The dynamic control ratio masks bilateral asymmetries - A gender-specific analysis of 264 healthy and ACL-injured athletes

Isokinetic strength tests are frequently applied to assess anterior cruciate ligament (ACL) rehabilitation processes. However, diverging methodologies cause misleading conclusions. This cross-sectional study evaluated the effects of gender (male vs. female), group (healthy vs. ACL-injured) and limb...

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Bibliographic Details
Published in:Research in sports medicine 2022, Vol.30 (1), p.1-18
Main Authors: Alt, Tobias, Breitenmoser, Thomas, Vonhoegen, Jan, Horn, Dennis, Severin, Jannik, Nolte, Kevin, Knicker, Axel J., Jaitner, Thomas, Strüder, Heiko K.
Format: Article
Language:English
Subjects:
Anterior Cruciate Ligament
Anterior Cruciate Ligament Injuries - surgery
Athletes
Biomechanical Phenomena
Cross-Sectional Studies
Female
Females
Gender
Humans
injury prevention
isokinetic dynamometry
joint moments
Knee
Knee Joint
Ligaments
Male
Muscle Strength
rehabilitation
return to sport
Screening tool
Sports injuries
thigh muscle balance
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Summary:Isokinetic strength tests are frequently applied to assess anterior cruciate ligament (ACL) rehabilitation processes. However, diverging methodologies cause misleading conclusions. This cross-sectional study evaluated the effects of gender (male vs. female), group (healthy vs. ACL-injured) and limb (dominant/healthy vs. non-dominant/ACL-injured) on thigh muscle balance of 138 female and 126 male athletes (50% ACL-injured, averagely 12.8 months after surgery). Balance was analysed between legs (bilateral asymmetry) and between concentric knee extensor (Qcon) and eccentric knee flexor strength (Hecc) (DCR = dynamic control ratio, DCRe = DCR at the equilibrium point). Females were generally 17-27% weaker than males. Independent of gender and time after surgery, ACL-injured athletes demonstrated bilateral asymmetries (7-20%) in peak (PM Qcon , PM Hecc ) and DCRe moments (p ≤0.030; 0.018≤η p 2 ≤0.215). ACL-injured athletes' affected (24-28%) and unaffected (12-24%) hamstrings and quadriceps peak moments were significantly weaker compared to healthy athletes (p
ISSN:1543-8627
1543-8635
DOI:10.1080/15438627.2021.1943389