Analysis of balance and functional hop tests used for return to sports in athletes with lower extremity injuries by dual task

The aim of our study is to examine the potential performance changes of the athletes by performing the balance and functional jump tests, which are the return to the sport tests applied after the injury, simultaneously with a cognitive task added to the physical task, which we think reflects the field conditions more realistically. Our study included high school or university level, physically active athletes who do team sports involving sudden change of direction and jumping. 19 subjects with a previous lower extremity injury history (case group) and 20 individuals without (control group) were included in the study. Demographic information of the participants was taken, injury history, training frequency and duration, average number of matches per week were noted. Mini Mental State Scores were calculated and the backward digit test of the Wechsler intelligence scale was preferred to determine the cognitive task difficulty to be used during the measurements. Biodex Balance System SD device was used for balance measurements. Among the functional hop tests, the 6-meter time hop test and the triple hop distance and crossover hop distance tests were carried out on the jump carpet. LSI (limb symmetry index) was calculated for the hop test results. All measurements were made under two conditions, as single task and dual task (together with numerical task). Statistical analyzes were made with the IBM SPSS 22 package program and the level of significance was determined as p<0.05. In both conditions, case group performed better in all balance parameters; control group outperformed all jump measurements. In the measurement of crossover hop distance, which is more complex physically and cognitively compared to other measurement tests we used in our study, it was observed that while control group increases the LSI percentage; case group reduced the LSI percentage. These results show that physical performance measurements made in isolation are insufficient to measure the mental stress that the athletes may be exposed to when they return to the sport. For this reason, we think that adapting both the return to the sport tests and the injury prevention protocols in which the neurocognitive skills of the athlete can be tested will prepare the athlete to return to the sport in a more versatile way. Key Words: Lower extremity injuries, performance measures, dual task, balance, functional hop