Secondary Logo

Journal Logo

Institutional members access full text with Ovid®

The Dynamic Postural Control Is Impaired in Patients with Chronic Ankle Instability: Reliability and Validity of the Multiple Hop Test

Eechaute, Christophe PT, MT*; Vaes, Peter PhD*; Duquet, William PhD†1

Clinical Journal of Sport Medicine: March 2009 - Volume 19 - Issue 2 - p 107-114
doi: 10.1097/JSM.0b013e3181948ae8
Original Research

Objective: To investigate the reliability and validity of a clinical evaluation method for the assessment of the dynamic postural control in patients with chronic ankle instability (CAI).

Design: Cross-sectional study.

Setting: All tests were conducted at the practice room of the Physical Therapy Department.

Participants: Twenty-nine healthy subjects and 29 patients with CAI were selected.

Interventions: Participants performed twice a multiple hop test within a 1-week time interval. Subjects hopped on 10 different tape markers while trying to avoid any postural correction.

Main Outcome Measures: The number and type of balance errors were documented by analyzing the digital video images.

Results: Test-retest reliability of the number of balance errors was excellent in patients (intraclass correlation coefficient, ICC = 0.83; standard errors of measurement = 2.6) and moderate in healthy subjects (ICC = 0.64; standard errors of measurement = 2.8). The intra-observer and inter-observer reliability was excellent (ICC > 0.90). Both for the test (P = 0.000) and for the retest (P = 0.000), the number of balance errors in patients was significantly higher (17.9 ± 6.6) when compared with healthy subjects (10.9 ± 4.6). On both test occasions, patients with CAI used significantly more a change-in-support strategy (test: P = 0.000; retest: P = 0.000). The number of balance errors was significantly correlated with the time needed to perform the test (r = 0.60; P = 0.000) and the perceived difficulty of the hop test as rated on a visual analogue scale (r = 0.44; P = 0.014).

Conclusions: The multiple hop test is a reliable and valid test for detecting an impaired dynamic postural control in patients with CAI.

From the *Physical Therapy Department; and †Human Biometry and Biomechanics Department, Vrije Universiteit Brussel, Brussels, Belgium.

Submitted for publication April 14, 2008; accepted November 7, 2008.


The collection of data was funded by the Research Council of the Vrije Universiteit Brussel (OZR 880).

The authors state that they have no financial interest in the products mentioned in this article.

Reprints: Christophe Eechaute, PT, MT, Physical Therapy Department, Vrije Universiteit Brussel, Laarbeeklaan 101, B-1090 Brussels, Belgium (e-mail:

© 2009 Lippincott Williams & Wilkins, Inc.