What is the true evidence for gender-related differences during plant and cut maneuvers? A systematic review.
OBJECTIVE
Female athletes have a significantly higher risk of sustaining an anterior cruciate ligament (ACL) injury than male athletes. Biomechanical and neuromuscular factors have been reported as the main cause. The purpose of this review was to critically review results of the published literature on gender differences regarding biomechanical and neuromuscular movement patterns during plant and cutting maneuvers.


METHODS
MEDLINE (1966 to December 2008), EMBASE (1947 to December 2008) and CINAHL (1981 to December 2008) searches were performed. The seven studies meeting the inclusion criteria were analyzed.


RESULTS
Biomechanical gender differences were of questionable clinical relevance. Quadriceps dominance was not found in women.


CONCLUSIONS
The question raises whether ACL injuries during plant and cutting maneuvers are purely gender related and whether women do have to move like men in order to reduce injury risk? Caution is warranted in making inferences as studies were heterogeneous in terms of subject and study characteristics and had low statistical power as a result of insufficient number of subjects. It is advised that future research moves beyond the isolated gender comparison and that larger sample sizes will be included. This review may aid in improving experiments to draw valid conclusions, in order to direct future ACL injury prevention programs, which might need to be more individualized.
Benjaminse
Anne
A
Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands. a.benjaminse@med.umcg.nl
Gokeler
Alli
A
Fleisig
Glenn S
GS
Sell
Timothy C
TC
Otten
Bert
B
D000070598:Anterior Cruciate Ligament Injuries; D001265:Athletic Injuries / Q000453:epidemiology; D001696:Biomechanical Phenomena; D004576:Electromyography; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000453:epidemiology* / Q000517:prevention & control; D008297:Male; D009068:Movement / Q000502:physiology; D012737:Sex Factors; D012916:Soccer / Q000293:injuries*