Young Females Exhibit Decreased Coronal Plane Postural Stability Compared to Young Males

Abstract

Background

Female athletes are at significantly higher risk of noncontact ACL injury than males, particularly in pivoting sports such as soccer and basketball. Sex-based differences in proprioception and core stability may contribute to this elevated risk.

Questions/Purpose

This study evaluates a novel method of assessing dynamic stability to test the hypothesis that healthy adolescent controls have sex-based differences in postural stability.

Methods

Seventy-nine male and 72 female subjects completed three rounds of dynamic postural stability testing. During the assessment, subjects attempted to stabilize their torso and upper body in response to random movements of the platform. The total time a subject lasted on the platform and dynamic motion analysis (DMA) score, a summation of motion in five planes throughout testing, was calculated for each subject. The average score for each subject was included in the analysis.

Results

Males lasted longer on the platform (98 ± 14 s) than females (94 ± 13 s) (p = 0.04). Coronal plane and rotation stability differed significantly between genders (323 ± 126 vs. 365 ± 128, p = 0.04) and (318 ± 82 vs. 403 ± 153, p = 0.0002), respectively. No statistically significant difference was seen in the other planes of motion.

Conclusions

Females have less dynamic postural stability than their male counterparts in the coronal plane based on a novel assessment tool. This finding may contribute to better understanding of sex-based differences in rates of injury such as noncontact ACL tears.

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References

  1. 1.

    Arendt E, Dick R. Knee injury patterns among men and women in collegiate basketball and soccer. NCAA data and review of literature. Am J Sports Med. 1995; 23: 694-701.

    Article  CAS  PubMed  Google Scholar 

  2. 2.

    Boden BP, Sheehan FT, Torg JS, et al. Noncontact anterior cruciate ligament injuries: mechanisms and risk factors. J Am Acad Orthop Surg. 2010; 18: 520-7.

    PubMed Central  PubMed  Google Scholar 

  3. 3.

    Borchers JR, Pedroza A, Kaeding C. Activity level and graft type as risk factors for anterior cruciate ligament graft failure: a case-control study. Am J Sports Med. 2009; 37: 2362-7.

    Article  PubMed  Google Scholar 

  4. 4.

    Broglio SP, Sosnoff JJ, Rosengren KS, et al. A comparison of balance performance: computerized dynamic posturography and a random motion platform. Arch Phys Med Rehabil. 2009; 90: 145-50.

    Article  PubMed  Google Scholar 

  5. 5.

    Chandy TA, Grana WA. Secondary school athletic injury in boys and girls: a three year comparison. Phys Sportsmed. 1985; 13: 106-11.

    Google Scholar 

  6. 6.

    Charnock BL, Wiliams MW, Sims EL, et al. Proprio 5000: a new method for assessing dynamic balance. Med Sci Sports Exerc. 2007; 39: S154-S155.

    Article  Google Scholar 

  7. 7.

    Cohen J. Statistical Power Analysis for the Behavioral Sciences, 2nd Editoin. Mahwah: Lawrence Erlbaum Associates; 1988.

    Google Scholar 

  8. 8.

    Ford KR, Shapiro R, Myer GD, et al. Longitudinal sex differences during landing in knee abduction in young athletes. Med Sci Sports Exerc. 2010; 42: 1923-31.

    PubMed Central  Article  PubMed  Google Scholar 

  9. 9.

    Gray J, Taunton JE, McKenzie DC, et al. A survey of injuries to the anterior cruciate ligament of the knee in female basketball players. Int J Sports Med. 1985; 6: 314-6.

    Article  CAS  PubMed  Google Scholar 

  10. 10.

    Hewett TE, Lindenfeld TN, Riccobene JV, et al. The effect of neuromuscular training on the incidence of knee injury in female athletes. A prospective study. Am J Sports Med. 1999; 27: 699-706.

    CAS  PubMed  Google Scholar 

  11. 11.

    Hewett TE, Myer GD, Ford KR, et al. Biomechanical measures of neuromuscular control and valgus loading of the knee predict anterior cruciate ligament injury risk in female athletes: a prospective study. Am J Sports Med. 2005; 33: 492-501.

