title: Assessment of lower limb neuromuscular control in prepubescent athletes.
abstract: BACKGROUND
  Although neuromuscular indices have been extensively studied in adolescents and adults, limited data exist for prepubescent children.
  
  
  OBJECTIVE
  No differences exist between prepubescent boys and girls in lower limb strength, symmetry on single-legged hop testing, and limb alignment during drop-jump testing.
  
  
  METHODS
  Cross-sectional study (prevalence); Level of evidence, 1.
  
  
  METHODS
  The authors tested 27 female and 25 male athletes who were aged 9 to 10 years and matched for both body mass index and years of organized sports participation. In a drop-jump screening test, the distance between the right and left hips, knees, and ankles was measured as an indicator of lower limb axial alignment in the coronal plane. The distance between the knees and ankles was normalized by the hip separation distance. Quadriceps and hamstrings strengths were measured isokinetically at 180 deg/s. Lower limb symmetry was determined from 2 single-legged hop function tests.
  
  
  RESULTS
  Boys demonstrated greater mean absolute and normalized knee and ankle separation distances on the drop-jump test. Even so, 76% of boys had a normalized knee separation distance of 60% or less of the hip separation distance, as did 93% of girls, indicating a distinctly valgus alignment. There were no differences between the sexes in quadriceps and hamstrings peak torques, hamstrings/quadriceps ratio, time to peak torque, total work, or lower limb symmetry values.
  
  
  CONCLUSIONS
  A high percentage of the prepubescent athletes studied had a distinctly valgus lower limb alignment during the drop-jump test and a lack of lower limb symmetry during the hop tests. These same indices have been hypothesized to increase the risk for knee ligament injuries in older athletes. Neuromuscular training may be needed to address these issues in children.
authors.affiliation: Cincinnati Sportsmedicine Research and Education Foundation, Deaconess Hospital, 311 Straight Street, Cincinnati, OH 45219, USA. sbwestin@csmref.org
authors.forename: Sue D
authors.initials: SD
authors.lastname: Barber-Westin
authors.forename: Marc
authors.initials: M
authors.lastname: Galloway
authors.forename: Frank R
authors.initials: FR
authors.lastname: Noyes
authors.forename: George
authors.initials: G
authors.lastname: Corbett
authors.forename: Catherine
authors.initials: C
authors.lastname: Walsh
mesh_terms: D001696:Biomechanical Phenomena; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007870:Leg Length Inequality / Q000503:physiopathology*; D035002:Lower Extremity / Q000502:physiology*; D008297:Male; D018482:Muscle, Skeletal / Q000502:physiology*; D012737:Sex Factors; D013177:Sports / Q000502:physiology*; D019415:Torque; D014741:Video Recording