The Single Hop for Distance Test: Reviewing the Methodology to Measure Maximum and Repeated Performance.

CONTEXT: The single hop for distance (SHD) and Limb Symmetry Index are often used to assess readiness for returning to sport postinjury. However, the sensitivity of SHD Limb Symmetry Index for detecting functional abnormalities is questionable due to the methodological inconsistencies in the literature. The common methods use few repetitions; lacking consideration of repeated maximum performance, or the effect of fatigue (or failed attempts) on repeated maximum performance, required for sport. The objectives were to review the SHD for evaluating repeated maximum performance, and the effect of failed attempts on consistency of performance, in a healthy population of sportspersons. DESIGN: A quantitative, nonexperimental, same-subject, repeated-measures design with 15 healthy Cardiff University students. METHOD: Participants performed the SHD up to 30 times on each limb, with standardized rests. A failed attempt, if the landing was not controlled, was noted but distance not recorded. Participants stopped if 3 consecutive distances decreased, or 30 repetitions were achieved. RESULTS: Average hop distance increased with each repetition. Only the 28th to 30th hops were between the maximum average value and 1 SD below. With failed repetitions included, the maximum average hop was at repetition 21 with more results falling between the maximum and 1 SD below, demonstrating more consistency in repeated performance. The number of failed repetitions had a trend to increase over time; whether subjects overreach in attempt to achieve maximum performance, or whether due to fatigue is unknown. CONCLUSION: Maximum performance of SHD is not achieved until multiple repetitions have been conducted. Repeated maximum performance does not drop-off until over 21 repetitions have been conducted. Consistency of repeated maximum performance varies depending on whether failed attempts are included in the analysis. Further investigation into the reasons for failed attempts is required to improve clinical decision making for return to sport postinjury.

Updating the UK competence framework for orthopaedic and trauma nurses 2019.

The updated RCN Competence Framework for orthopaedic and trauma practitioners was published in 2019 following completion of a 2 year project undertaken by a working group of representatives from England, Northern Ireland, Scotland and Wales. Expert musculoskeletal practitioners, including an allied health professional and working across the lifespan in varying domains of orthopaedic and trauma practice, collaborated to produce a working document applicable to trauma and orthopaedic (T&O) practitioners from all NHS (UK) pay bands. The 2019 document builds on the original and subsequent versions (2005 and 2012), importing new evidence and reformatting it so that it is contemporary and easily cross referenced with the NMC Code (2018). The restructure includes an example of a learning contract demonstrating how the framework can be applied in practice, whether for self-learning, or in conjunction with the revalidation process. This paper reflects on and describes the process undertaken by the working group in the development and restructuring of the 2019 framework, including its evaluation to date and planned in the future.