Next Article in Journal
Three-Dimensional Electrogoniometry Device and Methods for Measuring and Characterizing Knee Mobility and Multi Directional Instability During Gait
Previous Article in Journal
Increased Hip-Flexion Gait as an Exercise Modality for the Reduction of Knee Joint Contact Forces: A Preliminary Investigation
 
 
Brief Report
Peer-Review Record

Do Outcome or Movement Strategy Variables Provide Better Insights into Asymmetries During Multiple-Hops?

Biomechanics 2025, 5(3), 67; https://doi.org/10.3390/biomechanics5030067
by Anthony Sharp 1,*, Jonathon Neville 1, Ryu Nagahara 2, Tomohito Wada 3 and John Cronin 1,4
Reviewer 1: Anonymous
Reviewer 2:
Reviewer 3: Anonymous
Reviewer 4: Anonymous
Biomechanics 2025, 5(3), 67; https://doi.org/10.3390/biomechanics5030067
Submission received: 4 July 2025 / Revised: 22 August 2025 / Accepted: 2 September 2025 / Published: 2 September 2025

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

Dear Editor, thanks for the opportunity to review the present article.

This research investigates the multiple hops as assessment tools for lower limb performance asymmetry  in male athletes.  The strength of this work is related to the strong analysis of 3 and 5 hops tests from a kinematic and kinetic point of view, and the great interest of global audience for this topic (both sport performance and clinical professionals). From another point of view, the main limit is the heterogeneous sample involved in current study. Even if the health status and the age are similar, the differences related to sport activity, training experience and other individual factors for a single test session must be considered.

  1. Abstract is clearly described and well structured. The aim of the study and findings have been correctly presented. I suggest to evidence the level (professional, amateur) and sport fields in line 18-19
  2. Introduction is correctly described and literature is presented. Current literature about horizontal hop tests for performance and return to sport are described. The aim of the study is clear.

 I suggest to add some details about following points:

  • Cite the sport fields and levels where RSI demonstrated to be more reliable and specific
  • Describe briefly the main assessment tools used during kinematics and kinetic evaluation (video analysis, force platform…)
  1. Methodology characteristics are correctly presented and well structured. I suggest to implement the following points:
    • Add some details about sport level and training
    • Add more details about the exclusion criteria for previous injuries: 6 months?12 months? Or was every kind of injury enough to exclude them?
    • Add some details about the time length of warm up and the test conditions (time of the day, temperature…)
    • How did you find dominant leg? Insert here, not only in discussion paragraph
    • If possible, add some references for the assessment device that you used
  1. Results are widely described and presented in both tables.
    • Probably the legend of table 2 (line 198) needs the measure unit for ”impulse”
    • Since the data presentation is detailed, I suggest to evidence the main finding in the tables (significance?)
    • Probably the reference table in line 169 is wrong (I think you refer to table 3)
    • Since you initially presented 4 hypothesis and the data refer mainly to hypothesis 1 and 2 (magnitude of asymmetry and kinematic / kinetic variables), it could be useful to insert another table for resume the vertical vs horizontal kinetic comparison and the differences between 3 and 5 hops
  2. Discussion is correctly structured in relation to study’s hypothesis. Literature comparison is presented and the data are compared. Limits are widely described.
  3. Conclusion correctly summarize the present work. I suggest to reduce the length of this paragraph

Author Response

Thank you very much for taking the time to review this manuscript. Please find the detailed responses below and the track changes in the re-submitted files

Reviewer 1

Dear Editor, thanks for the opportunity to review the present article.

This research investigates the multiple hops as assessment tools for lower limb performance asymmetry  in male athletes.  The strength of this work is related to the strong analysis of 3 and 5 hops tests from a kinematic and kinetic point of view, and the great interest of global audience for this topic (both sport performance and clinical professionals). From another point of view, the main limit is the heterogeneous sample involved in current study. Even if the health status and the age are similar, the differences related to sport activity, training experience and other individual factors for a single test session must be considered.

1. Abstract is clearly described and well structured. The aim of the study and findings have been correctly presented. I suggest to evidence the level (professional, amateur) and sport fields in line 18-19

Response: Thank you for your kind comments, we have made those changes and including university sports clubs and teams.

 

2. Introduction is correctly described and literature is presented. Current literature about horizontal hop tests for performance and return to sport are described. The aim of the study is clear.

Response: thank you

 I suggest to add some details about following points:

  • Cite the sport fields and levels where RSI demonstrated to be more reliable and specific

Response: Thank you, we have added the reliability of RSIhor determined by Davey et al. (2021) in adolescent American football players.

