A Narrative Review of Limb Dominance: Task Specificity and the Importance of Fitness Testing

Gender-Based Differences in Biomechanical Walking Patterns of Athletes Using Inertial Sensors

Background: Wearable inertial sensors are essential tools in biomechanics and sports science for assessing gait in real-world conditions. This study explored gender-based differences in biomechanical walking patterns among healthy Greek athletes using the BTS G-Walk system, focusing on key gait parameters to inform gender-specific training and rehabilitation strategies. Methods: Ninety-five healthy athletes (55 men, 40 women), aged 18 to 30 years, participated in this study. Each athlete performed a standardized 14 m walk while 17 biomechanical gait parameters were recorded using the BTS G-Walk inertial sensor. Statistical analyses were conducted using SPSS to assess gender differences and left-right foot symmetry. Results: No significant asymmetry was found between the left and right feet for most gait parameters. Men exhibited longer stride lengths (left: p = 0.005, Cohen's d = 0.61; right: p = 0.009, Cohen's d = 0.53) and longer stride and gait cycle durations (left: p = 0.025, Cohen's d = 0.52; right: p = 0.025, Cohen's d = 0.53). Women showed a higher cadence (p = 0.022, Cohen's d = -0.52) and greater propulsion index (left: p = 0.001, Cohen's d = -0.71; right: p = 0.001, Cohen's d = -0.73), as well as a higher percentage of first double support (p = 0.030, Cohen's d = -0.44). Conclusions: These findings highlight the impact of biological and biomechanical differences on walking patterns, emphasizing the need for gender-specific training and rehabilitation. The BTS G-Walk system proved reliable for gait analysis, with potential for optimizing performance, injury prevention, and rehabilitation in athletes. Future research should explore larger, more diverse populations with multi-sensor setups.

Strength and dynamic balance performance in soccer players in the United States: age, sex, and bilateral differences

Quantification of asymmetries between the two limbs is informative in assessing the risk of injury and performance deficits, but there is a paucity of studies investigating the effects of age and sex on bilateral asymmetry in young soccer players. This cross-sectional study aimed to investigate the effects of age and sex on strength and dynamic balance in 7- to 24-year-old soccer players in the United States. A total of 174 young soccer players participated in the study (Age 7-9 years: 26 females and 16 males; Age 10-12 years: 32 females and 31 males; Age 13-17 years: 17 females and 25 males; Age >18 years: 13 females and 14 males). Jump displacement, peak force, and asymmetry during countermovement jump with arm swing and landing, peak force and asymmetry during push-up, and normalized reaching distances for upper and lower extremity reaching tests were quantified. Preferred legs and arms were defined as the preferred kicking leg or throwing arm. As age increased, both preferred and non-preferred sides demonstrated decreased landing forces, increased jump displacement, and increased normalized peak forces during push-ups in both males and females (p < 0.05). Males showed greater jump displacement, normalized landing forces, and normalized peak forces in push-ups compared to females in several age groups (p < 0.05). No significant differences were observed for asymmetry variables between ages or sexes, and on average, most bilateral asymmetry variables were less than 5%. Age was associated with strength but not dynamic balance performance in healthy soccer players in the United States. Male and female players demonstrated similar changes, and bilateral asymmetries were on average small. Soccer players may need more dynamic balance training over time as they progress to higher levels of competition. Landing technique training may be implemented for young soccer players to decrease the high impact landing forces and landing related injury risk. Asymmetries and their relationships with injury risk should be evaluated on an individual basis, as their relationships with age and sex were weak. Future longitudinal and cohort studies are warranted to further elucidate the relationship among strength, dynamic balance, and injury risk in soccer players.

Association Between Inter-Limb Asymmetry and Determinants of Middle- and Long-distance Running Performance in Healthy Populations: A Systematic Review

BACKGROUND

The presence of inter-limb asymmetry in the human body has traditionally been perceived to be detrimental for athletic performance. However, a systematic review addressing and comprehensively assessing the association of asymmetry between the lower limbs and middle- and long-distance running performance-related metrics is currently lacking.

OBJECTIVE

The main purpose of this systematic review was to examine the relationship between lower inter-limb asymmetry and determinants of running performance in healthy middle- and long-distance runners. The secondary objective was to identify possible avenues for further research in this area.

METHODS

PubMed, Web of Science and SPORTDiscus were systematically searched for studies investigating the relationship between lower inter-limb asymmetry and (determinants of) running performance in healthy and injury-free middle- and long-distance runners. The quality of studies eligible for inclusion was assessed using the Downs and Black Quality Index Tool.

RESULTS

Out of 4817 articles screened, 8 studies were included in this review which assessed the association between functional, morphological, kinematic and kinetic asymmetry and running performance-related metrics. The quality score of the included research varied between 5/10 and 9/10. Our results revealed mixed findings, showing both significant negative (n = 16) and positive (n = 1) associations as well as no significant associations (n = 30) between inter-limb asymmetry and running performance-related metrics.

CONCLUSIONS

A high heterogeneity across study methods and outcomes was apparent, making it difficult to draw a straightforward conclusion. Our results indicate that the majority of metrics of functional, morphological, kinematic and kinetic inter-limb asymmetry are negatively or not associated with running performance (and/or its determinants). Thus, a more extensive high-quality body of research using standardised asymmetry magnitude metrics is essential to determine whether, and to what extent asymmetry between the lower limbs could affect middle- and long-distance running performance. Future studies should establish potential trade-off values to help practitioners develop evidence-based training programs.

