Lower-limb motor-performance asymmetries in English community-level female field hockey players: Implications for knee and ankle injury prevention

Phys Ther Sport. 2020 May:43:43-51. doi: 10.1016/j.ptsp.2020.02.001. Epub 2020 Feb 10.

Abstract

Objectives: Side-to-side asymmetry of lower-limb motor-performance is associated with increased agility-sport noncontact injury-risk. Left leg preferential use (unilaterality) in hockey may influence lower-limb motor-performance asymmetry. Symmetry-analyses have not been reported for female hockey players. This study performed symmetry-analyses using the eyes-closed-balance test (ECB), anterior reach test (ART), triple-hop-for-distance (THD), and six-metre hop-for-time (6MHT).

Design: Cross-sectional.

Setting: Community-level club.

Participants: Thirty players (age 25.6 ± 4.5yr; height 165.6 ± 5.9 cm; mass 64.8 ± 5.5 kg).

Main outcome measures: Right-left group-level (t-test with Bonferroni adjustment) and individual-level (absolute-asymmetry (%)) comparisons. A limb symmetry index (LSI) was computed for each player and a clinically-significant absolute-asymmetry defined >10% as per previous literature. Clinically-significant absolute-asymmetry prevalence (%) was calculated across tests. For unilaterality, prevalence of superior left-side performance was calculated.

Results: There were no right-left significant differences across tests. Findings for ECB, ART, THD, and 6MHT were: absolute-asymmetry, 28.7 ± 26.9%, 3.5 ± 2.8%, 3.5 ± 3.4%, 6.1 ± 4.7%; prevalence of clinically-significant absolute-asymmetries, 70.0%, 3.3%, 6.7%, 26.7%; prevalence of superior left-side performance, 46.7%, 53.0%, 50.0%, 47.0%.

Conclusions: Statistical tests fail to expose clinically-significant absolute-asymmetries. Many players demonstrated clinically-significant absolute-asymmetries for ECB and 6MHT tests. Clinical interpretation of LSIs and absolute-asymmetries need not consider unilaterality. Clinically-significant absolute-asymmetries previously linked to injury-risk are common in a community-level, adult female hockey players.

Keywords: Ankle; Asymmetry; Field hockey; Knee.

MeSH terms

  • Adolescent
  • Adult
  • Ankle Injuries / physiopathology
  • Ankle Injuries / prevention & control
  • Athletic Performance / physiology*
  • Cross-Sectional Studies
  • Exercise Test*
  • Female
  • Hockey / physiology*
  • Humans
  • Knee Injuries / physiopathology
  • Knee Injuries / prevention & control
  • Lower Extremity / physiology*
  • Young Adult