
5
6
7
8
Wrestlers Football Players
Athlete Group
Trial 1
Tria 2
l
One-Arm Hop Test Time (sec)
0
1
2
3
4
5
6
7
8
Wrestlers Football
Players
Athlet Group
Dominant
Nondominant
e
One-Arm Hop Test Time (sec)
102 J Orthop Sports Phys Ther Volume 32 Number 3 March 2002
imposed on the upper extremity during functional
activities. Fitness levels of these subjects also varied,
and may be different than high school, college, or
professional athletes. Future research might assess
the validity of this test for subjects with functional
limitations.
CONCLUSION
The results of this preliminary study indicate that
with sufficient training of the subject, the one-arm
hop test may be a reliable upper-extremity perfor-
mance test. The results also show that nondominant-
upper-extremity performance averaged 4.4% slower
than dominant-upper-extremity performance. Clini-
cians, therefore, may be able to use this test to com-
pare a patients uninjured-upper-extremity test results
to the patients injured-upper-extremity test results.
ACKNOWLEDGMENTS
We thank Philip L. Witt, PT, PhD, for his critical
review of the research proposal and manuscript; and
William B. Ware, PhD, for his excellent consultation
on the statistical analyses.
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J Orthop Sports Phys Ther Volume 32 Number 3 March 2002 103
RESEARCH REPORT
... The one-arm hop test was developed in efforts to make functional testing more sport specific to wrestling and football (49). The athlete is required to assume a one-arm push-up position on the floor, hop onto a 10.2-cm step and then back to the floor for five repetitions for time. ...
... After 1 minute, the contralateral side is tested. The dominant upper extremity has been shown to complete the test 4.4% faster than the nondominant upper extremity, and the test has established normative values for wrestlers and football players (49). ...
... The Close Kinetic Chain Upper Extremity Stability (CKCUES) Test [16,27,31,64], The Upper Quarter Y-Balance Test (UQYBT) [10,70] and The One-Arm hop test [23] were found as measurement instruments of stability and are presented in Supplementary table 6. ...
... The One Arm Hop Test also requires the joint to be stable, but with higher physical demands since this procedure requires concentric and eccentric strength and control with considerable external load. It might have potential in the end stage of rehabilitation as a performance test since it is an endurance test in which athletes are asked to hop for fifteen seconds and thereby demanding stability of the glenohumeral joint while developing muscle fatigue [23]. Sufficient ROM in the shoulder to participate in the desired sport is critical, and should therefore be monitored during the rehabilitation process to determine if sufficient ROM is achieved. ...
... The exclusion criteria were a history of upper extremities or spinal surgery, and the use of hypnotic and sedative medications. The subjects were also excluded if they reported a new injury within the first two days of the test period, and pain or fatigue following the first trial [16,17]. ...
Article
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Objective: Despite the studies that have investigated the reliability of Upper Extremity Functional Tests(UEFTs), the reliability of Closed Kinetic Chain Upper Extremity Stability(CKCUES), Seated Medicine Ball Throw(SMBT), push-up(PU) and Unilateral Seated Shot Put(USSP) tests in overhead athletes has yet to be assessed. The objective of this study was to determine both the relative and absolute test-retest reliability of the four UEFTs in female overhead athletes. Methods: Twenty-nine female overhead athletes (age: 26.6 ± 5.29 years) underwent the four UEFTs twice within a three- day interval. The upper limb stability was assessed through PU and CKCUES tests, while the power was assessed though SMBT and USSP tests. The Intraclass Correlation of Coefficient (ICC) was applied to assess the relative reliability. Absolute reliability was determined by calculating the Standard Error of Measurement (SEM) and the Minimal Detectable Change (MDC). Furthermore, Bland-Altman plots were used to detect the agreements between the two measurements. Results: The relative reliability of PU, CKCUES, SMBT, and non-dominant arm USSP tests was excellent (ICC = 0.83, 0.80, 0.91, and 0.83, respectively). SEM was within a range of 1.69 to 1.72 for stability tests and a range of 13.61 to 52.12 for power (based on a 95% confidence interval). The MDC was 4.68 for PU and 4.75 for CKCUES test. At least four repetitions are needed to be considered a real improvement on PU and CKCUES tests. This value was 144.04, in SMBT and 59.03, 37.62 cm (dominant and non-dominant arm, respectively) in USSP tests, which represents the minimum change that must occur to be considered an athlete's progression. Conclusion: This study revealed that both the upper limb stability and power tests have acceptable relative and absolute intra-rater reliability in female overhead athletes. These can be considered as reliable tools in research and clinical settings.