  • Describe briefly the main assessment tools used during kinematics and kinetic evaluation (video analysis, force platform…)

Response: We have added this. Thank you.

3. Methodology characteristics are correctly presented and well structured. I suggest to implement the following points:

    • Add some details about sport level and training

Response: We have added this thanks to you.

    • Add more details about the exclusion criteria for previous injuries: 6 months?12 months? Or was every kind of injury enough to exclude them?

Response: Any participants with Achilles tendinopathy or ACL rupture were excluded; everyone else must have been injury-free and not excluded from full participation in their sport or training.

  • Add some details about the time length of warm up and the test conditions (time of the day, temperature…)

Response: This has been added. Thank you.

  • How did you find dominant leg? Insert here, not only in discussion paragraph

Response: Thank you, we have added this.

    • If possible, add some references for the assessment device that you used

Response: An website link has been added.

4. Results are widely described and presented in both tables.

    • Probably the legend of table 2 (line 198) needs the measure unit for ”impulse”

Response: thank you this has been added

    • Since the data presentation is detailed, I suggest to evidence the main finding in the tables (significance?)

Response: thank you this has been added where appropriate

    • Probably the reference table in line 169 is wrong (I think you refer to table 3)

Response: Changed to Table S1

    • Since you initially presented 4 hypothesis and the data refer mainly to hypothesis 1 and 2 (magnitude of asymmetry and kinematic / kinetic variables), it could be useful to insert another table for resume the vertical vs horizontal kinetic comparison and the differences between 3 and 5 hops

Response: Thank you for your suggestion, we have added a third table in the main text showing the individualized approach to asymmetry direction and limb dominance.

5. Discussion is correctly structured in relation to study’s hypothesis. Literature comparison is presented and the data are compared. Limits are widely described.

Response: Thank you

6. Conclusion correctly summarize the present work. I suggest to reduce the length of this paragraph

Response: Thank you, we have done this now.

 

 

Reviewer 2 Report

Comments and Suggestions for Authors

The authors have attempted to assess the potential relationship between kinematic (spatial-temporal) and kinetic variables and multiple hop tests. While participants performed both the 3-hop and 5-hop tests, asymmetries of their dominant and non-dominant limbs were assessed within hops and for the overall hop test. They found that of the dependent variables evaluated, the kinetic variables showed the greatest asymmetries for the group mean data.

The study has the ability to further develop the understanding of the asymmetries in movement mechanics during the horizontal hop tests. However, there are several challenges in the current presentation that are suggested to be adjusted prior to publication.

Major suggestions:

The authors present literature in the introduction (Davey et al) and discussion (Lloyd et al), which suggests that asymmetry data should be analyzed in a more single-subject design approach. However, they have chosen to proceed with a group analysis design, which has increased the variability (Standard deviations) of several of the dependent variables. It is strongly recommended that the authors present the individual data (not in supplemental form) as the major analysis of this manuscript. The fact that the authors are stating the need to analyze this type of data in ‘an individualized approach’ (Line 334-335), indicates they know they should treat this data differently. This reporting could be simply highlighting the number of participants who have a difference per dependent variable and condition (hop). Or the authors can follow the Bates et al. method of a post hoc grouping of the participants by a variable and identifying the potential differences between the groups (movement strategies).

The methods section should be improved to further develop the variables of analysis. How were the GRF phases divided into braking and propulsive? Specifically, the vertical component, as this theoretically does not have a negative value, and there is no center of mass to track. The more detail, the better for the repeatability of studies.

The use of ‘movement strategy’ needs to be developed. Which of the variables that the authors are presenting do they consider ‘strategy’ variables, and which do they maintain are outcome variables? From the variables that are presented, it seems that the strategy variables are the kinetic, and the outcomes are the kinematic. If that is the case, it should be described in such a way. The current title and manuscript are difficult to decipher.

Additionally, using a single-subject approach would allow the authors to further develop the idea of strategies.

The authors make a claim in the abstract: ‘These findings suggest that the kinetic variables are more sensitive in assessing movement quality, providing insights for rehabilitation and return-to-play decisions.’ However, the rationale for this statement is not fully developed in the discussion or introduction. It seems the authors are making this statement due to the greater asymmetry reported for these variables, as stated in the discussion (lines 240-241). However, the importance of variable X versus variable Y is not developed. Also, the GRF data was BW normalized across participants, which reduces the variability within the participant population, which increases the likelihood of a significant difference. Because the authors have not presented the raw mean±SD data (no supplemental files were present), and instead only presented percentage differences, it is difficult for a reader to decide if they agree with this statement or not. 

