Performance Function Tests in Assessing Ankle Fitness

J Am Acad Orthop Surg Glob Res Rev. 2019 Jan 14;3(1):e096. doi: 10.5435/JAAOSGlobal-D-18-00096. eCollection 2019 Jan.

Abstract

Introduction: A challenge for any physician caring for athletes is determining readiness for return to competition after an injury. A wide variety of performance function tests (PFTs) have been described, but no norms or minimum performance levels exist for any of them. In this study, healthy athletes were given a series of PFTs to complete. We propose that there will be a minimum performance level for each of the PFTs that all athletes can complete. We also propose, for tests that assess the right and left legs independently, that performance of the right leg will consistently be within 10% of the left. Finally, we propose that performance on one of the functional tests will be predictive of function on all the tests.

Methods: Athletes were put through a testing protocol, beginning with range of motion and progressing through a series of functional ankle tests of increasing difficulty. Right and left leg data were recorded separately for the first five tests. For each test, mean values, ranges, and SDs were calculated.

Results: Eighty-one athletes completed the protocol. A wide variation existed in performance ability between athletes; the SD for any of the tests was too high to determine a minimum performance threshold. However, when comparing right to left leg in any one athlete, the difference in performance testing was always less than 10%. Furthermore, performance on the side hop test was predictive of performance on the other tests.

Discussion: A wide range of performance was noted in all the PFTs, so it is not possible to define a minimum threshold. However, performance of an injured leg to within 10% of the opposite (uninjured) leg suggests achievement of normal function. The side hop test might be a good test by itself to represent overall ankle readiness.