... Der One-Arm-Hop-Test und der Line-Hop-Test [5,19] ...
Article
Background Uniform procedures for rehabilitation and follow-up treatment after injuries and surgeries at the upper extremity do not exist. Accordingly, only a few approaches for the follow-up treatment of instabilities of the elbow joint have been described.Objectives The authors show how rehabilitation before sport-specific training after rupture of the ulnar collateral ligament in a female handball player was objectivized and controlled using the results of functional tests.Materials and methodsThe follow-up treatment of a semi-professional female handball player (aged 20) after rupture of the ulnar collateral ligament was objectivized and controlled using the return to activity algorithm. In addition to the comparisons with the values of the unaffected side, comparative results of 14 uninjured female handball players were used for guidance.Results/conclusionsThe patient was able to participate fully in sport-specific training after 15 weeks and participate in her first competitive match after 20 weeks. On the affected side, she achieved a distance of 118% of her upper limb length on the medial reach of the upper quarter Y balance test and 63 valid contacts on the wall hop test. The values achieved at the end of rehabilitation were higher than the average values of the control group.
Article
The aim of this scoping review was to comprehensively examine the Upper Quarter Y-Balance Test (UQYBT), including reference values, reliability, determinants, and its practical application. By including studies irrespective of publication date, participant demographics, or research purpose, provided they were in English and incorporated UQYBT as a primary or secondary variable, an extensive dataset was collected. The focus was on limb-length-normalized results to establish standardized reference metrics. Reliability studies highlighted the UQYBT’s consistency across sessions and raters. The application of UQYBT to assess injury risk is questionable. Studies assessing its relationship with sports performance have also yielded varying results. UQYBT seems to be sensitive to various exercise based-interventions, as shown by several clinical trials. This review furnishes practitioners and clinicians with valuable insights for the application of UQYBT in sports and healthcare settings.
Article
Full-text available
Background: Understanding the relationships between exercise and performance tests is crucial for the sports rehabilitation expert. Objectives: To comprehensively review functional tests and their reliability for return to sport (RTS) after shoulder injuries. Methods: During this research, a comprehensive review of the functional tests for RTS after shoulder injuries was performed by searching the Web of Science, PEDro, Google Scholar, PubMed, ScienceDirect, SCOPUS, and CINAHL databases with the keywords shoulder RTS, return to play, upper limb and shoulder functional tests from 2000 to June 2021. English was used in this search. After gathering the research results, first, the titles and then the summary of the research papers were studied. If the research papers meet the inclusion and exclusion criteria, their results will be utilized in the study of review otherwise they will be excluded. Results: When searching the texts, 123 research papers were found, after deleting 11 identical titles, 112 abstracts were chosen for review. After analyzing the abstracts, 79 research papers were removed and 33 research papers were selected for full study. After reviewing the full-text research papers, 21 research papers were removed and 12 research papers were selected from among the research papers that were very closely related to the subject under study. Many functional tests exist, but few have been studied to evaluate the RTS after a shoulder injury. Conclusion: Functional tests can assist in estimating when an athlete will RTS or exercise without restrictions. Therefore, according to the results of the current research, functional tests can be an effective tool to assess RTS after shoulder injuries, but due to the limitations and lack of information in this area, further studies are required to be conducted. Therefore, caution should be taken and a general rule should not be drawn for all shoulder injuries.
