Single Limb Hop Tests

Single Leg Hop for Distance

• Munro & Herrington
  • Male: 7.87(% leg length x 100)
  • Female: 7.93 (% leg length x 100)
• Ross et al
  • 4.61 cm

Triple Hop

• Munro & Herrington
  • Male: 17.17 (% leg length x 100)
  • Female: 23.18 (% leg length x 100)
• Ross et al
  • 11.17 cm

6 m Timed Hop

• Munro & Herrington
  • Male: 0.084 s
  • Female: 0.076 s
• Ross et al
  • 0.06 s

Cross Over Hop

• Munro & Herrington
  • Male: 21.16 (% leg length x 100)
  • Female: 19.73 (% leg length x 100)
• Ross et al
  • 17.74 cm

Lateral Hop

• Kea et al
  • Mean after 2 occasions: 4 cm

Medial Hop

• Kea et al

Mean after 2 occasions: 5 cm

Single Leg Hop for Distance

• Munro & Herrington
  • Male: 21.81 (% leg length x 100)
  • Female: 21.98 (% leg length x 100)

Triple Hop

• Munro & Herrington
  • Male: 47.59 (% leg length x 100)
  • Female: 64.25 (% leg length x 100)

6 m Timed Hop

• Munro & Herrington
  • Male: 0.233 s 
  • Female: 0.211 s 

Cross Over Hop

• Munro & Herrington 
  • Male: 58.65 (% leg length x 100)
  • Female: 54.69 (% leg length x 100)

Lateral Hop

• Kea et al
  • 95% MDC: 11.1 cm

Medial Hop

• Kea et al

95% MDC: 13.9 cm

Single Leg Hop for Distance

• Grindem et al
  • Less than 85% on limb symmetry score was classified as having self-reported knee function below normal ranges
• Hopper et al (ACL)
  • Difference in limb performance >15% is classified as abnormal.
• Ito et al. (ACL deficient knees)
  •  ≤ 0.20m difference between limbs is classified as normal.
• Logerstedt et al
  • An optimum cut off score 89.3% of LSI was found.
• Munro & Herrington (healthy recreational athletes)
  • 100% of subjects had a limb symmetry index (LSI) > 90%
  • 73% of subjects had a LSI > 95%
• Noyes et al (ACL deficient knees)
  • Less than 85% on limb symmetry score is classified as abnormal ( )
• Petschnig et al (ACL)
  • Group A had a 97.4% LSI with a SD of 3.4
  • Group B had a 73.0% LSI with a SD of 9.9
  • Group C had a 88.4% LSI with a SD of 8.4

Triple Hop

• Grindem et al
  • Less than 85% on limb symmetry score were classified as having self-reported knee function below normal ranges
• Logerstedt et al

An optimum score of 95.2% of LSI was found to be optimal

• Munro & Herrington (healthy recreational athletes)
  • 100% of subjects had a LSI > 90%
  • 68% of subjects had a LSI > 95%
• Noyes et al (ACL deficient knees)
  • Less than 85% on limb symmetry score is classified as abnormal (
• Petschnig et al (ACL)
  • Group A had a 98.3% LSI with a SD of 4.1
  • Group B had a 71.0% LSI with a SD of 12.9
  • Group C had a 89.5% LSI with a SD of 12.0

6 m Timed Hop

• Grindem et al
  • Less than 85% on limb symmetry score were classified as having self-reported knee function below normal ranges
• Logerstedt et al
  • A LSI of 87.7% of LSI was found to be optimum
• Munro & Herrington (healthy recreational athletes)
  • 100% of subjects had a LSI > 90%
  • 86% of subjects had a LSI > 95%
• Noyes et al (ACL deficient knees)
  • Less than 85% on limb symmetry score is classified as abnormal ( )

Cross Over Hop

• Grindem et al
  • Less than 85% on limb symmetry score were classified as having self-reported knee function below normal ranges
• Logerstedt et al.
  • A LSI of 94.9% was found to be optimum
• Munro & Herrington (healthy recreational athletes)
  • 100% of subjects had a LSI > 90%
  • 64% of subjects had a LSI > 95%
• Noyes et al (ACL deficient knees)
  • Less than 85% on limb symmetry score is classified as abnormal ( )

Vertical Hop

• Petschnig et al (ACL)
  • Group A had a 95.2% LSI with a SD of 8.5
  • Group B had a 46.3% LSI with a SD of 12.9
  • Group C had a 74.9% LSI with a SD of 13.3

Figure-eight hop test  

• Ito et al. (ACL deficient knees)
  • ≤ 0.81s difference between limbs.

Up-down Hop Test

• Ito et al. (ACL deficient knees)
  • ≤ 0.72s difference between limbs.

Side hop test

• Ito et al. (ACL deficient knees)
  • ≤ 0.78s difference between limbs.