It is strongly recommended that the authors develop figures or graphs to present the data in a way a reader can identify the limb asymmetries and identify the actual differences in magnitudes. See Davey et al. 2021 Figures 1 and 2. In that paper, the figures accompany the tables that are similar to the tables in this manuscript.

The introduction could be improved by setting up the potential relationships of the dependent variables used in the study with asymmetry and return to play. Currently, the introduction does not provide the foundation for the hypothesis of the study (lines 81-84).

The selection of ‘limb dominance’ was highlighted as a limitation of the study, but it does not need to be. The authors can make the choice to determine which limb to use based on a variable of their choosing (greatest force produced, greatest propulsive impulse, furthest overall distance achieved). Currently, the choice they made is an arbitrary decision because it is the common choice in the literature, but has no relevance to the task at hand.

Minor Suggestions:

The authors use a manuscript their lab has submitted that is currently under review. I do not have an issue with this, but they would benefit from further developing what that data is. Currently, they only state that the stretch-load demand is lower in the 3-hop versus the 5-hop, but there is no indication of how they determined that. Is it a summation of the number of jumps, or is it because people have greater/reduced stiffness during contact, etc.?

The equation on lines 156-157 seems to be wrong. I believe the second IF statement is supposed to be a ‘less than’ symbol. If not, they are both the same. Also, please rewrite the equation to be more legible for the reader, like both the Bishop et al and Davey et al manuscripts.

Not sure what the importance of the statement in lines 233 -236 serves.

It is unclear how the authors have come to the conclusion stated in lines 318-321. This needs to be developed in the discussion and introduction, which this reviewer believes is lacking. Are the levels of asymmetries in the current study within a healthy range, or do they fall within a ‘deficit’ range? Also, there is no comparison within the current participants of a single-hop test.

Line 169: I believe the Table 2 reference here should be Table 1 – referring to the kinematic variables.

Author Response

Thank you very much for taking the time to review this manuscript. Please find the detailed responses below and the track changes in the re-submitted files

 

The authors have attempted to assess the potential relationship between kinematic (spatial-temporal) and kinetic variables and multiple hop tests. While participants performed both the 3-hop and 5-hop tests, asymmetries of their dominant and non-dominant limbs were assessed within hops and for the overall hop test. They found that of the dependent variables evaluated, the kinetic variables showed the greatest asymmetries for the group mean data.

 

The study has the ability to further develop the understanding of the asymmetries in movement mechanics during the horizontal hop tests. However, there are several challenges in the current presentation that are suggested to be adjusted prior to publication.

 

Major suggestions:

 

The authors present literature in the introduction (Davey et al) and discussion (Lloyd et al), which suggests that asymmetry data should be analyzed in a more single-subject design approach. However, they have chosen to proceed with a group analysis design, which has increased the variability (Standard deviations) of several of the dependent variables. It is strongly recommended that the authors present the individual data (not in supplemental form) as the major analysis of this manuscript. The fact that the authors are stating the need to analyze this type of data in ‘an individualized approach’ (Line 334-335), indicates they know they should treat this data differently. This reporting could be simply highlighting the number of participants who have a difference per dependent variable and condition (hop). Or the authors can follow the Bates et al. method of a post hoc grouping of the participants by a variable and identifying the potential differences between the groups (movement strategies).

Response: Thank you, we have now included an n=3 analysis of the data set showing the lack of uniformity in limb asymmetry magnitude and direction for both kinetic and kinematic variables. We have chosen to leave the group analysis design as the main topic of the article; however, we agree that including this additional table better explains the need to apply an individualized approach in practice.

 

The methods section should be improved to further develop the variables of analysis. How were the GRF phases divided into braking and propulsive? Specifically, the vertical component, as this theoretically does not have a negative value, and there is no center of mass to track. The more detail, the better for the repeatability of studies.

Response: Thank you this has been added.

 

The use of ‘movement strategy’ needs to be developed. Which of the variables that the authors are presenting do they consider ‘strategy’ variables, and which do they maintain are outcome variables? From the variables that are presented, it seems that the strategy variables are the kinetic, and the outcomes are the kinematic. If that is the case, it should be described in such a way. The current title and manuscript are difficult to decipher.

Response: Thank you, this has been developed further in the introduction to improve clarity on terms.

 

Additionally, using a single-subject approach would allow the authors to further develop the idea of strategies.

Response: An individual analysis of kinetic and kinematics has been added. Thank you.