KEY POINTS

In the majority of the metrics, the magnitude of lower inter-limb asymmetry was negatively or not associated with middle- and long-distance running performance. Coaches, athletes and researchers should be attentive of the task, time- and metric-specificity as well as the inter- and intra- individual variability of magnitude outcomes, when assessing inter-limb asymmetries.

Inter-limb differences in unilateral countermovement jump height are not associated with the inter-limb differences in bilateral countermovement jump force production

This study aimed to explore the relationship between the inter-limb differences in unilateral countermovement (CMJ) height and the inter-limb differences in bilateral CMJ force production, and to elucidate whether the self-reported preferred leg contributes more to force production than the non-preferred leg. Twenty-three senior basketball players performed in a single session eight unilateral CMJs (four with each leg) and four bilateral CMJs. Impulse, peak force, mean force were recorded during the bilateral CMJ, and jump height during the unilateral CMJ. Small correlations were observed between the inter-limb differences in unilateral CMJ height and the inter-limb asymmetries in bilateral CMJ impulse, peak force, and mean force (p ≥ 0.171; r≤-0.142). The self-reported preferred leg revealed a higher performance in 7 out of 23 participants (Kappa = -0.20) for the unilateral CMJ height, 7 out of 23 participants (Kappa = -0.11) for the bilateral CMJ impulse, 6 out of 23 participants (Kappa = -0.36) for the bilateral CMJ peak force, and 8 out of 23 participants (Kappa = -0.34) for the bilateral CMJ mean force. These results highlight that the asymmetries detected during bilateral CMJs cannot be extrapolated to unilateral CMJs, and that the preferred leg generally contributes less to force production than the non-preferred leg during both bilateral and unilateral CMJs.

The Clinical Significance of Lumbar Transverse Process Lengths Associated with Lumbosacral Transitional Vertebrae: A Landmark for Lumbar Spine Enumeration

OBJECTIVE

This study aimed to identify which lumbar vertebral level above a lumbosacral transitional vertebra (LSTV) demonstrated the longest transverse process (TVP) lengths.

METHODS

In this exploratory quantitative osteological cohort study using a digital Vernier caliper, dried human cadaveric lumbar TVPs were measured for linear horizontal length at each lumbar vertebra, left and right sides. Data collection was conducted in South Africa at the Raymond A. Dart Collection of Modern Human Skeletons and the Pretoria Bone Collection. The LSTV cohort consisted of 110 spinal columns and an LSTV-free control cohort of a sex-balanced randomized selection of 30 male and 30 female spinal columns.

RESULTS

Compared with the control cohort, the LSTV cohort demonstrated longer TVPs for every vertebral level, particularly L3, while the left side demonstrated longer TVPs overall. There were no statistical differences in TVP length within the LSTV cohort when comparing all levels (P > 0.05). The L3 TVPs demonstrated the longest mean lengths in both control (65%) and LSTV (58%) cohorts. The general trend was that the TVPs of L3 had the longest mean length for both the left and the right sides in both cohorts and both sexes.

CONCLUSIONS

In the absence of whole-spine imaging, these findings indicate that L3 TVPs may offer an alternative bony landmark, which may aid in spinal enumeration estimation in the setting of LSTV. This is of value for radiograph appraisal and may aid with correct-level intervention.

Change of Direction Asymmetry in Youth Elite Tennis Players: A Longitudinal Study

Longitudinal investigations into the development of inter-limb asymmetry in sports are scarce. This study examined the development of change of direction (COD) asymmetry magnitude in youth elite tennis players. Dominant (overall best performance) and non-dominant (best performance on the other side) scores and COD asymmetry magnitude were quantified annually (up to six years) in 323 male and 235 female players (ages 6 to13 years). Linear mixed effects regression models examined the development of COD performance and asymmetry magnitude according to players' chronological age and sex. Kappa coefficients examined the consistency for the direction of asymmetry across test occasions. Regardless of sex, COD performance significantly improved (p<0.001) while COD asymmetry magnitude significantly decreased (- 0.17±0.87% / year) with increasing chronological age. Regardless of age, males showed significantly lower COD times (- 0.111±0.091 s) and lower COD asymmetry magnitude (- 0.30±1.00%) compared to females. The slight and poor (k-value=0.02-0.00) kappa coefficients for males and females, respectively, highlight the direction specificity of functional asymmetry. These data show that whereas performance of the COD test improved, the magnitude of COD asymmetry declined across chronological age in youth tennis players.

Longitudinal Monitoring of Biomechanical and Psychological State in Collegiate Female Basketball Athletes Using Principal Component Analysis

Background

The growth in participation in collegiate athletics has been accompanied by increased sport-related injuries. The complex and multifactorial nature of sports injuries highlights the importance of monitoring athletes prospectively using a novel and integrated biopsychosocial approach, as opposed to contemporary practices that silo these facets of health.

Methods

Data collected over two competitive basketball seasons were used in a principal component analysis (PCA) model with the following objectives: (i) investigate whether biomechanical PCs (i.e., on-court and countermovement jump (CMJ) metrics) were correlated with psychological state across a season and (ii) explore whether subject-specific significant fluctuations could be detected using minimum detectable change statistics. Weekly CMJ (force plates) and on-court data (inertial measurement units), as well as psychological state (questionnaire) data, were collected on the female collegiate basketball team for two seasons.