Single Hop for Distance

• Booher et al.  0.77 - 0.99 ICC
• Munro & Herrington
  • Males 0.80 ICC
  • Females 0.80 ICC
• Ross et al
  • ICC 0.92

Triple Hop

• Munro & Herrington
  • Males 0.92 ICC
  • Females 0.8 ICC
• Ross et al
  • ICC 0.97

6 m Timed Hop

• Booher et al.  0.77 - 0.99 ICC
• Hopper et al (ACL)
  • Reconstructed 0.96 ICC
  • Uninjured 0.95 ICC
• Munro & Herrington
  • Males 0.6 ICC
  • Females 0.84 ICC
• Ross et al
  • ICC 0.92

Cross Over Hop

• Hopper et al (ACL)
  • Reconstructed 0.98 ICC
  • Uninjured 0.95 ICC
• Munro & Herrington
  • Males 0.86 ICC
  • Females 0.87 ICC
• Ross et al
  • ICC 0.93

Stair Hop

• Hopper et al (ACL)
  • Reconstructed 0.96 ICC
  • Uninjured 0.96 ICC

Vertical Hop

• Hopper et al (ACL)
  • Reconstructed 0.94 ICC
  • Uninjured 0.92 ICC
• Petschnig et al (ACL)
  • Group A (healthy males) 0.89 ICC (indicates good reliability)

Lateral Hop

• Kea et al
  • 0.95 ICC

Medial Hop

• Kea et al
  • 0.93 ICC

30 m Agility Hop

Booher et al.  0.77 - 0.99 ICC

Vertical Hop

• Hegedus et al (Knee injury)

Inter-rater reliability:0.75

Single Hop for Distance

• Petschnig et al (ACL)
  • Specificity for the single hop test was 98 (false-positive rate=2). The sensitivity for group B was 93 (false-negative rate=7) and 28 (false-positive rate=73) for group C.

Triple Hop 

• Petschnig et al (ACL)
  • Specificity for the triple hop test was 96 (false-positive rate=4). The sensitivity for group B was 90 (false-negative rate=10) and 16 (false-positive rate=84) for group C.

6 m Timed Hop

• Logerstedt et al.
  • The 6m timed hop had the strongest predictor validity of the four hop tests (single hop for distance, crossover hop, triple hop, and 6m timed hop).  Patients with decreased knee function were over five times more likely to be below the optimum cutoff score of 87.7% (rounded to 88%) compared to subjects with acceptable knee function, quantified by the IKDC 2000.

Cross Over Hop

• Logerstedt et al.
  • The cross over hop had high predictive validity, similar to the 6m timed hop test.  Subjects were 4x’s as likely to have impaired knee function when below the cutoff score, compared to subjects with acceptable knee function.

Vertical Hop

• Hegedus et al (Knee injury)
  • Evidence quality for criterion validity was mixed with one study of poor and one of good quality
• Petschnig et al (ACL)
  • Specificity for the vertical jump was 96 (false-positive rate=4). The sensitivity for group B was 100 (false-negative rate=0) and 72 (false-positive rate=28) for group C.
  • One-legged vertical jump is sensitive enough to detect functional limitations for the lower limb following knee ligament reconstruction. Sensitivity of the vertical jump decreases when both legs are used, as people may be compensating with the uninvolved leg.

Lower limb symmetry (chronic ACL tear) 

• Noyes et al
  • The study used a combination of hop tests (single hop and timed hop) to determine the predictability of chronic ACL tear. Using any two tests together (also including triple hop and cross over hop) was found to be a better predictor of ACL dysfunction (62% performed abnormally on at least one) than one test alone (half of the participants failed each test alone). The study concluded that one-legged function tests (single hop, timed hop) had low sensitivity (52, 49). However high specificity (97, 94) and low false positive rates (3, 6) indicated that these tests can be used to help confirm abnormal limb symmetry.

Single Leg Hop for Distance

●      Hegedus et al (Knee injury)

○    The quality rating of construct validity for the hop test is generally positive when examining discriminant validity and generally negative when describing convergent validity.

Single Leg Hop and Triple Leg Hop Test

• Reinke et al
  • The strongest relationship was found to be a moderate, positive correlation between the IKDC scores and the single hop test (o.3) and triple hop test (0.4). The KOOS Sports and Recreation subscore was weakly correlated with the triple hop test (0.2) and single hop test (0.2). For the KOOS Knee Related Quality of Life, only the correlation with the triple-hop ratio was significant and it had a moderate rho value of 0.31.

Hegedus et al

• Five studies reported on the responsiveness of five PPTs at the knee, however only one study demonstrated good methodological quality.

Kea et al

• Effect size for lateral hop test = 0.15
• Effect size for medial hop test = 0.26

Munro & Herrington

Effect sizes comparing males and females were high for all tests, ranging from 1.08-2.00, with the exception of the timed hop which had an effect size of 0.47. Therefore, genders were separated for analysis.