What is a common functional test for lower extremity strength and balance used in return-to-play decisions, and what constitutes a positive finding?

What is a common functional test for lower extremity strength and balance used in return-to-play decisions, and what constitutes a positive finding?

• A. Treadmill endurance test; faster time on the injured leg indicates readiness.
• B. Single-leg hop tests; symmetry or within ~90% of contralateral limb indicates readiness.
• C. Bilateral vertical jump; higher score on the injured leg indicates readiness.
• D. Static balance test on both legs; any sway indicates readiness.

Answer: (B)

The idea behind this question is that return-to-play decisions rely on a functional measure of how well the injured lower extremity can perform in a controlled, sport-like task. The single-leg hop tests test strength, power, and dynamic balance by having the athlete hop on the injured leg and compare that performance to the uninjured leg. The key marker is symmetry between sides. If the injured leg achieves about the same performance as the uninjured leg — typically defined as at least 90% of the contralateral limb, often expressed as a limb symmetry index of 90% or greater — this suggests the leg has recovered enough strength and neuromuscular control to handle the demands of sport and lowers re-injury risk. Other options miss this focused assessment: treadmill endurance looks at cardiovascular capacity rather than unilateral leg strength and control; a bilateral vertical jump can mask leg-to-leg deficits; and a static balance test on both legs doesn’t capture the dynamic, unilateral demands of most athletic activities.

The idea behind this question is that return-to-play decisions rely on a functional measure of how well the injured lower extremity can perform in a controlled, sport-like task. The single-leg hop tests test strength, power, and dynamic balance by having the athlete hop on the injured leg and compare that performance to the uninjured leg. The key marker is symmetry between sides. If the injured leg achieves about the same performance as the uninjured leg — typically defined as at least 90% of the contralateral limb, often expressed as a limb symmetry index of 90% or greater — this suggests the leg has recovered enough strength and neuromuscular control to handle the demands of sport and lowers re-injury risk. Other options miss this focused assessment: treadmill endurance looks at cardiovascular capacity rather than unilateral leg strength and control; a bilateral vertical jump can mask leg-to-leg deficits; and a static balance test on both legs doesn’t capture the dynamic, unilateral demands of most athletic activities.