Results

While some relationships (n = 2) were identified between biomechanical PCs and psychological state metrics, the magnitude of these associations was weak (r = |0.18-0.19|, p < 0.05), and no other overarching associations were identified at the group level. However, post-hoc case study analysis showed subject-specific relationships that highlight the potential utility of red-flagging meaningful fluctuations from normative biomechanical and psychological patterns.

Conclusion

Overall, this work demonstrates the potential of advanced analytical modeling to characterize components of and detect statistically and clinically relevant fluctuations in student-athlete performance, health, and well-being and the need for more tailored and athlete-centered monitoring practices.

Influence of Torsional Stiffness in Badminton Footwear on Lower Limb Biomechanics

Torsional stiffness of athletic footwear plays a crucial role in preventing injury and improving sports performance. Yet, there is a lack of research focused on the biomechanical effect of torsional stiffness in badminton shoes. This study aimed to comprehensively investigate the influence of three different levels of torsional stiffness in badminton shoes on biomechanical characteristics, sports performance, and injury risk in badminton players. Fifteen male players, aged 22.8 ± 1.96 years, participated in the study, performing badminton-specific tasks, including forehand clear stroke [left foot (FCL) and right foot (FCR)], 45-degree sidestep cutting (45C), and consecutive vertical jumps (CVJ). The tasks were conducted wearing badminton shoes of torsional stiffness measured with Shore D hardness 50, 60, and 70 (referred to as 50D, 60D, and 70D, respectively). The primary biomechanical parameters included ankle, knee, and MTP joint kinematics, ankle and knee joint moments, peak ground reaction forces, joint range of motion (ROM), and stance time. A one-way repeated measures ANOVA was employed for normally distributed data and Friedman tests for non-normally distributed data. The 70D shoe exhibited the highest ankle dorsiflexion and lowest ankle inversion peak angles during 45C task. The 60D shoe showed significantly lower knee abduction angle and coronal motions compared to the 50D and 70D shoes. Increased torsional stiffness reduced stance time in the FCR task. No significant differences were observed in anterior-posterior and medial-lateral ground reaction forces (GRF). However, the 70D shoe demonstrated higher vertical GRF than the 50D shoe while performing the FCR task, particularly during 70% - 75% of stance. Findings from this study revealed the significant role of torsional stiffness in reducing injury risk and optimizing performance during badminton tasks, indicating that shoes with an intermediate level of stiffness (60D) could provide a beneficial balance between flexibility and stability. These findings may provide practical references in guiding future badminton shoe research and development. Further research is necessary to explore the long-term effects of altering stiffness, considering factors such as athletic levels and foot morphology, to understand of the influence of torsional stiffness on motion biomechanics and injury prevalence in badminton-specific tasks.

Examining Unilateral and Bilateral Exercises through the Load-velocity Relationship

This study aimed to examine the load-velocity (L-V) relationship in the bench-press (BP) and leg-press (LP) exercises performed unilaterally, and compared this unilateral L-V relationship with the bilateral variants. Nineteen men (age=23.5±2.1 years) completed two incremental tests in BP and LP, performed bilaterally and unilaterally, across two sessions with a 48-hour rest period. We found a close relationship between medium propulsive velocity (MPV) and %1RM in unilateral BP (R2  =0.97, SEE=0.06 m·s-1) and LP (R2=0.96, SEE=0.06 m·s-1). No significant differences were observed between the preferred and non-preferred sides in the L-V relationship for either exercise. Additionally, higher velocities were achieved in unilateral exercises compared to bilateral exercises, particularly with light and moderate loads (30-70%1RM) in BP (p<0.05) and with light loads (30-45%1RM) in LP (p<0.05). Close L-V relationships were observed in unilateral exercises, without differences in the L-V relationships between preferred and non-preferred sides despite the interlimb asymmetries in the absolute strength values. Interestingly, lower velocities were observed at light loads (~30-45% 1RM) for bilateral compared to unilateral exercises, which could be explained by different strength deficits for these exercises.

Development of upper and lower extremity functional asymmetries in male and female elite youth tennis players: a longitudinal study

BACKGROUND

This longitudinal study aimed to examine the development of both upper and lower extremity functional performances, together with asymmetry magnitudes and directionality in youth tennis players.

METHODS

Dominant and non-dominant physical performance values of 90 players (53 males, 37 females) were determined yearly (with monitoring up to 3 years) using unilateral strength, power, speed and agility tests from which asymmetry magnitude percentages were calculated. Linear mixed effect models examined the development of performance values according to youth players' maturity offset, performance dominance, sex and training volume. Similarly, the development of functional asymmetry magnitudes was examined according to players' maturity offset, sex and training volume. Kappa coefficients (k) examined the consistency in directionality across test occasions.

RESULTS

Regardless of sex, the dominant and non-dominant physical performance values of every test significantly (P<0.05) improved with increasing maturity offset. No sex differences were apparent except for strength and power related tests where male players performed significantly better. Functional asymmetry magnitudes (ranging from 2.0 to 15.9%) did not significantly change with increasing maturity offset (range=-0.3-0.4% per year). Training volume was not significantly associated with the performance values and asymmetry magnitudes. The dominant upper extremity (which holds the tennis racket) consistently displayed the dominant performance value (k value: 1.00) across test occasions, which was not the case at lower extremity level (k value range: -0.28-0.31).