    Article  PubMed  Google Scholar 

  12. 12.

    Hewett TE, Stroupe AL, Nance TA, et al. Plyometric training in female athletes. Decreased impact forces and increased hamstring torques. Am J Sports Med. 1996; 24: 765-73.

    Article  CAS  PubMed  Google Scholar 

  13. 13.

    Larkin B, Nyazee H, Motley J, et al. The impact of hip arthroplasty type on Proprioception. Clin Orthop Relat Res. 2014; 472: 555-561.

    PubMed Central  Article  PubMed  Google Scholar 

  14. 14.

    Lindenfeld TN, Schmitt DJ, Hendy MP, et al. Incidence of injury in indoor soccer. Am J Sports Med. 1994; 22: 364-71.

    Article  CAS  PubMed  Google Scholar 

  15. 15.

    Mandelbaum BR, Silvers HJ, Watanabe DS, et al. Effectiveness of a neuromuscular and proprioceptive training program in preventing anterior cruciate ligament injuries in female athletes: 2-year follow-up. Am J Sports Med. 2005; 33: 1003-10.

    Article  PubMed  Google Scholar 

  16. 16.

    Marx RG, Stump TJ, Jones EC, et al. Development and evaluation of an activity rating scale for disorders of the knee. Am J Sports Med. 2001; 29: 213-8.

    CAS  PubMed  Google Scholar 

  17. 17.

    Mendiguchia J, Ford KR, Quatman CE, et al. Sex differences in proximal control of the knee joint. Sports Med. 2011; 41: 541-57.

    PubMed Central  Article  PubMed  Google Scholar 

  18. 18.

    Paterno MV, Myer GD, Ford KR, et al. Neuromuscular training improves single-limb stability in young female athletes. J Orthop Sports Phys Ther. 2004; 34: 305-16.

    Article  PubMed  Google Scholar 

  19. 19.

    Pollard CD, Sigward SM, Ota S, et al. The influence of in-season injury prevention training on lower-extremity kinematics during landing in female soccer players. Clin J Sport Med. 2006; 16: 223-7.

    Article  PubMed  Google Scholar 

  20. 20.

    Sutton KM, Bullock JM. Anterior cruciate ligament rupture: differences between males and females. J Am Acad Orthop Surg. 2013; 21: 41-50.

    Article  PubMed  Google Scholar 

  21. 21.

    Wild CY, Steele JR, Munro BJ. Why do girls sustain more anterior cruciate ligament injuries than boys?: a review of the changes in estrogen and musculoskeletal structure and function during puberty. Sports Med. 2012; 42: 733-49.

    Article  PubMed  Google Scholar 

  22. 22.

    Zazulak BT, Hewett TE, Reeves NP, et al. Deficits in neuromuscular control of the trunk predict knee injury risk: a prospective biomechanical-epidemiologic study. Am J Sports Med. 2007; 35: 1123-30.

    Article  PubMed  Google Scholar 

  23. 23.

    Zelisko JA, Noble HB, Porter M. A comparison of men's and women's professional basketball injuries. Am J Sports Med. 1982; 10: 297-9.

    Article  CAS  PubMed  Google Scholar 

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Disclosures

Conflict of Interest

Robert H. Brophy, MD, Jonathon R. Staples, MD, John Motley, PT, Ryan Blalock, MD, Karen Steger-May, MA and Mark Halstead, MD have declared that they have no conflict of interest.

Human/Animal Rights

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5).

Informed Consent

Informed consent was obtained from all patients for being included in the study.

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Correspondence to Robert H. Brophy MD.

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Level of Evidence: Cohort study, level 2b (prospective)

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Brophy, R.H., Staples, J.R., Motley, J. et al. Young Females Exhibit Decreased Coronal Plane Postural Stability Compared to Young Males. HSS Jrnl 12, 26–31 (2016). https://doi.org/10.1007/s11420-015-9458-4

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Keywords

  • core stability
  • dynamic stability
  • male
  • female
  • adolescent
  • ACL