Females have Lower Knee Strength and Vertical Ground Reaction Forces During Landing than Males Following Anterior Cruciate Ligament Reconstruction at the Time of Return to Sport
# Purpose There is a high rate of second anterior cruciate ligament (ACL) injury (ipsilateral graft or contralateral ACL) upon return-to-sport (RTS) following ACL reconstruction (ACLR). While a significant amount of epidemiological data exists demonstrating sex differences as risk factors for prima...
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| Format: | Article |
| Language: | English |
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North American Sports Medicine Institute
2022-06-01
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| Series: | International Journal of Sports Physical Therapy |
| Online Access: | https://ijspt.scholasticahq.com/article/35575-females-have-lower-knee-strength-and-vertical-ground-reaction-forces-during-landing-than-males-following-anterior-cruciate-ligament-reconstruction-at |
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| author | Zachary B. Sullivan Barrie S. Sugarman Mallory S. Faherty Carrie Killelea Dean C. Taylor Daniel Le Alison P. Toth Jonathan C. Riboh Lee H. Diehl Jocelyn R. Wittstein Annunziato Amendola Timothy C. Sell |
| author_facet | Zachary B. Sullivan Barrie S. Sugarman Mallory S. Faherty Carrie Killelea Dean C. Taylor Daniel Le Alison P. Toth Jonathan C. Riboh Lee H. Diehl Jocelyn R. Wittstein Annunziato Amendola Timothy C. Sell |
| author_sort | Zachary B. Sullivan |
| collection | DOAJ |
| description | # Purpose
There is a high rate of second anterior cruciate ligament (ACL) injury (ipsilateral graft or contralateral ACL) upon return-to-sport (RTS) following ACL reconstruction (ACLR). While a significant amount of epidemiological data exists demonstrating sex differences as risk factors for primary ACL injury, less is known about sex differences as potential risk factors for second ACL injury. The purpose of this study is to determine if there are sex-specific differences in potential risk factors for second ACL injury at the time of clearance for RTS.
# Methods
Ten male and eight female athletes (age: 20.8 years ±6.3, height: 173.2 cm ±10.1, mass: 76.6 kg ±18.3) participated in the study following ACLR at time of RTS (mean 10.2 months). Performance in lower extremity isokinetic and isometric strength testing, static and dynamic postural stability testing, and a single leg stop-jump task was compared between the sexes.
# Results
Normalized for body weight, males had significantly greater isokinetic knee flexion (141±14.1 Nm/kg vs. 78±27.4 Nm/kg, p=0.001) and extension strength (216±45.5 Nm/kg vs. 159±53.9 Nm/kg, p=0.013) as well as isometric flexion (21.1±6.87% body weight vs. 12.5±5.57% body weight, p=0.013) and extension (41.1±7.34% body weight vs. 27.3±11.0% body weight, p=0.016) strength compared to females. In the single-leg stop jump task, males had a greater maximum vertical ground reaction force during landing (332±85.5% vs. 259±27.4% body weight, p=0.027) compared to females.
# Conclusions
Based on these results, there are significant differences between sexes following ACLR at the time of RTS. Lower knee flexion and extension strength may be a potential risk factor for second ACL injury among females. Alternatively, the increased maximum vertical force observed in males may be a potential risk factor of second ACL injury in males. Although these results should be interpreted with some caution, they support that rehabilitation programs in the post-ACLR population should be individualized based on the sex of the individual.