 

The authors make a claim in the abstract: ‘These findings suggest that the kinetic variables are more sensitive in assessing movement quality, providing insights for rehabilitation and return-to-play decisions.’ However, the rationale for this statement is not fully developed in the discussion or introduction. It seems the authors are making this statement due to the greater asymmetry reported for these variables, as stated in the discussion (lines 240-241). However, the importance of variable X versus variable Y is not developed. Also, the GRF data was BW normalized across participants, which reduces the variability within the participant population, which increases the likelihood of a significant difference. Because the authors have not presented the raw mean±SD data (no supplemental files were present), and instead only presented percentage differences, it is difficult for a reader to decide if they agree with this statement or not.

Response: Thank you, raw data of mean±SD have been included in supplemental tables S1 and S2. The importance of each variable in determining performance is outside the scope of the article, rather the sensitivity to change across hops, trials, and subjects.

 

It is strongly recommended that the authors develop figures or graphs to present the data in a way a reader can identify the limb asymmetries and identify the actual differences in magnitudes. See Davey et al. 2021 Figures 1 and 2. In that paper, the figures accompany the tables that are similar to the tables in this manuscript.

Response: We have chosen to leave the data in a table format rather than repeat this in figures as we feel this replicates the data and provides no further insight. If the reviewer rather we replace these tables with figures we will consider this.

 

 

The introduction could be improved by setting up the potential relationships of the dependent variables used in the study with asymmetry and return to play. Currently, the introduction does not provide the foundation for the hypothesis of the study (lines 81-84).

Response: We believe that the literature in the introduction, and in particular Kotsikaki et al. (2021), demonstrates that kinematic assessment may not fully highlight the level of kinetic asymmetry and function, and therefore warrants further analysis. It was hypothesized that high-demand tasks (hops 3 & 4) of a 5-Hop assessment would amplify this asymmetry if evidenced.

 

The selection of ‘limb dominance’ was highlighted as a limitation of the study, but it does not need to be. The authors can make the choice to determine which limb to use based on a variable of their choosing (greatest force produced, greatest propulsive impulse, furthest overall distance achieved). Currently, the choice they made is an arbitrary decision because it is the common choice in the literature, but has no relevance to the task at hand.

Response: Thank you, we only identified this for comparison as opposed to left v right.

 

Minor Suggestions:

 

The authors use a manuscript their lab has submitted that is currently under review. I do not have an issue with this, but they would benefit from further developing what that data is. Currently, they only state that the stretch-load demand is lower in the 3-hop versus the 5-hop, but there is no indication of how they determined that. Is it a summation of the number of jumps, or is it because people have greater/reduced stiffness during contact, etc.?

Response: Thank you this has been added.

 

The equation on lines 156-157 seems to be wrong. I believe the second IF statement is supposed to be a ‘less than’ symbol. If not, they are both the same. Also, please rewrite the equation to be more legible for the reader, like both the Bishop et al and Davey et al manuscripts.

Response: We have corrected this. Thank you

 

Not sure what the importance of the statement in lines 233 -236 serves.

Response: Thank you this has been removed.

 

It is unclear how the authors have come to the conclusion stated in lines 318-321. This needs to be developed in the discussion and introduction, which this reviewer believes is lacking. Are the levels of asymmetries in the current study within a healthy range, or do they fall within a ‘deficit’ range? Also, there is no comparison within the current participants of a single-hop test.

Response: We have changed this to the following and agree that the conclusion is not appropriate, ‘ This study advances the understanding of the expected magnitude of asymmetries that can be observed in horizontally oriented hopping tasks by highlighting understanding of the potential asymmetries in critical kinematic and kinetic factors influencing performance’. Due to the high variability in kinetic variables, there might not be a ‘healthy range’, and the comparison with a single hop test is outside the scope of the article, rather an understanding of triple and quintuple hops.

 

Line 169: I believe the Table 2 reference here should be Table 1 – referring to the kinematic variables.

Response: This has been corrected thank you

 

 

Reviewer 3 Report

Comments and Suggestions for Authors

This study investigates whether kinematic or kinetic variables offer better insights into limb asymmetries during multiple-hop tasks in healthy male university athletes. Using 3-Hop and 5-Hop tests analyzed through force plate data, the study found that kinetic asymmetries - particularly braking impulses - were substantially larger (up to 95.4%) compared to kinematic asymmetries, which remained below 7.1%. These results support the conclusion that kinetic variables are more sensitive indicators of movement quality and asymmetry, especially for assessing eccentric load responses relevant to rehabilitation and return-to-play decisions.

