Rethinking Lower Extremity Limb Dominance: A Comparison of Performance-Based and Self-Selected Measures.

Abstract

Background: Limb dominance implies preferential or asymmetrical performance between limbs. There is currently no consensus regarding limb dominance definition for the lower extremity. Previous work described several methods of subjective reporting for lower extremity limb dominance; however, the correlation between objective performance and subjective perception of limb dominance is poorly understood, particularly among adolescent athletes. The purpose of this study was to test the agreement between objective performance and self-selected limb dominance in 3 different single-leg hopping tasks.

Hypothesis: There will be a positive association between self-selected limb dominance and objective performance.

Study design: Cross-sectional cohort study.

Level of evidence: Level 3.

Methods: Self-selected limb dominance was determined by asking, "Which leg would you use to kick a ball as far as you could?" Participants performed a series of single-leg hops, and 3-trial means of the single hop (SH), timed hop (TH), and vertical hop (VH) were used for analysis. Paired samples t test or Wilcoxon-signed rank test identified differences in limb performance for each hop test. Chi-square analysis evaluated associations between self-selected limb dominance and objective performance.

Results: A total of 352 healthy youth athletes (55% male; mean age, 11.1 ± 1.7 years) participated. There was a small statistically significant difference between limbs on all hop tests. Chi-square analysis revealed no associations (P > 0.05) between self-selected limb dominance and objective performance across all hop test constructs.

Conclusion: A single limb performed better on all hop tests by a small and not clinically relevant difference. Perceived limb dominance did not predict performance regardless of hopping task.

Clinical relevance: Symmetrical performance on the SH, TH, and VH is normal in uninjured athletes. When returning injured athletes to sport, clinicians should aim for restoring hop test symmetry regardless of whether the injured limb is the perceived dominant limb.