CONCLUSIONS

The functional asymmetry magnitudes did not change significantly with youth tennis players' maturity offset over a 3-year period.

Test-Retest Reliability and Convergent Validity of Piezoelectric Force Plate Measures of Single-Leg Sit-to-Stand Performance in Trained Adults

ABSTRACT

Makaracı, Y, Nas, K, Ruiz-Cárdenas, JD, Gündüz, K, Aydemir, M, and Orange, ST. Test-retest reliability and convergent validity of piezoelectric force plate measures of single-leg sit-to-stand performance in trained adults. J Strength Cond Res 37(12): 2373-2380, 2023-The single-leg sit-to-stand (STS) test has emerged as a promising method of assessing lower-limb functional strength and asymmetry. However, the reliability of its performance parameters on a force plate has not been explored. This study examined the test-retest reliability and convergent validity of the single-leg STS test performed on a piezoelectric-based force plate in trained subjects. Thirty trained male adults (age: 21.4 ± 1.7 years) performed 3 separate single-leg STS days of testing to assess both intraday and interday reliability. Performance parameters included STS time, ground reaction force (GRF), and center of pressure (CoP) sway velocity. The relationship between single-leg STS parameters and unilateral countermovement jump (CMJ) variables was assessed for convergent validity. Intraclass correlation coefficient (ICC) and coefficient of variation (CV) were calculated for reliability analyses, and convergent validity was assessed with Spearman's correlation coefficient (ρ). In the dominant leg, single-leg performance parameters showed moderate-to-excellent intraday reliability (ICC = 0.65-0.90, CV = 4.3-11.2%) and moderate interday reliability (ICC = 0.54-0.74, CV = 5.8-13.5%). In the nondominant leg, all single-leg STS performance parameters showed good intraday (ICC = 0.79-0.86, CV = 3.8-9.8%) and interday reliability (ICC = 0.75-0.82, CV = 4.6-9.7%). STS times in the dominant and nondominant legs were inversely related to unilateral CMJ velocity (ρ = -0.47 and -0.38, respectively). CoP sway velocity in the nondominant leg showed positive correlations with unilateral CMJ power and velocity (ρ = 0.38 and 0.54, respectively). In conclusion, the force plate-based single-leg STS test provides reliable measures of STS time, GRF, and CoP sway velocity in trained adults and could be used to assess lower-limb function and asymmetry.

Influence of limb dominance on body and jump asymmetries in elite female handball

Handball is a team sport subjected to asymmetric actions that require high physical capacity demands on players. The development of large asymmetries could negatively affect sports performance. However, few studies have analyzed body composition and the force asymmetries in elite female handball players. The aim of this study was to analyze the presence of asymmetries based on limb dominance in body composition parameters and lower limb power in jumping performances in an elite women's handball team. An entire elite women's handball team, comprised by of 14 players, was analyzed. Dual X-ray Absorptiometry (DXA) and bioimpedance were used to analyze body composition. Force plates were used to evaluate jump performance. Results show the presence of differences between all the players in the different parameters of the CMJ jump. In addition, an asymmetry between the power of the dominant and non-dominant lower limb was observed between the players. The results show differences in muscle mass between the upper limbs, but not in the lower limbs in terms of both muscle and fat mass. However, there were no crossed asymmetries or significant differences between members based on dominance. The results suggest that the presence of asymmetries does not have to be one of the main parameters to be taken into account by coaches in elite athletes and to highlight the importance of including specific analyzes of body composition and sports performance in an individualized way.

Monitoring lower limb biomechanical asymmetry and psychological measures in athletic populations-A scoping review

BACKGROUND

Lower limb biomechanics, including asymmetry, are frequently monitored to determine sport performance level and injury risk. However, contributing factors extend beyond biomechanical and asymmetry measures to include psychological, sociological, and environmental factors. Unfortunately, inadequate research has been conducted using holistic biopsychosocial models to characterize sport performance and injury risk. Therefore, this scoping review summarized the research landscape of studies concurrently assessing measures of lower limb biomechanics, asymmetry, and introspective psychological state (e.g., pain, fatigue, perceived exertion, stress, etc.) in healthy, competitive athletes.

METHODS

A systematic search of MEDLINE, Embase, CINAHL, SPORTDiscus, and Web of Science Core Collections was designed and conducted in accordance with PRISMA guidelines. Fifty-one articles were included in this review.

RESULTS

Significant relationships between biomechanics (k = 22 studies) or asymmetry (k = 20 studies) and introspective state were found. Increased self-reported pain was associated with decreased range of motion, strength, and increased lower limb asymmetry. Higher ratings of perceived exertion were related to increased lower limb asymmetry, self-reported muscle soreness, and worse jump performance. Few studies (k = 4) monitored athletes longitudinally throughout one or more competitive season(s).

CONCLUSION

This review highlights the need for concurrent analysis of introspective, psychological state, and biomechanical asymmetry measures along with longitudinal research to understand the contributing factors to sport performance and injury risk from biopsychosocial modeling. In doing so, this framework of biopsychosocial preventive and prognostic patient-centered practices may provide an actionable means of optimizing health, well-being, and sport performance in competitive athletes.

