The symmetry angle identifies less clinically relevant inter-limb asymmetries than the symmetry index in healthy adults

There are several methods for calculating inter-limb symmetry, an inter-limb difference ≥15% has been suggested as an indicator of sporting injury risk. The purpose of this study was to compare three common methods for determining symmetry: the Symmetry Index (percentage difference; SI) when referenced to the left limb (SILeft) or the average of both limbs (SIAverage), and the Symmetry Angle (vector difference; SA). 15 recreationally active participants completed a sprint protocol on a non-motorised treadmill. Accelerometers were positioned on both tibias to measure peak resultant acceleration (PRA). The SA identified less clinically relevant PRA inter-limb asymmetries than the SI in healthy adults. Once an appropriate level of asymmetry as measured by the SA is determined, this may help to more correctly identify asymmetry in athletes and patients than the SI.