The introduction provides sufficient background and references, outlining the limitations of traditional outcome-based metrics and justifying the inclusion of movement strategy variables. While already well-cited, the rationale could have been further strengthened by more detailed discussion of previous kinetic asymmetry research.

The research design is methodologically appropriate for the study’s aims. The within-subject approach, use of randomized limb testing, and high-resolution force plate data ensure robust measurement of asymmetries. However, the exclusive use of healthy male athletes limits generalizability, and the reliance on kicking limb to define dominance may not reflect actual strength asymmetry.

The methods are described in adequate detail, including equipment specifications, data processing techniques, and asymmetry calculations. The only improvements needed would be minor clarifications on trial selection criteria, reliability metrics, and rationale for some parameter choices (e.g., filter settings).

The results are clearly presented, with well-structured tables and narrative explanations. However, the absence of visual figures makes it harder to quickly interpret trends or compare asymmetry progression across hops. Statistical findings are transparently reported, though more visual data summaries would enhance accessibility.

The conclusions are fully supported by the results. The authors appropriately highlight the diagnostic value of kinetic variables over outcome measures and provide realistic, practice-oriented recommendations for individualized asymmetry analysis. Notably, their hypothesis that later hops would produce higher asymmetries was not confirmed - this was honestly acknowledged and contextualized.

In conclusion, the article presents a valuable contribution to clinical biomechanics, reinforcing the importance of using kinetic variables to assess limb asymmetries and supporting individualized approaches to athlete monitoring and rehabilitation.

Author Response

Thank you very much for taking the time to review this manuscript. Please find the detailed responses below and the track changes in the re-submitted files

This study investigates whether kinematic or kinetic variables offer better insights into limb asymmetries during multiple-hop tasks in healthy male university athletes. Using 3-Hop and 5-Hop tests analyzed through force plate data, the study found that kinetic asymmetries - particularly braking impulses - were substantially larger (up to 95.4%) compared to kinematic asymmetries, which remained below 7.1%. These results support the conclusion that kinetic variables are more sensitive indicators of movement quality and asymmetry, especially for assessing eccentric load responses relevant to rehabilitation and return-to-play decisions.

 

The introduction provides sufficient background and references, outlining the limitations of traditional outcome-based metrics and justifying the inclusion of movement strategy variables. While already well-cited, the rationale could have been further strengthened by more detailed discussion of previous kinetic asymmetry research.

 

The research design is methodologically appropriate for the study’s aims. The within-subject approach, use of randomized limb testing, and high-resolution force plate data ensure robust measurement of asymmetries. However, the exclusive use of healthy male athletes limits generalizability, and the reliance on kicking limb to define dominance may not reflect actual strength asymmetry.

Response: Thank you, we were very deliberate in identifying only ‘healthy’ and functioning cohorts, as this was lacking in the literature. We use a previously determined rationale for limb dominance (Dos’Santos et al., 2019).

 

The methods are described in adequate detail, including equipment specifications, data processing techniques, and asymmetry calculations. The only improvements needed would be minor clarifications on trial selection criteria, reliability metrics, and rationale for some parameter choices (e.g., filter settings).

Response: 3 trials are considered ‘normal practice’ to determine a mean performance; however, we reduced this to 2 trials in the quintuple due to the expected physical demand. The reliability of the assessment has been added to the methodology section. Rationale for the filter cut-off has been added. Thank you.

 

 

The results are clearly presented, with well-structured tables and narrative explanations. However, the absence of visual figures makes it harder to quickly interpret trends or compare asymmetry progression across hops. Statistical findings are transparently reported, though more visual data summaries would enhance accessibility.

Response: Thank you, we have added another descriptive table and paragraph to explain the lack of trends in magnitude and direction of hop asymmetries.

 

The conclusions are fully supported by the results. The authors appropriately highlight the diagnostic value of kinetic variables over outcome measures and provide realistic, practice-oriented recommendations for individualized asymmetry analysis. Notably, their hypothesis that later hops would produce higher asymmetries was not confirmed - this was honestly acknowledged and contextualized.

Response: Thank you.

 

In conclusion, the article presents a valuable contribution to clinical biomechanics, reinforcing the importance of using kinetic variables to assess limb asymmetries and supporting individualized approaches to athlete monitoring and rehabilitation.

Response: Thank you for your time and the feedback you have responded with.

