Tools
Tools
Nédélec, E, 2024. Sex hormones and neuromuscular function in relation to non-contact anterior cruciate ligament injury risk in females. PhD, Nottingham Trent University.
Preview |
Text
Elisa Nédélec 2024.pdf - Published version Download (10MB) | Preview |
Abstract
The rise in female sports participation and sustained physical activity has highlighted a higher prevalence of non-contact anterior cruciate ligament (ACL) injuries in female compared to males, driven by a complex interplay of physiological, anatomical, biomechanical, and neuromuscular factors, along with gender-specific environmental influences. The first chapters of this thesis investigated the role of sex hormone profiles, including the menstrual cycle (MC), hormonal contraceptive (HC) use, and menstrual irregularities (MI), in contributing to non-contact ACL injuries, while evaluating clinical methodologies for injury risk assessment. Chapter 3 presents a systematic review and meta-analysis on the influence of MC phases and HC use on anterior knee laxity (AKL) and non-contact ACL injury incidence. While no significant effects of hormonal factors were found, the results highlighted high methodological heterogeneity across studies, emphasising the need for robust protocols in hormonal assessment. In Chapter 4, the reliability of the GNRB, an automated knee arthrometer, was assessed, which demonstrated excellent reliability (ICC = 0.94) for AKL evaluation. This has clear potential for broader clinical application in ACL injury diagnosis and AKL monitoring. Chapter 5 identified methodological inconsistencies in common assessments of neuromuscular function (force steadiness [FS]), specifically in calculating the coefficient of variation (CoV) of force output, limiting cross-study comparisons and the development of clinical standards. Building on this, Chapter 6 evaluated knee extensors FS, maximal voluntary isometric strength (MVC), and vastus medialis (VM) and vastus lateralis (VL) muscle activation across the MC, finding no significant hormonal influence on these variables (p = 0.756-0.895; p = 0.393; p = 0.324; and p = 0.775, respectively) in eumenorrheic females. While these results suggested minimal impact of hormonal fluctuations on knee extensor neuromuscular performance, further research is required to explore additional neuromuscular factors, such as motor unit (MU) behaviour, using advanced decomposition techniques from high-density surface electromyography (HDsEMG). Overall, this thesis advances the understanding of non-contact ACL injury mechanisms in females, advocating for standardisation in hormonal assessment and supporting the GNRB’s utility in non-contact ACL injury prevention. Moreover, it identifies key areas of further research needed to explore neuromuscular factors that III may contribute to the elevated non-contact ACL injury risk in females, particularly during sport-specific movements.
| Item Type: | Thesis |
|---|---|
| Creators: | Nédélec, E. |
| Contributors: | Name Role NTU ID ORCID |
| Date: | September 2024 |
| Rights: | This work is the intellectual property of the author. You may copy up to 5% of this work for private study, or personal, non-commercial research. Any re-use of the information contained within this document should be fully referenced, quoting the author, title, university, degree level and pagination. Queries or requests for any other use, or if a more substantial copy is required, should be directed to the owner(s) of the Intellectual Property Rights. |
| Divisions: | Schools > School of Science and Technology |
| Record created by: | Jeremy Silvester |
| Date Added: | 04 Jul 2025 10:20 |
| Last Modified: | 04 Jul 2025 10:42 |
| URI: | https://irep.ntu.ac.uk/id/eprint/53881 |
https://orcid.org/0000-0001-9758-6295Actions (login required)
 |
Edit View |
Statistics
Views
Views per month over past year
Downloads
Downloads per month over past year
