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March 12, 2026Journal of Science in Sport and Exercise0 citationsOpen Access

Influence of Isometric Hamstring Assessment Modality: Asymmetries Across Bilateral and Unilateral Testing Procedures

ASAdam E. SundhNRNicholas J. RipleyALA. J. Lamb

Key Points

  • The central aim is to determine if unilateral and bilateral isometric assessments yield comparable results and to analyze asymmetry fluctuations.
  • Evaluated forty-four participants divided by gender.
  • Conducted two testing sessions with bilateral and unilateral isometric long-lever bridge.
  • Measured performance at a knee angle of 30° and analyzed limb symmetry index (LSI) over multiple time points.
  • Large variance differences between unilateral and bilateral assessments were observed.
  • Fair to slight agreement was noted between assessment methods (k = 0.05 – 0.24).
  • Strong relationships were found between early force and late force measures within the same assessment category.

Abstract

Abstract Purpose The aim of this study was to evaluate whether unilateral and bilateral assessments display comparable results during the isometric long-lever bridge and to examine the directionality of asymmetry fluctuations across testing occasions. Methods Forty-four participants comprising of 30 men (age: 19.4 ± 1.3 years; height: 179.8 ± 6.3 cm; body mass: 80.4 ± 10.3 kg) and 14 women (age: 20.0 ± 1.3 years; height: 166.9 ± 7.2 cm; body mass: 64.4 ± 7.4 kg) volunteered to participate in the study. All participants completed two separate testing sessions consisting of two maximal bilateral and unilateral repetitions respectively of the isometric long-lever bridge performed at a knee angle of 30° degrees. All data were analyzed to assess the limb symmetry index (LSI) between testing procedures at 50-, 100-, 150-, 200-, 250 ms and at peak force (N). Results Large differences in variance were observed within and between unilateral and bilateral tasks, particularly for rapid force and peak force asymmetry measures, as revealed by principal component analysis. Fair to slight agreement was observed between unilateral and bilateral assessment methods ( k = 0.05 – 0.24) and large to very large relationships were observed between early force (≤ 100 ms) and late force (150-, 200- and 250 ms) within the same assessment category. Conclusions These findings suggest that asymmetries assessed bilaterally do not carry over well to asymmetries assessed unilaterally, therefore displaying poor convergent validity. Furthermore, rapid asymmetry measures (asymmetries within 250 ms) and peak asymmetry measures (maximum during the trial) appear to demonstrate differing constructs.

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Cite This Study

Sundh et al. (2026) studied this question.

synapsesocial.com/papers/69b2588496eeacc4fcec8440https://doi.org/10.1007/s42978-025-00356-6
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