Preprint
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Background Orchestra musicians and music students complain about painful playing-related musculoskeletal disorders (PRMDs) without receiving appropriate therapeutical support. The aim of this pilot study was to provide a proof of concept of a new treatment regimen for PRMDs based on a comprehensive assessment. This regimen consisted of transcranial direct current stimulation (tDCS) in addition to physiotherapeutic exercises and psychological coaching. As a part of the assessment, we tried to demonstrate the feasibility of multiple new diagnostic tools that could potentially investigate the efficacy of the treatment regimen and elucidate pathophysiological mechanisms of PRMDs. Methods Musicians from the Orchestra Academy of the Vienna Philharmonic Orchestra were asked for their voluntary participation. Seven participated in their choice of self-administered tDCS sessions with concurrent physiotherapeutic exercises, physiotherapeutic and psychological assessments, the pain questionnaire, and medical imaging or 3D motion capture acquisitions. The feasibility of these methods was determined through observation of the investigators and participant feedback, as well as a safety questionnaire and a checklist. Results All pilot trials (n = 10) were completed successfully without any major issues. Some minor problems, such as lack of electrode connectivity or tingling/burning sensations of the scalp, were encountered by the participants during the tDCS sessions (n = 2/2 participants), the physiotherapeutic assessments (n = 1/3) and exercises (n = 1/2), the psychological assessments (n = 1/2) and the medical imaging (n = 1/2). Conclusions The trials showed very promising results for all investigated study parts, therefore demonstrating the feasibility and safety of studying this new treatment regimen in a randomized clinical trial with a larger sample of musicians. Also, the medical imaging and 3D motion capture acquisitions encourage further investigation to evaluate their potential diagnostic applicability for musicians’ PRMDs.
Article
Full-text available
The purpose of this study was to evaluate the effectiveness of five hopping, jumping, and cutting-type (shuttle run) tests in determining lower extremity functional limitations in anterior cruciate ligament- (ACL) deficient knees. Ninety-three normal subjects were tested. No statistical significance was found between right and left lower limb scores (limb symmetry index) as related to sports activity level, gender, or dominant side. This allowed an overall symmetry index score to be established for the population as a whole. An 85% symmetry index score was found in more than 90% of the normal population for the one-legged hop for distance test and the one-legged timed hop test. Thirty-five patients with ACL-deficient knees were tested. The patients also had KT-1000 and Cybex testing and completed questionnaires rating symptoms, sports activity levels, and sports functional limitations. The cutting-type tests and the vertical jump test did not detect functional limitations in a reliable manner. In the one-legged hop tests, 50% of the patients performed normally, however, all reported giving-way episodes with sports, indicating a lack of sensitivity of these tests in defining functional limitations. Patients with abnormal one-legged hop test scores were considered at serious risk for giving way and limitations during sports activities. Statistically significant relationships were found among abnormal scores on the one-legged hop-type tests and (1) self-assessed difficulty with pivoting, cutting, and twisting, (2) quadriceps weakness (Cybex), and (3) patellofemoral compression pain.
Article
Full-text available
This study assessed the sensitivity of four different types of one-legged hop tests. The goal was to deter mine alterations in lower limb function in ACL deficient knees. Regression analyses were conducted between limb symmetry as measured by the hop tests and muscle strength, symptoms, and self-assessed func tion. In 67 patients, 50% had abnormal limb symmetry scores on a single hop test. When the results of two hop tests were calculated, the percent of abnormal scores increased to 62%. The percentage of normal scores indicated that these hop tests had a low sensi tivity rate. However, the high specificity and low false- positive rates allow the tests to be used to confirm suspected defects in lower limb function. Statistical trends were noted between abnormal limb symmetry on the hop tests and low velocity quadriceps isokinetic test results.
Article
Full-text available
Reliability coefficients often take the form of intraclass correlation coefficients. In this article, guidelines are given for choosing among 6 different forms of the intraclass correlation for reliability studies in which n targets are rated by k judges. Relevant to the choice of the coefficient are the appropriate statistical model for the reliability study and the applications to be made of the reliability results. Confidence intervals for each of the forms are reviewed. (23 ref) (PsycINFO Database Record (c) 2006 APA, all rights reserved).
Article
Most physicians, trainers, and therapists are accustomed to thinking of open and closed kinetic chain terminology in terms of exercise and its application in rehabilitation protocols. This terminology can also be used to describe the mechanism by which injuries occur. Categorizing upper extremity injuries in this way not only provides vital insight into the mechanism of the injuries and helps identify possible injured structures but also allows the clinician to better develop treatment protocols. In this article, this categorization is applied to common shoulder and elbow injuries to provide insight into the nature of these injuries.
