Testing limb symmetry and asymmetry after Anterior Cruciate Ligament injury: 4 considerations to increase its utility
Article
Jordan, M and Bishop, C. 2023. Testing limb symmetry and asymmetry after Anterior Cruciate Ligament injury: 4 considerations to increase its utility. Strength and Conditioning Journal. https://doi.org/0.1519/SSC.0000000000000821
Type | Article |
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Title | Testing limb symmetry and asymmetry after Anterior Cruciate Ligament injury: 4 considerations to increase its utility |
Authors | Jordan, M and Bishop, C. |
Abstract | Anterior cruciate ligament (ACL) injury occurs frequently in sport and surgical reconstruction (ACLR) is often recommended to restore knee joint stability. To guide rehabilitation and determine return to sport readiness, practitioners have used a long-standing practice of calculating the limb symmetry index (LSI) in various functional, biomechanical, and strength tests to compare the injured limb to the non-injured contralateral limb. However, the evidence in support of the LSI calculation to quantify rehabilitation status and return to sport readiness is mixed. We synthesize scientific literature on the LSI calculation and discuss potential reasons for the mixed evidence and limitations. We present four considerations to improve the utility of the LSI calculation including: (1) the importance of establishing the right benchmark of recovery such as the pre-injury contralateral limb or a sport-specific non-injured control benchmark; (2) strategies to manage the high variation in movement asymmetry calculations and the importance of quantifying the intra-subject variability for the component parts of the LSI; (3) the evidence for assessing the movement strategy alongside performance when using the LSI; and (4) how a sport-specific envelope of function can be used to inform post-ACL injury testing that incorporates the LSI. |
Keywords | asymmetry; return to sport; return to play; strength testing; hop testing; injury prevention |
Sustainable Development Goals | 3 Good health and well-being |
Middlesex University Theme | Health & Wellbeing |
Publisher | Lippincott, Williams and Wilkins |
Journal | Strength and Conditioning Journal |
ISSN | 1524-1602 |
Electronic | 1533-4295 |
Publication dates | |
Online | 28 Nov 2023 |
Publication process dates | |
Accepted | 11 Sep 2023 |
Deposited | 14 Sep 2023 |
Output status | Published |
Accepted author manuscript | |
Copyright Statement | This is a non-final version of an article published in final form in: Jordan, Matthew J.; Bishop, Chris. Testing Limb Symmetry and Asymmetry After Anterior Cruciate Ligament Injury: 4 Considerations to Increase Its Utility. Strength and Conditioning Journal ():10.1519/SSC.0000000000000821, November 28, 2023. | DOI: 10.1519/SSC.0000000000000821 |
Digital Object Identifier (DOI) | https://doi.org/0.1519/SSC.0000000000000821 |
Language | English |
https://repository.mdx.ac.uk/item/q778q
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