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Hop Testing Procedures

The document describes procedures for administering a series of 4 hop tests to test lower extremity function. The tests included a single hop for distance, a 6-meter timed hop, a triple hop for distance, and a crossover hop for distance. The tests were performed in that order and subjects were given practice trials and breaks between tests to minimize fatigue. Distance and timing were recorded for each hop and criteria were provided for classifying successful vs unsuccessful hops. The procedures aimed to standardize administration of the hop tests in order to reliably evaluate lower extremity function.

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106 views

Hop Testing Procedures

The document describes procedures for administering a series of 4 hop tests to test lower extremity function. The tests included a single hop for distance, a 6-meter timed hop, a triple hop for distance, and a crossover hop for distance. The tests were performed in that order and subjects were given practice trials and breaks between tests to minimize fatigue. Distance and timing were recorded for each hop and criteria were provided for classifying successful vs unsuccessful hops. The procedures aimed to standardize administration of the hop tests in order to reliably evaluate lower extremity function.

Uploaded by

pfi_jen
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Hop Testing Procedures

The series of 4 hop tests was administered in accordance with the protocols outlined by Noyes
et al,18 Barber et al,34 and Daniel et al.35 The tests were a single hop for distance, a 6-m timed
hop, a triple hop for distance, and a crossover hop for distance (Fig. 2). In keeping with the
original description,18the tests were administered in that order on each test occasion, followed
by the administration of the self-report measures. The hop testing course was constructed on
low-pile, rubber-backed carpet glued over concrete floor. The course consisted of a 6-m-long
15-cm-wide marking placed on the floor.

For each hop test, the subjects performed one practice trial for each limb, followed by 2
measured and recorded trials. Consistent with the original description of the 4 hop tests, no
additional warm-up activity was performed. For each set of tests, the subjects were instructed
to begin with the nonoperative limb. To minimize fatigue, a rest period was offered between
types of hop tests (up to 2 minutes) and between individual hop test trials if needed (typically
less than 30 seconds was sufficient). Subjects started each test with the lead toe behind a
clearly marked starting line. No restrictions were placed on arm movement during testing, and
no instructions were provided regarding where to look. Subjects were encouraged to wear the
footwear they would normally wear during their rehabilitation sessions.

For the hops for distance (single, triple, and crossover) to be deemed successful, the landing
must have been maintained for 2 seconds. An unsuccessful hop was classified by any of the
following: touching down of the contralateral lower extremity, touching down of either upper
extremity, loss of balance, or an additional hop on landing. If the hop was unsuccessful, the
subject was reminded of the requirement to maintain the landing, and the hop was repeated.
No further instructions were provided to the subjects. Typically, 1 or 2 extra trials were
required.
The single hop for distance was performed as outlined by Daniel et al.35 The subjects stood on
the leg to be tested, hopped, and landed on the same limb. The distance hopped, measured at
the level of the great toe, was measured and recorded to the nearest centimeter from a
standard tape measure that was permanently affixed to the floor. The timed 6-m hop was
performed as outlined by Barber et al.34 Subjects were instructed to perform large one-legged
hops in series over the total distance. A standard stopwatch was used to record time. The
stopwatch was started when a subjects heel lifted from the starting position and was stopped
the moment that the tested foot passed the finish line. Measurements were recorded to the
nearest 10th of a second.
The triple hop for distance was performed as outlined by Noyes et al.18 Subjects were instructed
to stand on one leg and perform 3 consecutive hops as far as possible, landing on the same
leg. The total distance for 3 consecutive hops was recorded. Finally, the crossover hop for
distance18 was performed over a 15-cm strip on the floor. The subjects hopped forward 3 times
while alternately crossing over a marking. The total distance hopped forward was recorded.
Subjects were instructed to position themselves such that the first of the 3 hops was lateral with
respect to the direction of crossover. The series of hop tests took approximately 10 minutes to
administer.

The following description provides an example of how a physical therapist might use these
values in clinical practice. Following adequate practice with hop testing, a patient 16 weeks
after ACL reconstruction scores a limb symmetry index of 80% for the overall combination of
hops, and the score improves to 90% following 6 weeks of treatment. Upon initial assessment,
the clinician can be 90% confident that the true limb symmetry index value could vary from 75%
to 85% simply due to measurement error (ie, 80% approximately 5%). When tested 6 weeks
later, the clinician can be confident that this patient has truly improved because the observed
change of 10% (ie, an increase from 80% to 90%) exceeds the minimal detectable change of
approximately 7%. Also note that the minimal detectable change could represent deterioration
in performance. For example, if the patients score dropped to 70% upon reassessment, the
clinician can be confident that this patient has truly deteriorated because the observed change
of 10% (ie, a decrease from 80% to 70%) also exceeds the minimal detectable change of
approximately 7%.

We decided to keep the order of the individual hop tests that make up the full test consistent
with its original description.18 In our experience, the 4 hop tests progress logically from less
difficult to more difficult, and the initial tests may help to improve performance on the later,
more difficult tests. Although reliability would not likely differ from the present findings if a
clinician decided to administer just the single hop for distance test (indeed, the present ICC is
similar to those reported by Kramer et al29 on just the single hop test), reliability is more likely
to change if a clinician decided to administer just one of the more difficult hop tests without
adequate practice. Similarly, our experience with these tests suggests that considerable motor
learning is likely when first performing them. It is advisable, therefore, to incorporate
considerable practice before stable values can be recorded (eg, we used a practice day in the
present study to ensure that our subjects performances were stable). The limitation in the
generalizability of the present findings to the described order of testing and the use of a
practice session should be recognized.

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