Relationship between Asymmetry Profiles and Jump Performance in Youth Female Handball Players

The relationships between asymmetries and performance or the identification of the asymmetry profile that has been routinely studied during jumping tests are largely derived from male-only and small sample size studies. Therefore, the aims of this study were: 1) to evaluate the magnitude and the direction of jump asymmetries (vertical and lateral) in three different age groups of adolescent female handball players, and 2) to identify the effect of asymmetry between limbs on jump performance in the three age groups. One hundred and eighty-five adolescent female handball players (age: 14.88 ± 1.49 years) were distributed in three groups: U14, U16 and U18 and performed two tests to assess jumping ability which were the single leg countermovement jump (SL-CMJ) and the single leg hop lateral (SL-HL). The magnitude of asymmetry in the SL-CMJ test (10.80%) was higher compared to that of the SL-LH test (6.47%), and there were no significant differences between particular categories. The direction of asymmetry represented by the Kappa values showed "poor" and "fair" levels of agreement in U14 and U16 categories, which means that asymmetries rarely favored the same side during each jumping test, but in contrast, in the U18 category the Kappa value result was "slight". There were significant correlations between SL-CMJ jumping asymmetries and jumping performance in the U18 category (r = 0.31 to 0.49). These data indicate that in order to identify the player's asymmetry profile, we need to consider the magnitude and the direction of different tests which will help better understand the natural deficits, contextualize them and consider appropriate training interventions for the reduction of inter-limb asymmetries.

Somatic characteristic, morphological asymmetry and postural stability of youth male canoeists compared to control. A cross-sectional study

OBJECTIVE

To determine the relationships between selected morphological characteristics and the level of body composition asymmetry with postural stability among canoeists and a control group.

METHODS

The sample consisted of 43 males (21 canoeists 21.8±3.29 years and 22 university students 21.7±1.32 years). Measurements included body height and weight. Segmental body composition analysis was assessed using the bioelectrical impedance by determining: fat mass (FM, kg, %), fat-free mass (FFM, kg) and predicted muscle mass (PMM, kg). Postural stability was tested using the BIODEX Balance System. Anterior-posterior stability index (APSI), medial-lateral stability index (MLSI) and overall stability index (OSI) were calculated.

RESULTS

Our findings suggest that the canoeists had statistically lower level of fatty tissue compared to controls. There was a statistically important difference between groups in lower limb FM (% and kg). In both groups morphological asymmetry was observed, but in most cases-in athletes. Asymmetries between right and left arms appeared in all parameters, while asymmetries between right and left legs were noted in all parameters except FM (kg). There were relationships between stature and body weight with postural stability in canoeists. Canoeists demonstrated better balance than controls, particularly in the APSI. For all stability indices, significant differences were observed between right and left legs across all participants.

CONCLUSIONS

Athletes, with larger asymmetries or poorer balance, require more attention to improve performance and reduce the risk of overload injury. Future studies needed to develop sport-specific level of morphofunctional asymmetry which would be optimal for sport results and health as well.

Offset Loading in a Bilateral Squatting Movement Pattern Influences Ground-Reaction Force and Muscle Activity in the Dominant and Nondominant Limb

PURPOSE

The purpose of this study was to explore whether offset loading in the barbell squat altered ground-reaction force (GRF) and muscle activation in the dominant (D) and nondominant (ND) lower limb compared to traditional squats.

METHODS

Twelve well-trained men (age 26.4 [3.2] y; 10.3 [1.9] y experience) performed 3 sets of 10 repetitions at 60% of their previously measured 1-repetition maximum. Sets were quasi-randomized between traditional loading (TDL), dominant-side offset loading (OS-D), and nondominant-side offset loading (OS-ND). All repetitions were performed on a dual force plate with electromyography sensors on the prime mover muscles of the squat. GRF symmetry was assessed using the symmetry index (SI) to determine the direction (D [+] or ND [-]) and magnitude (%) of the asymmetry. Finally, the first 3 and final 3 repetitions of each set were compared for compensatory changes in symmetry.

RESULTS

OS-D induced a significant change in limb SI relative to TDL (5.21% vs 1.44%; P = .011); however, no significant difference in limb SI was seen between TDL and OS-ND (-0.66% vs 1.44%; P = .278). No asymmetries between D and ND muscle activation were present in any condition. TDL and OS-D squats exhibited significant improvements in limb SI between the first 3 and final 3 repetitions (P = .035 and .011, respectively); however, no such improvement was seen in OS-ND.

CONCLUSIONS

OS-D is capable of significantly altering GRF limb SI in a bilateral squat; however, OS-ND appears to exhibit no GRF or electromyography effects relative to TDL. Thus, the results of this study do not support the use of OS-ND in the pursuit of strengthening a weaker limb, suggesting that unilateral training may be a preferred mode of exercise for this desired outcome.

Seasonal Variation of Physical Performance, Bilateral Deficit, and Interlimb Asymmetry in Elite Academy Soccer Players: Which Metrics Are Sensitive to Change?