# Level of Evidence
Level 3 |
| format | Article |
| id | doaj-art-81c5760431f44789919b3fc361a62e37 |
| institution | Kabale University |
| issn | 2159-2896 |
| language | English |
| publishDate | 2022-06-01 |
| publisher | North American Sports Medicine Institute |
| record_format | Article |
| series | International Journal of Sports Physical Therapy |
| spelling | doaj-art-81c5760431f44789919b3fc361a62e372025-02-11T20:27:09ZengNorth American Sports Medicine InstituteInternational Journal of Sports Physical Therapy2159-28962022-06-01174Females have Lower Knee Strength and Vertical Ground Reaction Forces During Landing than Males Following Anterior Cruciate Ligament Reconstruction at the Time of Return to SportZachary B. SullivanBarrie S. SugarmanMallory S. FahertyCarrie KilleleaDean C. TaylorDaniel LeAlison P. TothJonathan C. RibohLee H. DiehlJocelyn R. WittsteinAnnunziato AmendolaTimothy C. Sell# Purpose There is a high rate of second anterior cruciate ligament (ACL) injury (ipsilateral graft or contralateral ACL) upon return-to-sport (RTS) following ACL reconstruction (ACLR). While a significant amount of epidemiological data exists demonstrating sex differences as risk factors for primary ACL injury, less is known about sex differences as potential risk factors for second ACL injury. The purpose of this study is to determine if there are sex-specific differences in potential risk factors for second ACL injury at the time of clearance for RTS. # Methods Ten male and eight female athletes (age: 20.8 years ±6.3, height: 173.2 cm ±10.1, mass: 76.6 kg ±18.3) participated in the study following ACLR at time of RTS (mean 10.2 months). Performance in lower extremity isokinetic and isometric strength testing, static and dynamic postural stability testing, and a single leg stop-jump task was compared between the sexes. # Results Normalized for body weight, males had significantly greater isokinetic knee flexion (141±14.1 Nm/kg vs. 78±27.4 Nm/kg, p=0.001) and extension strength (216±45.5 Nm/kg vs. 159±53.9 Nm/kg, p=0.013) as well as isometric flexion (21.1±6.87% body weight vs. 12.5±5.57% body weight, p=0.013) and extension (41.1±7.34% body weight vs. 27.3±11.0% body weight, p=0.016) strength compared to females. In the single-leg stop jump task, males had a greater maximum vertical ground reaction force during landing (332±85.5% vs. 259±27.4% body weight, p=0.027) compared to females. # Conclusions Based on these results, there are significant differences between sexes following ACLR at the time of RTS. Lower knee flexion and extension strength may be a potential risk factor for second ACL injury among females. Alternatively, the increased maximum vertical force observed in males may be a potential risk factor of second ACL injury in males. Although these results should be interpreted with some caution, they support that rehabilitation programs in the post-ACLR population should be individualized based on the sex of the individual. # Level of Evidence Level 3https://ijspt.scholasticahq.com/article/35575-females-have-lower-knee-strength-and-vertical-ground-reaction-forces-during-landing-than-males-following-anterior-cruciate-ligament-reconstruction-at |
| spellingShingle | Zachary B. Sullivan Barrie S. Sugarman Mallory S. Faherty Carrie Killelea Dean C. Taylor Daniel Le Alison P. Toth Jonathan C. Riboh Lee H. Diehl Jocelyn R. Wittstein Annunziato Amendola Timothy C. Sell Females have Lower Knee Strength and Vertical Ground Reaction Forces During Landing than Males Following Anterior Cruciate Ligament Reconstruction at the Time of Return to Sport International Journal of Sports Physical Therapy |
| title | Females have Lower Knee Strength and Vertical Ground Reaction Forces During Landing than Males Following Anterior Cruciate Ligament Reconstruction at the Time of Return to Sport |
| title_full | Females have Lower Knee Strength and Vertical Ground Reaction Forces During Landing than Males Following Anterior Cruciate Ligament Reconstruction at the Time of Return to Sport |
| title_fullStr | Females have Lower Knee Strength and Vertical Ground Reaction Forces During Landing than Males Following Anterior Cruciate Ligament Reconstruction at the Time of Return to Sport |
| title_full_unstemmed | Females have Lower Knee Strength and Vertical Ground Reaction Forces During Landing than Males Following Anterior Cruciate Ligament Reconstruction at the Time of Return to Sport |
| title_short | Females have Lower Knee Strength and Vertical Ground Reaction Forces During Landing than Males Following Anterior Cruciate Ligament Reconstruction at the Time of Return to Sport |
| title_sort | females have lower knee strength and vertical ground reaction forces during landing than males following anterior cruciate ligament reconstruction at the time of return to sport |
| url | https://ijspt.scholasticahq.com/article/35575-females-have-lower-knee-strength-and-vertical-ground-reaction-forces-during-landing-than-males-following-anterior-cruciate-ligament-reconstruction-at |
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