Reviewer 4 Report

Comments and Suggestions for Authors

Thank you for the opportunity to review this manuscript entitled Do outcome or movement strategy variables provide better insights into asymmetries during multiple hops? This study investigates the comparative value of outcome-based versus movement strategy-based variables in detecting asymmetries during 3-hop and 5-hop tasks in healthy male athletes, with implications for performance evaluation and return-to-play decision-making. The topic is clinically and practically relevant, especially in the context of lower-limb functional assessments and asymmetry profiling. The authors present a robust dataset and employ appropriate biomechanical and statistical methods. However, the manuscript would benefit from considerable revision in several key areas. Specifically, the presentation of results lacks clarity and integration with visuals; the interpretation of asymmetry metrics remains underdeveloped; and the discussion could better contextualize findings with respect to variable sensitivity and translational relevance to rehabilitation and athletic monitoring. I encourage the authors to strengthen the narrative around the diagnostic value of kinetic vs. kinematic variables, streamline figure/table presentation to enhance readability, and deepen the interpretation of asymmetry patterns across hopping tasks. Please see my comments below:

Abstract

1.Statistical descriptions are too vague. Report both average and peak asymmetries (e.g., for vertical braking impulse) to clarify diagnostic value.

2.The phrase “These results have practical applications” is generic. Specify target scenarios—e.g., ACL rehab or return-to-play assessments.

Introduction

3.The proposed stretch-loading rationale for the 5-Hop test is underdeveloped. Please expand on its theoretical or physiological link to neuromuscular recovery.

4.There’s a noticeable gap in narrative flow—several citations (e.g., Bishop, Kotsifaki) are introduced without clear transitional logic. The shift from outcome-based limitations to advocating movement strategy variables would benefit from a more structured progression.

5.Explicitly listing and numbering the study hypotheses at the end of the introduction would help the reader follow the logic and align with later discussion.

Methodology

6.Limb dominance defined by the “kicking leg” is debatable. This should be acknowledged, ideally with support from functional dominance metrics.

7.It is not clear whether the order of the 3-Hop and 5-Hop trials was randomized. Please clarify, as task sequence could influence fatigue or adaptation effects.

8.Figure 1 is too minimal. Add jump direction, force plate placement, and key phases. Also, increase image quality.

9.The computation of RSI (Reactive Strength Index) is not explicitly stated. Include the formula used, parameters involved, and any normalization method.

10.Clarify which statistical tests were used for each comparison—paired t-tests, ANOVA, etc.—and note any correction for multiple comparisons.

Results

11.Add p-values and/or effect sizes for key between-limb comparisons, along with brief interpretation regarding their potential clinical relevance.

12.Tables are dense. Suggest condensing to highlight key variables in-text, and moving the rest to supplementary materials.

13.Consider adding at least one visual (e.g., line graph or radar plot) to summarize asymmetry trends across hops—this would enhance interpretability.

14.Several expected asymmetries (particularly in 5-Hop) did not reach statistical significance. These null results should be acknowledged and potential explanations offered (e.g., compensatory strategies, variability, underpowering).

Discussion

15.The discussion does not systematically follow the four stated aims. Consider structuring this section to reflect those objectives more explicitly. Some recently studies could be added, such as: ‘Characteristics of Lower Limb Running-Related Injuries in Trail Runners: A Systematic Review’, Physical Activity and Health, 8(1), p. 137–147.

16.Why are propulsive asymmetries lower and more consistent? This could suggest limited utility in return-to-play screening and warrants more comment.

17.Although kinetic asymmetries were substantial, the clinical relevance is underdeveloped. Discuss how these findings could inform rehabilitation staging or performance monitoring.

18.No practical differentiation is made between the use of 3-Hop and 5-Hop protocols. Are these interchangeable or context-dependent (e.g., rehab vs performance)? This distinction should be explored.

Conclusion and Practical Application

19.The recommendations in this section lack stratification by user group. Suggest clarifying how different practitioners (e.g., clinicians vs coaches) might apply movement strategy metrics in various contexts.

20.The conclusion omits suggestions for future research. Consider proposing directions such as validation in injured populations, testing under fatigue, or using wearable sensors for field-based assessments.