ABSTRACT

Bishop, C, Abbott, W, Brashill, C, Loturco, I, Beato, M, and Turner, A. Seasonal variation of physical performance, bilateral deficit, and interlimb asymmetry in elite academy soccer players: Which metrics are sensitive to change? J Strength Cond Res 37(2): 358-365, 2023-This study aimed to report seasonal variations for (a) physical performance, (b) interlimb asymmetry, and (c) bilateral deficit (BLD) data over the course of a competitive soccer season and determine which metrics are sensitive to change. This study used a repeated-measures observational design for 19 under-20, elite, academy, soccer players (age: 17.58 ± 0.61 years; height: 1.81 ± 0.09 m; body mass: 74.36 ± 7.58 kg), who conducted bilateral and single-leg countermovement jumps (CMJ and SLCMJ), linear speed (5, 10, 20, and 30-m) and 505 change of direction (COD) speed tests, at pre, mid, and end of season time points. For jump tests, jump height, reactive strength index modified, time to takeoff, and countermovement depth metrics were monitored, with interlimb asymmetry and the BLD also calculated for each. Significant improvements ( p < 0.05) in performance were evident in all fitness tests: CMJ (effect size [ES]: 0.61 to 1.03), SLCMJ (ES: 0.60 to 2.25), linear speed (ES: -0.54 to -1.96), and COD speed (ES: -0.68 to -1.14). Significant reductions in asymmetry (ES: -0.68 to -1.07) and significant increases in the BLD (ES: 1.15 to 1.57) were also evident throughout the season. Additionally, kappa coefficients were used to determine consistency in limb dominance throughout the season, but only poor to fair levels of agreement (kappa: -0.17 to 0.37) were evident, highlighting the fluctuating nature of limb dominance throughout the season. Despite all tests exhibiting meaningful change, the SLCMJ and linear speed showed the most frequent and largest differences in performance, highlighting their usefulness in the ongoing monitoring process of physical capacities in elite male academy players across a competitive soccer season.

The Ecological Validity of Countermovement Jump to On-Court Asymmetry in Basketball

Jump-based asymmetry is often used as an indicator of sport performance and may be used to discern injury susceptibility. Due to task specificity, however, countermovement jump asymmetry may not be representative of on-court asymmetry. As such, we assessed the association between countermovement jump asymmetry and on-court impact asymmetry metrics (n=3, and n=4, respectively) using linear regressions (α=0.05). Fifteen female basketball athletes completed countermovement jump and on-court sessions across a competitive season. A significant negative association was found between peak landing force asymmetry and both overall and medium acceleration on-court asymmetry (b=–0.1, R ² =0.08, p<0.001; b=–0.1, R ² =0.11, p<0.001, respectively), as well as between peak propulsive force asymmetry and on-court medium acceleration asymmetry (b=–0.24, R ² =0.04, p=0.01). Alternatively, both peak landing and peak propulsive force asymmetry were significantly positively associated with on-court high acceleration asymmetry (b=0.17, R ² =0.08, p<0.001; b=0.35, R ² =0.02, p=0.04, respectively). While some overlap may exist, countermovement jump and on-court impact asymmetry appear to be independent. Thus, sport-specific monitoring may be necessary to adequately monitor injury susceptibility using asymmetry.

Why Sports Should Embrace Bilateral Asymmetry: A Narrative Review

(1) Background: Asymmetry is ubiquitous in nature and humans have well-established bilateral asymmetries in their structures and functions. However, there are (mostly unsubstantiated) claims that bilateral asymmetries may impair sports performance or increase injury risk. (2) Objective: To critically review the evidence of the occurrence and effects of asymmetry and sports performance. (3) Development: Asymmetry is prevalent across several sports regardless of age, gender, or competitive level, and can be verified even in apparently symmetric actions (e.g., running and rowing). Assessments of bilateral asymmetries are highly task-, metric-, individual-, and sport-specific; fluctuate significantly in time (in magnitude and, more importantly, in direction); and tend to be poorly correlated among themselves, as well as with general performance measures. Assessments of sports-specific performance is mostly lacking. Most studies assessing bilateral asymmetries do not actually assess the occurrence of injuries. While injuries tend to accentuate bilateral asymmetries, there is no evidence that pre-existing asymmetries increase injury risk. While training programs reduce certain bilateral asymmetries, there is no evidence that such reductions result in increased sport-specific performance or reduced injury risk. (4) Conclusions: Bilateral asymmetries are prevalent in sports, do not seem to impair performance, and there is no evidence that suggests that they increase injury risk.

Strength Asymmetries Are Muscle-Specific and Metric-Dependent

We investigated if dominance affected upper limbs muscle function, and we calculated the level of agreement in asymmetry direction across various muscle-function metrics of two heterologous muscle groups. We recorded elbow flexors and extensors isometric strength of the dominant and non-dominant limb of 55 healthy adults. Participants performed a series of explosive contractions of maximal and submaximal amplitudes to record three metrics of muscle performance: maximal voluntary force (MVF), rate of force development (RFDpeak), and RFD-Scaling Factor (RFD-SF). At the population level, the MVF was the only muscle function that showed a difference between the dominant and non-dominant sides, being on average slightly (3–6%) higher on the non-dominant side. At the individual level, the direction agreement among heterologous muscles was poor for all metrics (Kappa values ≤ 0.15). When considering the homologous muscles, the direction agreement was moderate between MVF and RFDpeak (Kappa = 0.37) and low between MVF and RFD-SF (Kappa = 0.01). The asymmetries are muscle-specific and rarely favour the same side across different muscle-performance metrics. At the individual level, no one side is more performative than the other: each limb is favoured depending on muscle group and performance metric. The present findings can be used by practitioners that want to decrease the asymmetry levels as they should prescribe specific exercise training for each muscle.

