Sex differences in the relationship of hip strength and functional performance to chronic ankle instability scores

Abstract

Background While decreased hip abductor strength, functional performance, and self-reported instability scores have all been shown in association with CAI, any sex difference in the relationship between these indicators is unclear. This study was to determine whether sex differences are present in the relationship between these indicators in individuals with CAI. Methods Thirty-two women and twenty-nine men with unilateral CAI took part. Hip abductor strength and functional performance were respectively assessed using a hand-held dynamometer and the figure-8-hop test. All 61 participants scored the Cumberland Ankle Instability Tool (CAIT) for self-reported ankle instability. Independent sample t-tests and correlation analysis were conducted. Results Normalized hip abductor strength and functional performance measures for females were lower than for males. The self-reported ankle instability CAIT score, where higher values represent less instability, was significantly and positively correlated with both normalized hip abductor strength (p = 0.003) and functional performance (p = 0.001) on the affected side in females, but not in males (p = 0.361 and p = 0.192 respectively). Conclusions Sex differences were observed in that there were significant relationships between normalized hip abductor strength, functional performance, and CAIT scores in female CAI participants, but not males, suggesting that CAI evaluation and rehabilitation strategies should be sex-specific. Highlights In females with CAI, hip abductor strength and functional performance showed significant relationships with self-reported instability scores. Correspondingly, in clinical practice with individuals with CAI, evaluation criteria may be formulated according to these observed sex differences. Sex differences should be factored into the evaluation and treatment of CAI individuals. Hip strength assessment should be employed with CAI individuals. Hip strengthening and functional hopping may be recommended for the rehabilitation of CAI, especially in female patients.

Ankle Inversion Proprioception Impairment in Persons with Chronic Ankle Instability Is Task-Specific

“…All these factors could impact the result, and thus future studies may explore the effect of these variables on ankle proprioceptive performance associated with CAI. In addition, CAI may occur in younger and older populations, and recent research has shown that male and female individuals with CAI performed differently on some functional tasks (Lu et al, 2022). Thus, caution is needed when generalizing our findings to different age groups, and there may be sex differences in task-specific findings for different proprioceptive assessment methods.…”

Effect of Different Landing Heights and Loads on Ankle Inversion Proprioception during Landing in Individuals with and without Chronic Ankle Instability

“…We did not use any instruments to control whether participants had a balanced distribution of weight between the two feet, a feature which should be improved for future study. In addition, previous research has shown that female and male individuals with CAI performed differently on a range of functional tasks [ 57 ]. However, given the relatively small sample size of the current study, the sex differences in this proprioceptive task were not revealed.…”

Knee osteoarthritis patients assessed during walking for ankle inversion movement discrimination sensitivity

“…However, a recent large-sample, prospective investigation based in an Asian community suggested that muscle strength was not associated with fear of falling ( Mat et al, 2020 ), signifying the need of further investigations regarding the characteristics of neuromuscular control during walking, as this remains the most common functional activity where fall accidents occur ( Promsri et al, 2023 ). To date, a gender difference on lower limb proprioception has been investigated in healthy cohorts, and some clinical populations ( Karkousha, 2016 ; Lu et al, 2022 ; Shi et al, 2023a ), yet not in KOA ( Salamanna et al, 2023 ). It remains unclear whether ankle proprioception during walking could be affected to different degrees in female and male patients with KOA.…”