Introduction: A limb symmetry index (LSI) >90% on hop tests is a widely advocated benchmark for functional recovery and return-to-sport clearance after ACL injury. Yet, the LSI assumes the contralateral limb is the “gold standard” and immune to decline. Due to the bilateral functional deficits evident after ACL injury and ACLR, other assessment methods such as comparing performance of both limbs to age, sex and activity-level matched uninjured peers may be required. Our primary aim was to describe the functional performance changes in the ACL-injured and contralateral limbs 1- to 5-years post-ACL reconstruction (ACLR) to determine the influence on LSI. Our secondary aim was to compare the ACLR group results to uninjured healthy controls.
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