RehabMeasures Instrument
  1. Rehabilitation Measures Database
  2. Single Limb Hop Tests

Single Limb Hop Tests

Last Updated

Purpose

To review the measurement properties of physical performance tests (PPTs) of the knee as each pertains to athletes, and to determine the relationship between PPTs and injury in athletes age 12 years to adult.

Link to Instrument

Instrument Details

Area of Assessment

Balance – Non-vestibular
Coordination
Functional Mobility
Occupational Performance
Strength

Assessment Type

Performance Measure

Cost

Free

Diagnosis/Conditions

  • Pain Management
  • Sports & Musculoskeletal Injuries

Populations

Non-Specific Patient Population

Key Descriptions

  • One leg single hop for distance - hop forward on one leg as far as possible
  • -One leg triple hop for distance - hop forward three times on one leg as far as possible
  • 6m timed hop - hop on one leg as quickly as possible for 6m
  • Crossover hop for distance - hop forward as far as possible three times, each time crossing over a line
  • Triple jump - in a continuous manner, complete three phases of movement as far as possible:
    1) Hop
    2) Step
    3) Jump
  • Single leg vertical jump - jump as high as possible off of one leg
  • Lateral Hop - using dominant leg, hop as far as possible laterally (landing on same leg)
  • Medial Hop - using dominant leg, hop as far as possible medially (landing on same leg)
  • Figure 8 Hop – subjects hop in figure 8 over 5m distance for time (2 consecutive laps)
  • Up-down hop – subjects hop up onto a 20cm high step and back down 10 times as fast as they can
  • Side hop – subjects hop transversely (more than 30cm) for ten hops as quickly as possible
  • Stair hop – subjects hop up and down 3 steps, then they turn around and repeat
  • Vertical hop – single hop for maximum height on a force plate

Number of Items

6

Equipment Required

  • Vertex
  • Tape Measure
  • Marker
  • Stopwatch

Time to Administer

Approximately 10-20 minutes

Required Training

No Training

Age Ranges

Adolescent

13 - 17

years

Adult

18 - 64

years

Elderly Adult

65 +

years

Instrument Reviewers

Amber Penna, SPT; Garrett Bullock, SPT; Caroline Ubben, SPT; Derek Poulson, SPT; Cassie Swafford, SPT; Kelly Patterson, SPT; Bobby Prengle, SPT; Thomas Hammett, SPT; Cayla Lowe, SPT; Lynnea Kraft, SPT; Alisha Laing, SPT; Courtney Emerson, SPT.

Body Part

Lower Extremity

ICF Domain

Body Structure
Body Function
Activity
Participation

Measurement Domain

Motor
Sensory

Professional Association Recommendation

Munro & Herrington

●      Although previous studies have used a LSI > 85% to indicate “normal” limb symmetry, these results suggest that a cut-off of 90% should be used to ensure that the function of the injured limb is being restored.  

 

Noyes et al

●      Hop tests should be used in conjunction with other clinical assessment tools (isokinetic testing, arthrometer testing, thorough patient history) to provide confirmation as to the extent of lower limb functional limitations for individuals with chronic ACL deficient knees.

Considerations

PPTs are a wide array of tests which are not well established. Caution should be used when making clinical decisions based on the results of these tests. Clinicians should use additional valid and reliable tests along with the PPTs before making clinical decisions.

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Non-Specific Patient Population

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Standard Error of Measurement (SEM)

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

Minimal Detectable Change (MDC)

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

Cut-Off Scores

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.

Test/Retest Reliability

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

Interrater/Intrarater Reliability

Vertical Hop

  • Hegedus et al (Knee injury)

Inter-rater reliability:0.75

Criterion Validity (Predictive/Concurrent)

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.

Construct Validity

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.

Responsiveness

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.

Bibliography

Booher, L., Hench, K., Worrell, T., & Stikeleather, J. (1993). Reliability of Three Single-Leg Hop Tests. Journal of Sport Rehabilitation, 2(3), 165-170.

Fitzgerald, K.G., Lephart S. M., Hwang J.H., Wainner M. R. S. “Hop Tests as Predictors of Dynamic Knee Stability.” Journal of Orthopaedic and Sports Physical Therapy 31.10 (2001): 588-597.

Grindem, H., Logerstedt, D., Eitzen, I., Moksnes, H., Axe, M. J., Snyder-Mackler, L., ... & Risberg, M. A. (2011). Single-legged hop tests as predictors of self-reported knee function in nonoperatively treated individuals with anterior cruciate ligament injury. The American Journal of Sports Medicine, 39(11), 2347-2354.

Hegedus EJ, McDonough S, Bleakley C, Cook CE, Baxter GD. Clinician-friendly lower extremity physical performance measures in athletes: a systematic review of measurement properties and correlation with injury, part 1. The tests for knee function including the hop tests. Br J Sports Med. 2015 May;49(10):642-648. doi: 10.1136/bjsports-2014-094094. Epub 2014 Dec 10.

Hopper, D. M., Goh, S. C., Wentworth, L. A., Chan, D. Y., Chau, J. H., Wootton, G. J., ... & Boyle, J. J. (2002). Test–retest reliability of knee rating scales and functional hop tests one year following anterior cruciate ligament reconstruction.Physical Therapy in Sport, 3(1), 10-18.

Itoh, H., Kurosaka, M., Yoshiya, S., Ichihashi, N., & Mizuno, K. (1998). Evaluation of functional deficits determined by four different hop tests in patients with anterior cruciate ligament deficiency. Knee Surgery, Sports Traumatology, Arthroscopy, 6, 241-245.

Kea, J., Kramer, J., Forwell, L., & Birmingham, T. (2001). Hip Abduction-Adduction Strength and One-Leg Hop Tests: Test-Retest Reliability and Relationship to Function in Elite Ice Hockey Players. J Orthop Sports Phys Ther Journal of Orthopaedic & Sports Physical Therapy, 31(8), 446-455.

Logerstedt D, Grindhem H, Lynch A, Eitzen I, Engebretsen L, Risberg MA, Axe MJ, Snyder-Mackler L.  Single-legged hop tests as predictors of self-reported knee function after anterior cruciate ligament reconstruction: the Delaware-Oslo ACL cohort study,  The American Journal of Sports Medicine.  2012 Oct; 40(10), 2348-56.

Munro, Allen & Herrington, Lee. Between Session Reliability of Four Hop Tests and the Agility T-Test. Journal of Strength and Conditioning Research. 2011. 25(5), 1470-77.

Noyes, F. R., Barber, S. D., & Mangine, R. E. (1991). Abnormal lower limb symmetry determined by function hop tests after anterior cruciate ligament rupture. The American Journal of Sports Medicine, 19 (5), 513-518.

Petschnig, R., Baron, R., & Albrecht, M. (1998). The relationship between isokinetic quadriceps strength test and hop tests for distance and one-legged vertical jump test following anterior cruciate ligament reconstruction. Journal of Orthopaedic & Sports Physical Therapy, 28(1), 23-31.

Reinke, Emily K, et al. “Hop Tests correlate with IKDC and KOOS at Minimum of 2 years after Primary ACL Reconstruction.” Knee surgery, sports traumatology, arthroscopy: official journal of the ESSKA 19.11 (2o11): 1806-1816. PMV. Web. 9 July 2015.

Ross, M.D., B. Langford, and P.J. Whelan. Test-retest reliability of 4 single leg horizontal hop tests. Journal of Strength and Conditioning Research. 16(4):617-622. 2002.

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