Establishing Normative Values for Inter-Limb Kinetic Symmetry During Landing in Uninjured Adolescent Athletes

BACKGROUND: Assessment of inter-limb kinetic symmetry during landing could provide valuable insights when working with athletes who have undergone anterior cruciate ligament reconstruction. However, it is difficult to determine if the asymmetry exhibited by an injured athlete is excessive or within a range that is similar to uninjured athletes, until normative values are established. PURPOSE: The purpose of this study was to establish normative values for inter-limb impact force symmetry in uninjured adolescent athletes. In addition, an example is provided of how these normative values could be used to identify athletes who exhibit atypically high levels of asymmetry following anterior cruciate ligament reconstruction. STUDY DESIGN: Cross-sectional study METHODS: One hundred and thirty-six uninjured athletes completed drop vertical jumps and countermovement jumps while force plates recorded ground reaction forces. Symmetry indices captured inter-limb symmetry in impact forces during landing for both tasks. These symmetry indices were also combined to create an index that captured symmetry across both tasks. Normative values were established using the uninjured athletes’ data. Eleven athletes who had undergone anterior cruciate ligament reconstruction and been cleared to return to landing and jumping performed the same tasks and their data were compared to the results for the uninjured group. RESULTS: Measures of central tendency, variability, percentiles, and outliers were calculated/identified based on the uninjured athletes’ symmetry indices. Six of the 11 injured athletes exhibited atypically high symmetry index values. CONCLUSION: The normative values established as part of this study may serve as a basis for identifying athletes who exhibit atypically high levels of inter-limb impact force asymmetry during jumping tasks following anterior cruciate ligament reconstruction. LEVEL OF EVIDENCE: 3b