ReviewGender differences in knee abduction during weight-bearing activities: A systematic review and meta-analysis
Section snippets
Background
Anterior cruciate ligament (ACL) injury and patellofemoral pain (PFP) are common sports-related injuries [1], [2]. Such injuries are more frequent in women than in men [1], [2]. Although the evidence is limited, it is suggested that increased knee abduction may be a contributing factor for this gender difference [3]. Indeed, greater knee abduction is consistently reported to form part of the mechanism of non-contact ACL injury [4], [5], [6], [7], and is associated with greater strain on the ACL
Methods
A systematic review and meta-analyses were conducted according to the PRISMA guidelines. The study protocol was pre-registered (PROSPERO 2013: CRD42013005415).
Study selection
A total of 4987 abstracts were screened against the inclusion criteria. Sixty-seven articles proceeded to quality assessment. One author reported on the same subjects in three studies [37], [38], [39]; the article with the highest quality score was included [39]. Another author reported on the same subjects in two studies [40], [41]. Of these articles, the one that reported data for more than one functional task was included [41]. Seven articles did not reach the predefined limit of a 50% score
Discussion
The results from this systematic review and meta-analysis report that women without knee injury or with PFP, execute functional tasks with greater knee abduction than their male counterparts. In healthy individuals, the specific tasks in which differences were apparent between women and men were jump landings, cutting and running. Limited data were available in individuals with a history of ACL injury or PFP; findings indicate greater peak knee abduction in women in some weight-bearing tasks.
Conclusions
This systematic review and meta-analyses reveal that women, with or without knee injury, exhibit increased knee abduction during the execution of several different weight-bearing functional tasks compared to men. Given the reported gender-difference in knee abduction during functional tasks, there may need to be a greater focus on this movement pattern during prevention and rehabilitation training in women, whereas other factors may be more relevant in men. The majority of studies included
Authors’ contribution
AC contributed to the design of the study, was responsible for collecting the data, was responsible for the analysis and interpretation of the data, and drafted the manuscript. MWC contributed to the conception and design of the study, contributed in analysis and interpretation of data, and provided feedback on drafts of the manuscript. JN contributed in collecting the data, and provided feedback on drafts of the manuscript. EA contributed to the conception and design of the study, contributed
Conflict of interest
Anna Cronström, Mark W Creaby, Jenny Nae and Eva Ageberg declare that they have no competing interests.
Acknowledgements
This research was funded by the Swedish Research Council (2009-1447), the Crafoord Foundation, the Swedish Rheumatism Association, the Swedish National Centre for Research in Sports, and the Faculty of Medicine of Lund University.
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2019, Best Practice and Research: Clinical RheumatologyCitation Excerpt :For example, women of all ages (>14 years) typically have half to three-quarters the quadriceps strength of men, with discrepancies, although of lower magnitude, persisting after adjustment for body weight [43]. Although there is compelling evidence from more than 30 biomechanical studies showing that healthy uninjured women display greater dynamic knee abduction angles during weight-bearing tasks than their male counterparts [44], which is a common impairment in people with PFP, greater knee abduction has limited evidence as a risk factor for PFP [5]. Further research should help to elucidate other potential mechanisms underlying the greater incidence of PFP in women than in men.