10 Sex differences in lower limb motor performance relevant to knee injury control

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Abstract

Female agility-sport (AS) athletes experience higher noncontact knee injury incidence than males. Lower limb motor performance (LLMP) can help inform about AS athletes’ knee injury risk. No study has compared normalised single-leg hop (SLH) and dynamic balance (SLDB) performance between sexes. The aim of this study was to compare normalised LLMP for both limbs between male and female AS athletes using the adapted crossover hop for distance (ACHD), single hop for distance (SHD), vertical hop (VH) and Y-balance (YB) tests. It was hypothesised that males would perform better than females across tests. Thirteen male (age 21.6±3.8 y; height 178.3±8.3 cm; mass 81.0±10.9 kg) and 10 female (age 25.7±5.9 y; height 165.1±5.7 cm; mass 63.9±6.5 kg) athletes participated. Test order considered skill demand and cumulative fatigue: ACHD (cm), SHD (cm), VH (cm), YB (cm). Limb order (R, L) was randomised. All tests have reported reliability. Practice trials preceded three measured trials. Normalisation (% leg length (LL)) was performed for all trials: (test distance LL (cm)) × 100. Mean of measured trials was used for analyses. Variables were normally distributed (Shapiro-Wilk, p>0.05). Two variables had unequal variance between sexes (Levene, p<0.05). Mann-Whitney U was used to assess between-sex differences. Bonferroni-corrected α was set a priori: 0.004. Male median values (%LL): ACHD R 719.4, L 691.7; SHD R 212.5, L 212.5; VH R 41.0, L 49.7; YB anterior (YBA) R 61.3, L 58.7; YB posteromedial (YBPM) R 117.1, L 114.0; YB posterolateral (YBPL) R 114.6, L 113.5. Female median values (%LL): ACHD R 522.4, L 533.5; SHD R 181.1, L 178.6; VH R 31.8, L 33.7; YBA R 61.0, L 60.4; YBPM R 108.9, L 109.8; YBPL R 106.8, L 108.5. There were between-sex differences for SHD (R p=0.004, L p=0.004) and VH (R p=0.003, L p=0.002), a trend for ACHD (R p=0.006, L p=0.018). There were no between-sex differences for YBA (R p=0.620, L p=0.457), YBPM (R p=0.041, L p=0.193) or YBPL (R p=0.145, L p=0.094). Males performed better than females on both limbs for most SLH tests with no between-sex differences for any YB direction on either limb. Consideration is warranted for between-sex differences in knee injury incidence involving LLMP characteristics contained in SLH rather than SLDB performance.

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