Development of upper and lower extremity functional asymmetries in male and female elite youth tennis players: a longitudinal study

Association Between Inter-Limb Asymmetry and Determinants of Middle- and Long-distance Running Performance in Healthy Populations: A Systematic Review

BACKGROUND

The presence of inter-limb asymmetry in the human body has traditionally been perceived to be detrimental for athletic performance. However, a systematic review addressing and comprehensively assessing the association of asymmetry between the lower limbs and middle- and long-distance running performance-related metrics is currently lacking.

OBJECTIVE

The main purpose of this systematic review was to examine the relationship between lower inter-limb asymmetry and determinants of running performance in healthy middle- and long-distance runners. The secondary objective was to identify possible avenues for further research in this area.

METHODS

PubMed, Web of Science and SPORTDiscus were systematically searched for studies investigating the relationship between lower inter-limb asymmetry and (determinants of) running performance in healthy and injury-free middle- and long-distance runners. The quality of studies eligible for inclusion was assessed using the Downs and Black Quality Index Tool.

RESULTS

Out of 4817 articles screened, 8 studies were included in this review which assessed the association between functional, morphological, kinematic and kinetic asymmetry and running performance-related metrics. The quality score of the included research varied between 5/10 and 9/10. Our results revealed mixed findings, showing both significant negative (n = 16) and positive (n = 1) associations as well as no significant associations (n = 30) between inter-limb asymmetry and running performance-related metrics.

CONCLUSIONS

A high heterogeneity across study methods and outcomes was apparent, making it difficult to draw a straightforward conclusion. Our results indicate that the majority of metrics of functional, morphological, kinematic and kinetic inter-limb asymmetry are negatively or not associated with running performance (and/or its determinants). Thus, a more extensive high-quality body of research using standardised asymmetry magnitude metrics is essential to determine whether, and to what extent asymmetry between the lower limbs could affect middle- and long-distance running performance. Future studies should establish potential trade-off values to help practitioners develop evidence-based training programs.

KEY POINTS

In the majority of the metrics, the magnitude of lower inter-limb asymmetry was negatively or not associated with middle- and long-distance running performance. Coaches, athletes and researchers should be attentive of the task, time- and metric-specificity as well as the inter- and intra- individual variability of magnitude outcomes, when assessing inter-limb asymmetries.

Change of Direction Asymmetry in Youth Elite Tennis Players: A Longitudinal Study

Longitudinal investigations into the development of inter-limb asymmetry in sports are scarce. This study examined the development of change of direction (COD) asymmetry magnitude in youth elite tennis players. Dominant (overall best performance) and non-dominant (best performance on the other side) scores and COD asymmetry magnitude were quantified annually (up to six years) in 323 male and 235 female players (ages 6 to13 years). Linear mixed effects regression models examined the development of COD performance and asymmetry magnitude according to players' chronological age and sex. Kappa coefficients examined the consistency for the direction of asymmetry across test occasions. Regardless of sex, COD performance significantly improved (p<0.001) while COD asymmetry magnitude significantly decreased (- 0.17±0.87% / year) with increasing chronological age. Regardless of age, males showed significantly lower COD times (- 0.111±0.091 s) and lower COD asymmetry magnitude (- 0.30±1.00%) compared to females. The slight and poor (k-value=0.02-0.00) kappa coefficients for males and females, respectively, highlight the direction specificity of functional asymmetry. These data show that whereas performance of the COD test improved, the magnitude of COD asymmetry declined across chronological age in youth tennis players.