Article
When the upper extremity is injured, open kinetic chain (OKC) exercises are primarily used to increase strength and restore functional ability-the goals of rehabilitation. It is also imperative, however, that the receptors responsible for static and dynamic stabilization of the joint be trained. This can be done with closed kinetic chain (CKC) exercises. The purposes of this study were to investigate the effect of a 4-week CKC training program on the neuromuscular control of the upper extremity and to determine whether then was a significant difference between skill-dominant limb and nondominant limb stability indices. Thirty-two physically active participants (14 men, 18 women) were tested on the FASTEX 4 weeks apart. The training group's scores significantly improved, whereas the control group's scores remained the same. It was concluded that the CKC training significantly improved the training group's ability to remain stable. The results suggest that CKC training can increase the accuracy of joint position sense because of increased stimulation of the mechanoreceptors.
Article
The confusion between the terms open kinetic chain and closed kinetic chain becomes even greater with application to the upper extremity. Upper extremity function is very difficult to define, due to the numerous shoulder positions and the great velocities with which the shoulder can move. Classifying exercises for rehabilitation of the upper extremity is very difficult due to the complexity of the joint. Many definitions and classification systems have been proposed; however, none of these entirely encompass rehabilitation of the upper extremity. Using previous classifications we have developed a Functional Classification System that is designed to serve as a template for upper extremity rehabilitation. This system has been designed to restore functional shoulder stability, which is dependent upon proper scapulothoracic and glenohumeral stability, and humeral control; all of these are in part mediated by neuromuscular mechanisms. The objective of our new Functional Classification System is to restore functional stability of the shoulder by reestablishing neuromuscular control for overhead activities.
Article
Confusion of the terms open and closed kinetic chain and scarcity of research comparing kinetic chain exercises that have similar mechanics and loading prompted this case study. Exercises were classified by the boundary condition of the distal segment and presence of an external load. Classifications included a fixed boundary condition with an external load (FEL), a movable boundary with an external load (MEL), and a movable boundary with no external load (MNL). It was hypothesized that if the direction and mass of loading in MEL and FEL exercises were similar, the electromyographic activity of the primary muscle groups involved would be comparable. Muscular activity was monitored from six shoulder muscles during one MNL, four MEL, and five FEL exercises. The results indicated that MEL and FEL exercises having similar biomechanics produced comparable muscular activity. Evaluation and selection of exercises for patients should be based upon mechanics and loading that achieve appropriate muscle activity.
Article
Following injury to the articular ligaments, disruption of mechanoreceptors results in partial deafferentation of the joint. This has been shown to inhibit normal neuromuscular joint stabilization, and it contributes to repetitive injuries and the progressive decline of the joint. Assessment of proprioception is valuable in identification of proprioceptive deficits and subsequent planning of the rehabilitation program. A shoulder rehabilitation program must address both the mechanical and sensory functions of articular structures by incorporating a proprioceptive training element within the normal protocol. The objective of proprioception rehabilitation is to enhance cognitive appreciation of the respective joint relative to position and movement, and to enhance muscular stabilization of the joint in the absence of structural restraints. If these objectives are properly addressed, the restoration of the proprioceptive mechanism will prevent further disability of the shoulder
Article
The use of closed kinetic chain exercise has grown in the past several years. Closed kinetic chain exercises for the lower extremity have been firmly established in the literature and have been strongly recommended as an integral part of rehabilitation of the patient with anterior cruciate ligament injury. While the scientific and clinical rationale for using closed kinetic chain exercise for the lower extremity appears obvious, the scientific rationale for using closed kinetic chain exercise for the upper extremity is less clear. The purpose of this manuscript is to discuss the scientific rationale for closed kinetic chain for the upper extremity patient. In addition, exercise drills to enhance dynamic stability of the glenohumeral joint are discussed, and a rationale for using these exercises for specific glenohumeral joint pathologies is provided. The concepts of closed and open kinetic chain as applied to the lower extremity may not apply to the upper extremity due to the unique anatomical and biomechanical features as well as the function of the shoulder. It is recommended that clinicians use both closed kinetic chain and open kinetic chain exercises when treating the shoulder patient.