The predictive validity of a single leg bridge test for hamstring injuries in football players

Single Leg Bridge Test is Not a Valid Clinical Tool to Assess Maximum Hamstring Strength

“…The SLBT became popular after a prospective study showed that low scores were associated with an increased risk of HSI throughout the season in Australian football players. 13 Since HSI have been usually associated with low levels of maximum strength measured in isokinetic tests 3-5 and Nordic hamstring exercise tests, 6 interpretation of the SLBT as a new tool for assessment of maximum hamstring strength perhaps has occurred naturally in some contexts. The prospect of evaluating the hamstring capacity using a test with low technology requirements (i.e., just a box) is tempting for clinicians without access to isokinetic dynamometers or other strength assessment devices.…”

“…In other words, it is unknown whether a player with a higher score in a quick, cyclical, repetition-to-failure test such as SLBT responds with less hamstring fatigue to a longer, intermittent, and multicomponent exercise exposition such as a soccer game. Furthermore, despite the increased HSI risk found in Australian football players with low SLBT scores highlights the potential of this assessment tool, 13 there is a lack of prospective studies evidencing the association of the SLBT with the HSI in soccer and other sports; thus, caution is recommended in considering SLBT score as a risk factor for HSI in all athletic populations.…”

“…At least a 10-minute rest period was given before performing the SLBT. During the rest period, raters introduced the SLBT to volunteers using video records and standard explanations, following recommendations by Freckleton et al 13 Players were instructed to lie down on the ground with one heel on a box measuring 60 cm high. The testing limb was positioned in approximately 20° knee flexion.…”

“…In the last decade, the single leg bridge test (SLBT) has emerged as a clinical assessment of the hamstring capacity. 13 This test requires a single rater and a 60 cm high box. It may be performed at the edge of the field, as well as inside the physical therapy room, gym, locker room or other sports facility.…”

“…The score is given by the number of valid repetitions performed until exhaustion, and SLBT has good intra-rater reliability (intraclass correlation coefficients of 0.77-0.89 and 0.89-0.91, respectively). 13 The SLBT has been introduced in the sports context as a way of estimating the hamstring capacity in a range of athletic populations, [13][14][15][16] including athletes in rehabilitation following HSI. 9 However, considering the nature of the SLBT (i.e., a repetition-to-failure test), it seems reasonable to hypothesize that the SLBT score would not be correlated with the maximum hamstring strength, which is the outcome mostly traditionally related to prevention and rehabilitation of HSI.…”