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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.
2–4,17,18,20–22,25,27
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 non–weight-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 subject’s 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 1–2 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 subject’s 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:
ⱍ
trial 1⫺trial 2
ⱍ
× 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 (subject’s 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:
dominant⫺nondominant
× 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 patient’s uninjured-upper-extremity test results
to the patient’s 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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