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A hierarchy in functional muscle roles at the knee is influenced by sex and anterior cruciate ligament deficiency

Del Bel, Michael J. ; Flaxman, Teresa E. ; Smale, Kenneth B. ; Alkjaer, Tine ; Simonsen, Erik B. ; Krogsgaard, Michael R. and Benoit, Daniel L. LU (2018) In Clinical Biomechanics 57. p.129-136
Abstract

Background: Sex-related neuromuscular differences have been linked to greater risk of anterior cruciate ligament injuries in females. Despite this, it remains unclear if sex-related differences are present after injury. This study sought to determine if sex differences are present in the functional roles of knee joint muscles in an anterior cruciate ligament deficient population. Methods: An isometric, weight-bearing, force-generation protocol required injured and healthy males and females to modulate ground reaction forces. Electromyography was used to classify the functional role of 10 lower limb muscles in their contribution to knee joint stability during various loading directions. These roles were compared between the four groups... (More)

Background: Sex-related neuromuscular differences have been linked to greater risk of anterior cruciate ligament injuries in females. Despite this, it remains unclear if sex-related differences are present after injury. This study sought to determine if sex differences are present in the functional roles of knee joint muscles in an anterior cruciate ligament deficient population. Methods: An isometric, weight-bearing, force-generation protocol required injured and healthy males and females to modulate ground reaction forces. Electromyography was used to classify the functional role of 10 lower limb muscles in their contribution to knee joint stability during various loading directions. These roles were compared between the four groups at 12 loading directions using a directional analysis. Findings: Functional muscle roles were different between groups, except for injured males and healthy females. Healthy males had either joint actuators or specific joint stabilisers, but no general stabilisers; the vastus medialis and lateralis of injured males and healthy females were classified as general stabilisers while injured females added the gluteus medialis and medial gastrocnemius as general stabilisers. Interpretation: A population-based hierarchy in functional muscle roles was discovered. Healthy males demonstrated the most specific muscle roles, which can be viewed as more adaptive to variable loading conditions. The more generalised stabilisation strategies seen in injured males and females would alter joint loading which may be detrimental to the knee joint health over time. In summary, (1) these injuries alter muscle roles; (2) these alterations are sex-specific; (3) rehabilitation might be optimised if sex-differences are considered.

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author
; ; ; ; ; and
publishing date
type
Contribution to journal
publication status
published
keywords
ACL injury, Knee stability, Neuromuscular control, Sex-differences
in
Clinical Biomechanics
volume
57
pages
129 - 136
publisher
Elsevier
external identifiers
  • pmid:29986275
  • scopus:85049308192
ISSN
0268-0033
DOI
10.1016/j.clinbiomech.2018.06.014
language
English
LU publication?
no
additional info
Publisher Copyright: © 2018
id
0667c303-7673-415a-b732-c41865da238f
date added to LUP
2023-08-24 16:28:12
date last changed
2024-04-05 23:16:35
@article{0667c303-7673-415a-b732-c41865da238f,
  abstract     = {{<p>Background: Sex-related neuromuscular differences have been linked to greater risk of anterior cruciate ligament injuries in females. Despite this, it remains unclear if sex-related differences are present after injury. This study sought to determine if sex differences are present in the functional roles of knee joint muscles in an anterior cruciate ligament deficient population. Methods: An isometric, weight-bearing, force-generation protocol required injured and healthy males and females to modulate ground reaction forces. Electromyography was used to classify the functional role of 10 lower limb muscles in their contribution to knee joint stability during various loading directions. These roles were compared between the four groups at 12 loading directions using a directional analysis. Findings: Functional muscle roles were different between groups, except for injured males and healthy females. Healthy males had either joint actuators or specific joint stabilisers, but no general stabilisers; the vastus medialis and lateralis of injured males and healthy females were classified as general stabilisers while injured females added the gluteus medialis and medial gastrocnemius as general stabilisers. Interpretation: A population-based hierarchy in functional muscle roles was discovered. Healthy males demonstrated the most specific muscle roles, which can be viewed as more adaptive to variable loading conditions. The more generalised stabilisation strategies seen in injured males and females would alter joint loading which may be detrimental to the knee joint health over time. In summary, (1) these injuries alter muscle roles; (2) these alterations are sex-specific; (3) rehabilitation might be optimised if sex-differences are considered.</p>}},
  author       = {{Del Bel, Michael J. and Flaxman, Teresa E. and Smale, Kenneth B. and Alkjaer, Tine and Simonsen, Erik B. and Krogsgaard, Michael R. and Benoit, Daniel L.}},
  issn         = {{0268-0033}},
  keywords     = {{ACL injury; Knee stability; Neuromuscular control; Sex-differences}},
  language     = {{eng}},
  pages        = {{129--136}},
  publisher    = {{Elsevier}},
  series       = {{Clinical Biomechanics}},
  title        = {{A hierarchy in functional muscle roles at the knee is influenced by sex and anterior cruciate ligament deficiency}},
  url          = {{http://dx.doi.org/10.1016/j.clinbiomech.2018.06.014}},
  doi          = {{10.1016/j.clinbiomech.2018.06.014}},
  volume       = {{57}},
  year         = {{2018}},
}