Steiner Martina, Baur Heiner, Blasimann Angela
Division of Physiotherapy, Bern University of Applied Sciences, School of Health Professions, Bern (CH), Switzerland.
Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, Wilrijk (BE), Belgium.
Arch Physiother. 2023 Feb 15;13(1):4. doi: 10.1186/s40945-022-00158-x.
The rupture of the anterior cruciate ligament (ACL) is one of the most common injuries of the knee. Women have a higher injury rate for ACL ruptures than men. Various indicators for this sex-specific difference are controversially discussed.
A systematic review of the literature that compares surface electromyography (EMG) values of adult female and male subjects to find out if there is a difference in neuromuscular activation of the knee stabilizing muscles.
This systematic review has been guided and informed by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Studies which examined sex-specific differences with surface EMG measurements (integral, root mean squares, mean values, analysis of time and amplitude) of the knee stabilizing muscles were retrieved via searches from the databases PubMed, CINAHL, Embase, CENTRAL and SPORTDiscus. The risk of bias of included studies was assessed with the National Heart, Lung and Blood Institute (NHLBI) study quality assessment tool. A synthesis of results was performed for relevant outcomes.
Fifteen studies with 462 healthy participants, 233 women (mean age 21.9 (± 2.29) years) and 299 men (mean age 22.6 (± 2.43) years), were included in the systematic review. The methodological quality of the studies was mostly rated "fair" (40%). A significantly higher activity of the muscles vastus lateralis and vastus medialis was found in females, in three studies. Two studies found significantly lower neuromuscular activity in the muscles biceps femoris and semitendinosus in females. All other included studies found no significant differences or reported even contradicting results.
The controversial findings do not allow for a concluding answer to the question of a sex-specific neuromuscular activation. Further research with higher statistical power and a more homogeneous methodical procedure (tasks and data normalisation) of the included studies may provide insight into possibly existing sex-specific differences in neuromuscular activation. This systematic review could help to improve the methodical design of future studies to get a more valid conclusion of the issue.
CRD42020189504.
前交叉韧带（ACL）断裂是膝关节最常见的损伤之一。女性ACL断裂的发生率高于男性。关于这种性别差异的各种指标存在争议。
对比较成年女性和男性受试者表面肌电图（EMG）值的文献进行系统综述，以确定膝关节稳定肌的神经肌肉激活是否存在差异。
本系统综述遵循系统评价与Meta分析的首选报告项目（PRISMA）指南进行指导和参考。通过检索PubMed、CINAHL、Embase、CENTRAL和SPORTDiscus数据库，获取使用表面肌电图测量（积分、均方根、平均值、时间和幅度分析）膝关节稳定肌性别差异的研究。采用美国国立心肺血液研究所（NHLBI）研究质量评估工具评估纳入研究的偏倚风险。对相关结果进行综合分析。
系统综述纳入了15项研究，共462名健康参与者，其中233名女性（平均年龄21.9（±2.29）岁）和299名男性（平均年龄22.6（±2.43）岁）。这些研究的方法学质量大多被评为“中等”（40%）。三项研究发现女性股外侧肌和股内侧肌的活动明显更高。两项研究发现女性股二头肌和半腱肌的神经肌肉活动明显更低。其他所有纳入研究均未发现显著差异，甚至报告了相互矛盾的结果。
这些有争议的研究结果无法对性别特异性神经肌肉激活问题给出结论性答案。对纳入研究进行更具统计学效力且方法程序更统一（任务和数据标准化）的进一步研究，可能有助于深入了解神经肌肉激活中可能存在的性别差异。本系统综述有助于改进未来研究的方法学设计，以更有效地得出关于该问题的结论。
CRD42020189504。