Author Response

Thank you for the opportunity to review this manuscript entitled “Do outcome or movement strategy variables provide better insights into asymmetries during multiple hops?” This study investigates the comparative value of outcome-based versus movement strategy-based variables in detecting asymmetries during 3-hop and 5-hop tasks in healthy male athletes, with implications for performance evaluation and return-to-play decision-making. The topic is clinically and practically relevant, especially in the context of lower-limb functional assessments and asymmetry profiling. The authors present a robust dataset and employ appropriate biomechanical and statistical methods. However, the manuscript would benefit from considerable revision in several key areas. Specifically, the presentation of results lacks clarity and integration with visuals; the interpretation of asymmetry metrics remains underdeveloped; and the discussion could better contextualize findings with respect to variable sensitivity and translational relevance to rehabilitation and athletic monitoring. I encourage the authors to strengthen the narrative around the diagnostic value of kinetic vs. kinematic variables, streamline figure/table presentation to enhance readability, and deepen the interpretation of asymmetry patterns across hopping tasks. Please see my comments below:

 

Abstract

 

1.Statistical descriptions are too vague. Report both average and peak asymmetries (e.g., for vertical braking impulse) to clarify diagnostic value.

Response: Thank you this has been included.

 

2.The phrase “These results have practical applications” is generic. Specify target scenarios—e.g., ACL rehab or return-to-play assessments.

Response: Thank you this has been addressed.

 

Introduction

 

3.The proposed stretch-loading rationale for the 5-Hop test is underdeveloped. Please expand on its theoretical or physiological link to neuromuscular recovery.

Response: We have added the differences in biomechanical demand between the assessments.

 

4.There’s a noticeable gap in narrative flow—several citations (e.g., Bishop, Kotsifaki) are introduced without clear transitional logic. The shift from outcome-based limitations to advocating movement strategy variables would benefit from a more structured progression.

Response: We have provided a budgeting sentence to improve clarity and flow, thank you.

 

5.Explicitly listing and numbering the study hypotheses at the end of the introduction would help the reader follow the logic and align with later discussion.

Response: Whilst we have not explicitly cited our hypothesis, we feel we have clearly defined the aims of the study at the end of the introduction, which were clearly responded to in the discussion.

 

Methodology

 

6.Limb dominance defined by the “kicking leg” is debatable. This should be acknowledged, ideally with support from functional dominance metrics.

Response: Dominance was determined by their ‘kicking limb’, as has been determined and commonplace in other similar studies (Dos’Santos et al., 2019). Subsequent statistical analysis showed no significant difference in hop distance between dominant and non-dominant limbs (p<0.05).

 

7.It is not clear whether the order of the 3-Hop and 5-Hop trials was randomized. Please clarify, as task sequence could influence fatigue or adaptation effects.

Response: Line 112 states that hops were complete in a randomized order.

 

8.Figure 1 is too minimal. Add jump direction, force plate placement, and key phases. Also, increase image quality.

Response: The Figure depicts a kinogram and a silhouette figure between ground contact phases, the figures from START to TOTAL DISTANCE depict the jump directly, as does the kinogram. Force platform were embedded in series and throughout the entire hopping surface. Phases have been added, and the image quality has been improved.

 

9.The computation of RSI (Reactive Strength Index) is not explicitly stated. Include the formula used, parameters involved, and any normalization method.

Response: We have included an equation for RSI, thank you.

 

10.Clarify which statistical tests were used for each comparison—paired t-tests, ANOVA, etc.—and note any correction for multiple comparisons.

Response: Paired t-tests were used to determine any significant difference between dominant and non-dominant pairs.

 

Results

 

11.Add p-values and/or effect sizes for key between-limb comparisons, along with brief interpretation regarding their potential clinical relevance.

Response: p-values are included in limb comparisons on the supplementary tables, and the understanding of clinical relevance or lack thereof is explained in the discussion.

 

12.Tables are dense. Suggest condensing to highlight key variables in-text, and moving the rest to supplementary materials.

Response: Whilst tables are dense, we feel that those in the manuscript provide a complete description of the data, and comparisons are in the supplementary tables.

 

13.Consider adding at least one visual (e.g., line graph or radar plot) to summarize asymmetry trends across hops—this would enhance interpretability.

Response: We have added another table (Table 3) to describe some of the individual asymmetries and direction of these across varying quintuple hop success, as we believe averages tend to mask these directions, which we have addressed in the article.

 

 

14.Several expected asymmetries (particularly in 5-Hop) did not reach statistical significance. These null results should be acknowledged and potential explanations offered (e.g., compensatory strategies, variability, underpowering).

Response: Thanks you this has now been acknowledged.

 

Discussion

 

15.The discussion does not systematically follow the four stated aims. Consider structuring this section to reflect those objectives more explicitly. Some recently studies could be added, such as: ‘Characteristics of Lower Limb Running-Related Injuries in Trail Runners: A Systematic Review’, Physical Activity and Health, 8(1), p. 137–147.

Response: Thank you, we have restructured the discussion. With due respect, we do not feel the suggested article is relevant to our line of thought and analysis.