Effects of lead leg selection on bilateral landing force-time characteristics: Return to sport testing implications

We quantified the effect of lead leg selection on landing force-time characteristics during a vertical drop landing (VDL) initiated with a step-off. Plyometric-trained subjects (male: n = 8; female: n = 5; age =23 ± 3.3 years; body mass =74.4 ± 11.2 kg) performed 6 step-off-initiated VDLs from a 45-cm box (n = 3/lead leg). Pooled and lead leg stratified between-limb comparisons of limb-specific initial ground contact timing, peak vertical ground reaction force (Fz_peak ), and early landing-phase impulse (Impulse_100ms ) were assessed by a two-factor, within-subject ANOVA, and limb symmetry indexes were calculated (α = 0.05). Pooled data showed that the lead leg made contact prior to the trail leg and contributed a greater fraction to Fz_peak compared with the trail leg. Stratifying trials by lead leg selection led to significant between-limb differences in Fz_peak (p < 0.05) and Impulse_100ms (p < 0.01) with the right leg leading but not with the left leg leading. Lead leg selection in step-off-initiated VDLs influenced landing performance and limb symmetry indexes of variables associated with lower limb injury risk, suggesting the need to control for lead leg selection in these tasks. A step-off may not be a suitable technique to initiate landing tasks when assessing limb symmetry.

Load-Induced Changes of Inter-Limb Asymmetries in Dynamic Postural Control in Healthy Subjects

Inter-limb asymmetries are associated with a higher potential risk for non-contact injuries. Differences in function or performance between the limbs might lead to imbalances and promote instability, increasing the potential risk for injuries. Consequently, an investigation of inter-limb asymmetries should be included in injury risk assessment. Furthermore, since non-contact injuries mainly occur under loaded conditions, an investigation of load-induced changes of inter-limb asymmetries can provide additional information on the athlete's potential injury risk. Therefore, the current study aimed to investigate the influence of physical load on inter-limb asymmetries in dynamic postural control, which is essential in situations with a high risk for non-contact injuries such as landing, cutting, or stopping. In total, dynamic postural control of 128 active and healthy subjects (64 males and 64 females, age: 23.64 ± 2.44, height: 176.54 ± 8.96 cm, weight: 68.85 ± 10.98 kg) was examined. Dynamic postural control was tested with the Y-Balance Test (YBT) before and after a loading protocol on a bicycle ergometer or a treadmill. The results showed no significant increase of the inter-limb asymmetries in anterior direction [F (1, 126) = 4.44, p = 0.04, η2 p = 0.03]. Moreover, there is high variation between the subjects regarding the magnitude and the direction of the asymmetries and the changes due to load. Therefore, a more individual analysis considering the magnitude and the direction of the asymmetries is required. Thereby, considering different modifying factors, e.g., sex, injury history, and baseline level of asymmetries, can be helpful. Moreover, an analysis of the changes during load might provide further insights, reveal possible differences, and help detect the reasons and mechanisms underlying inter-limb asymmetries and asymmetrical loading.

No Relationship between Lean Mass and Functional Asymmetry in High-Level Female Tennis Players

The relationship between lean mass and functional asymmetry in terms of their magnitude and direction was examined in 22 high-level female tennis players (20.9 ± 3.6 years). Lean mass of both upper and lower extremities was examined using Dual X-ray Absorptiometry. Functional asymmetry was assessed using a battery of field tests (handgrip strength, seated shot-put throw, plate tapping, single leg countermovement jump, single leg forward hop test, 6 m single leg hop test, and 505 change of direction (time and deficit)). Paired sample t-tests compared the dominant (overall highest/best (performance) value) against the non-dominant value (highest/best (performance) value of the opposing extremity). Linear regressions were used to explore the relationship between lean mass and functional asymmetry magnitudes. Kappa coefficients were used to examine the consistency in direction between the extremity displaying the highest lean mass value and the extremity performing dominantly across tests. Significant asymmetry magnitudes (p < 0.05) were found for all upper and lower extremity lean mass and functional values. No relationship was apparent between lean mass and functional asymmetry magnitudes (p-value range = 0.131–0.889). Despite finding perfect consistency in asymmetry direction (k-value = 1.00) for the upper extremity, poor to fair consistency (k-value range = −0.00–0.21) was found for the lower extremity. In conclusion, lean mass and functional asymmetries should be examined independently.

Seasonal variation of inter-limb jumping asymmetries in youth team-sport athletes

The main objective of the present study was to provide seasonal variation data for inter-limb asymmetry in youth elite team-sport athletes. Fifty-nine players performed the single-leg countermovement jump (SLCMJ) and the one leg hop for distance (OLHT) tests during pre-season, mid-season and end-season. A repeated-measures analysis of variance was conducted to determine magnitude differences in asymmetry scores between time points. Kappa coefficients (κ) were calculated to determine the levels of agreement for the direction of asymmetry. When comparing inter-limb asymmetry magnitudes across the season, the SLCMJ test showed significantly higher asymmetries at mid-season in comparison with pre-season and end-season (p< 0.01, d= -1.03 for pre to mid; p< 0.01, d= 1.12 for pre to end). However, OLHT inter-limb asymmetry magnitude remained consistent throughout the season (ES range = -0.02 to -0.06). For the direction of asymmetry, levels of agreement ranged from poor to slight in the SLCMJ (k= -0.10 to 0.18) and in the OLHT (k= -0.21 to 0.18). No significant differences were found between mean asymmetry values at any time point or for either test when comparing males and females. In conclusion, jump height asymmetry during the SLCMJ was the only metric to show significant magnitude changes across the season.

