Drop Jump Test | Dynamic Knee Valgus | Post ACL Surgery Test
A deficiency in the neuromuscular control of the hip has been identified as a key risk factor for noncontact anterior cruciate ligament injury. This deficiency can manifest itself as a valgus knee alignment during tasks involving hip and knee flexion. The Drop jump test is a test to observe and evaluate the dynamic knee valgus. It helps clinicians decide whether patients have a low-risk of high-risk landing mechanism.
Kappa coefficients for intra-rater and inter-rater agreement ranged from 0.75 – 0.85, indicating that ratings were reasonably consistent over time and between physiotherapists. Sensitivity and specificity values were inadequate, ranging from respectively 67% – 87% and 60% – 72%. To detect a greater proportion of individuals at risk of ACL injury, clinicians should ensure that they include additional tests for other high-risk characteristics in their screening protocols.
To conduct the test, let your patient stand on a 31cm high box. Then the patient drops down to the floor and immediately performs a maximum vertical jump. The patient needs to keep his or her arms in the “stop position”. The shoulders should be abducted at 45° and the elbows flexed at 90°, to reduce momentum from the arm swing. To minimize learning effects, 3 practice trials of the drop-jump are allowed. After this, 9 consecutive drop-jump trials were conducted. A ten-second rest between trials is allowed to reduce fatigue.
To observe the test, it’s easiest to film the patient with a camera. An easy tool you can use is the app called “Huddle”. You can film the patient and watch the video back in slow-motion. After observing the performance, the clinician decides whether the performance was a high-risk or a low-risk.
A low-risk landing mechanism is a landing where the patella has remained in line with the first toe. A high-risk landing mechanism is a landing where the patella has moved inward and ended up medial to the first toe. Be aware, however, that it is as yet unknown exactly how much dynamic knee valgus may predispose an individual to future injury. Until this is known, the validity of screening guidelines such as this will remain unclear. Recent literature discusses the fact that unilateral knee valgus could be a potential risk factor as well. People at higher risk shows increased knee valgus and ipsilateral trunk motion. Studies comparing bilateral and unilateral leg drop jumps have shown that the dynamic change in lower limb alignment is greater in the single-leg drop jump compared to bilateral leg drop jump. Considering this information and the fact that the drop jump test isn’t very accurate in screening athletes, we think that unilateral hop tests can be useful as well in the rehab- and return to sport process. You can see the video about unilateral hop tests right next to me.
Other useful performance tests that you might be interested in are:
Ekegren CL, Miller WC, Celebrini RG, Eng JJ, Macintyre DL. Reliability and validity of observational risk screening in evaluating dynamic knee valgus. journal of orthopaedic & sports physical therapy. 2009 Sep;39(9):665-74.
Numata, H., Nakase, J., Kitaoka, K., Shima, Y., Oshima, T., Takata, Y., Shimozaki, K. and Tsuchiya, H., 2018. Two-dimensional motion analysis of dynamic knee valgus identifies female high school athletes at risk of non-contact anterior cruciate ligament injury. Knee Surgery, Sports Traumatology, Arthroscopy, 26(2), pp.442-447.
Dingenen B, Malfait B, Nijs S, Peers KH, Vereecken S, Verschueren SM, Staes FF. Can two-dimensional video analysis during single-leg drop vertical jumps help identify non-contact knee injury risk? A one-year prospective study. Clinical biomechanics. 2015 Oct 1;30(8):781-7.
Taylor JB, Ford KR, Nguyen AD, Shultz SJ. Biomechanical comparison of single-and double-leg jump landings in the sagittal and frontal plane. Orthopaedic journal of sports medicine. 2016 Jun 28;4(6):2325967116655158.
Krosshaug T, Steffen K, Kristianslund E, Nilstad A, Mok KM, Myklebust G, Andersen TE, Holme I, Engebretsen L, Bahr R. The vertical drop jump is a poor screening test for ACL injuries in female elite soccer and handball players: a prospective cohort study of 710 athletes. The American journal of sports medicine. 2016 Apr;44(4):874-83.
- Verena Fric12/03/22
ACL Injuries: From Theory to Practice Lots of relevant informationen around ACL, many ideas how to manage in practice and especially in late phase after ACL Surgery. I defintively recommand this course to everyone who wants to be update and increase his/her knowledge about ACL Rehab.Omar12/03/22
ACL Injuries: From Theory to Practice VERY INFORMATIVE COURSE!
Can’t be more satisfied with this course content that cover all aspects in the ACL managementMostafa12/01/22
ACL Injuries: From Theory to Practice THE BEST OF THE BEST!
I am a physiotherapist from Egypt and I have been working in the sports field for two years and dealt with many cases of ACL, but I always stood at certain points and i couldnt understand what was happening and I had many questions that I did not know the answer to, and after I took this course Many points became clear to me, and I had much more confidence in dealing with ACL cases.
I recommend this course to everyone who deals with acl cases , because it is really as it is in the title, from theory to practice.
I would like to thank Dr. Bart and Physiotutors for their wonderful effort.
ACL Injuries: From Theory to Practice Very complete course covering all the problems that can be encountered in clinical practice. From understanding the mechanisms of injury to injury prevention and return to performance. Lots of information, all based on recent scientific literature and the instructor’s experience. Thanks Bart & Physiotutors !JOSÉ GUALÃO27/05/21
ACL Injuries: From Theory to Practice VERY GOOD
Extremely happy with the contentDavid05/04/21
ACL Injuries: From Theory to Practice TOP!
Cursus die van A tot Z weergeeft wat een ACL letsel is en hoe de aanpak moet zijn! Het volgen van deze cursus is echt nodig om ACL optimal rehab te kunnen aanbieden.
ACL Injuries: From Theory to Practice EVERYTHING YOU NEED TO KNOW ABOUT ACL INJURIES!
This is the most complete course ever. It contains everything you need to know about ACL injuries. I strongly recommend it to everyone!PAVEL SASMSONOV28/10/20
ACL Injuries: From Theory to Practice OUTSTANDING COURSE!
This course is more than just webinar. It gives you deep understanding of different aspects and principles of rehabilitation ACL injured and reconstructed patients. Thank you, Bart and all Physiotutors team for uptodated information on different topics regarding this definetly tough topic. Despite that fact that I had some experience working with different ACL-patients I got structured whole information and gained a lot of new ideas to implement into my clinical practise!
Thank you so much!ANDRÉ23/10/20
ACL Injuries: From Theory to Practice JUST DO IT!
This course have been nothing but great. So much good information and you can expect to learn a whole lot about all factors affecting the rehabilitation. It was worth every penny and I really recommend anyone treating patients with ACL-injuries to enroll in this course.
EVERYTHING YOU NEED TO KNOW ABOUT ACL INJURIES
This really is a fabulous course. Everything you need to know about ACL injuries and rehabilitation is discussed and supported by research. I would highly recommend this course – thank you Bart!PEDRO J.01/08/20
ACL Injuries: From Theory to Practice GREAT COURSE!
I think it’s the most comprehensive course on ACL right now. It perfectly addresses the latest updates on the subject. My congratulations to the whole team for the course and to Bart Dingenen for sharing all his work. Greetings!Ben Saldivar27/05/20
ACL Injuries: From Theory to Practice If you want to provide the best possible care to your ACL patients this course is a must.
Extremely detailed over all areas. Nothing else I’ve seen like it. Great job guys.