 

16.Why are propulsive asymmetries lower and more consistent? This could suggest limited utility in return-to-play screening and warrants more comment.

Response: One explanation could be that propulsive variables are largely determined by physical capacity, assuming that the same effort is applied to each hop, whereas braking variables are largely determined by the preceding hop strategy, limb placement and ongoing adjustment due to the position of the centre of mass.

 

17.Although kinetic asymmetries were substantial, the clinical relevance is underdeveloped. Discuss how these findings could inform rehabilitation staging or performance monitoring.

Response: Thank you, we believe that adding an n=3 understanding of individual asymmetries emphasizes the importance of recognizing differences across trials and hops within a person. Along with videographic analysis, this should provide valuable insight into an individual's development areas, especially in a rehabilitative setting and supports the work by Bishop et al. (2022) that’s highlights this consideration.

 

18.No practical differentiation is made between the use of 3-Hop and 5-Hop protocols. Are these interchangeable or context-dependent (e.g., rehab vs performance)? This distinction should be explored.

Response: The advice of the authors would be that it is in our belief that the physical requirements of the additional hops of a 5-hop protocol place considerable demand on the subject and should be limited to either more advanced athletes or later-stage rehabilitation. This evidence is currently under review;

Sharp, A.P.; Neville, J.; Nagahara, R.; Wada, T.; Cronin, J.B. Stretch-load demands in multiple hops: Implications for athletic performance and rehabilitation. (in review), 2024.

 

 

Conclusion and Practical Application

 

19.The recommendations in this section lack stratification by user group. Suggest clarifying how different practitioners (e.g., clinicians vs coaches) might apply movement strategy metrics in various contexts.

Response: Thank you, we have added some detail in the conclusion that does not detract from the original aim.

 

20.The conclusion omits suggestions for future research. Consider proposing directions such as validation in injured populations, testing under fatigue, or using wearable sensors for field-based assessments.

Response: Thank you this has been addressed.

 

Round 2

Reviewer 1 Report

Comments and Suggestions for Authors

Dear Authors,

Thanks for correcting your work with previous indications. The paper implemented the overall quality and structure.

Many requested details have been inserted in order to better understand the work.

Anyway, my suggestion is still connected to previous following points:

  • Results: the Table 3 shows individual features about both tests and offers three comparisons about different measurements. Even if this table evidences specific details, the table 1 and 2 have not been modified about the addition of main findings (significance) described in the paragraph. So, i still suggest to report these evidence to keep easier the result’s analysis.
  • Conclusion: the length of this paragraph has not been reduced (as the author reported in the response). On the contrary, the number of lines increased. Since this paragraph has been strongly modified, a general check about structure and language is needed in order to avoid repetitions and focus on main points (in particular between lines 356 and 367).
  • References: a general check about the bibliography is needed to uniform the style. In particular, some Journals are reported in abbreviation form while others in complete form (for example, article 17 vs article 19). I suggest to use the same approach.

Author Response

Thank you once again for taking the time to review this article and for making it better. Please see my responses below.

Results: the Table 3 shows individual features about both tests and offers three comparisons about different measurements. Even if this table evidences specific details, the table 1 and 2 have not been modified about the addition of main findings (significance) described in the paragraph. So, i still suggest to report these evidence to keep easier the result’s analysis.

Response: Thank you, we have now indicated the level of significance in both the tables in the text (1&2) and in the supplementary material.

Conclusion: the length of this paragraph has not been reduced (as the author reported in the response). On the contrary, the number of lines increased. Since this paragraph has been strongly modified, a general check about structure and language is needed in order to avoid repetitions and focus on main points (in particular between lines 356 and 367).

Response: Thank you, we have reduced the length of this conclusion and tried to make it more concise.

 

References: a general check about the bibliography is needed to uniform the style. In particular, some Journals are reported in abbreviation form while others in complete form (for example, article 17 vs article 19). I suggest to use the same approach.

Response: Thank you we have made these changes.

Reviewer 2 Report

Comments and Suggestions for Authors

Thank you for addressing several of the concerns I had in the previous version of the manuscript. 

Author Response

Thank you for addressing several of the concerns I had in the previous version of the manuscript. 

Response: Thank you so much for taking the time to review this article. Your input has made it better.

Reviewer 4 Report

Comments and Suggestions for Authors

All my questions have been well addressed, I recommend to accept now. 

Author Response

All my questions have been well addressed, I recommend to accept now. 

Response: Thank you so much for taking the time to review this article. Your input has made it better.

Back to TopTop