Between-session reliability of performance and asymmetry variables obtained during unilateral and bilateral countermovement jumps in basketball players

This study aimed to evaluate the between-session reliability of single-leg performance and asymmetry variables during unilateral and bilateral countermovement jumps (CMJ). Twenty-three basketball players completed two identical sessions which consisted of four unilateral CMJs (two with each leg) and two bilateral CMJs. Mean and peak values of force, velocity and power, impulse, and jump height were obtained separately for each leg using a dual force platform. All performance variables presented an acceptable reliability (CVrange = 4.05-9.98%) with the exceptions of jump height for the unilateral CMJs and mean power, peak velocity, peak power, and impulse for the left leg during the bilateral CMJ (CV≥11.0%). Nine out of 14 variables were obtained with higher reliability during the unilateral CMJ (CVratio≥1.16), and 4 out of 14 during the bilateral CMJ (CVratio≥1.32). Asymmetry variables always showed an unacceptable reliability (ICCrange = 0.15-0.64) and poor/slight levels of agreement in direction (Kapparange = -0.10 to 0.15) for the unilateral CMJ, while an acceptable reliability (ICCrange = 0.74-0.77) and substantial levels of agreement in direction (Kapparange = 0.65 to 0.74) were generally obtained for the bilateral CMJ. These results suggest that single-leg performance can be obtained with higher reliability during the unilateral CMJ, while the bilateral CMJ provides more consistent measures of inter-limb asymmetries.

Unilateral or Bilateral Standing Broad Jumps: Which Jump Type Provides Inter-Limb Asymmetries with a Higher Reliability?

This study aimed to compare the between-session reliability of performance and asymmetry variables between unilateral and bilateral standing broad jumps (SBJ). Twenty-four amateur basketball players (12 males and females) completed two identical sessions which consisted of four unilateral SBJs (two with each leg) and two bilateral SBJs. Mean and peak values of force, velocity and power, and impulse were obtained separately for each leg using a dual force platform. Inter-limb asymmetries were computed using the standard percentage difference for the unilateral SBJ, and the bilateral asymmetry index-1 for the bilateral SBJ. All performance variables generally presented an acceptable absolute reliability for both SBJs (CV range = 3.65-9.81%) with some exceptions for mean force, mean power, and peak power obtained with both legs (CV range = 10.00-15.46%). Three out of 14 variables were obtained with higher reliability during the unilateral SBJ (CVratio ≥ 1.18), and 5 out of 14 during the bilateral SBJ (CVratio ≥ 1.27). Asymmetry variables always showed unacceptable reliability (ICCrange = -0.40 to 0.58), and slight to fair levels of agreement in their direction (Kappa range = -0.12 to 0.40) except for unilateral SBJ peak velocity [Kappa = 0.52] and bilateral SBJ peak power [Kappa = 0.51]) that showed moderate agreement for both SBJs. These results highlight that single-leg performance variables can be generally obtained with acceptable reliability regardless of the SBJ variant, but the reliability of the inter-limb asymmetries in the conditions examined in the present study is unacceptable to track individual changes in performance.

International vs. National female tennis players: a comparison of upper and lower extremity functional asymmetries

BACKGROUND

Asymmetries have been reported to negatively impact sport performance. This study examined the magnitude and direction of whole-body functional asymmetry in international versus national female tennis players.

METHODS

Ten internationally and twelve nationally ranked tennis players participated. Upper extremity functional asymmetries (or side-to-side performance differences) were evaluated using handgrip strength, seated shot-put throw and plate tapping. Lower extremity functional asymmetries were determined using the single leg countermovement jump, single leg forward hop test, 6 m single leg hop test, 505 changes of direction (time and deficit), and Y-balance test (anterior, posteromedial, posterolateral). ANOVAs were used to compare the dominant (overall best or fastest result of a specific test) versus non-dominant performance values (best or fastest result of the corresponding extremity) within the internationally versus nationally ranked players. Functional asymmetry magnitudes differences (expressed as a %) were examined using Mann-Whitney U tests. Kappa coefficients examined the consistency as to which extremity performed dominantly across tests.

RESULTS

Significant asymmetries for every upper and lower extremity test were found. The functional asymmetry magnitude was significantly (p=0.020) higher on the single leg forward hop test for the nationally (6.3%) versus internationally ranked players (2.9%). Kappa coefficients showed perfect levels of consistency regarding all upper extremity tests (k=1.00), indicating true limb dominance whereas more variance was found as to which lower extremity performed dominantly across tests (k range=-0.067-0.174).

CONCLUSIONS

The included female tennis players displayed significant whole-body functional asymmetries. Poor consistency as to which lower extremity performed dominantly across tests warrants individual asymmetry monitoring.