Nae J, Creaby MW, Cronström A, Ageberg E. Sex differences in postural orientation errors and association with objective and patient-reported function in patients with ACL injury: an exploratory cross-sectional study. 

The full paper can be found here




Tell us more about yourself and the author team.

In our team, we combine expertise within physical therapy, biomechanics, and clinical experience. This paper is part of a larger project where we validate a test battery for visual assessment of postural orientation. Jenny and Anna are post-doctoral fellows in the research group Sport Sciences at Lund University, Lund, Sweden. Eva is a Professor in Physical Therapy and Head of that research group. Anna is also a post-doctoral fellow at Umeå University, Umeå, Sweden. Mark is a senior lecturer with expertise in biomechanics at the Australian Catholic University (ACU), Brisbane, Australia.


What is the story behind your study?

The idea behind this research started around 2011 when I worked as a physical therapist in a sports clinic. I began to reflect that how the patients move must be important too, and not only how far they could jump and how much force they could develop. So, I tried to find a way to evaluate movement quality, specifically postural orientation, but I did not find a systematic way to do this. So, I ended up doing my PhD project about visual assessment of postural orientation, where I developed and evaluated a way to assess the postural orientation of the lower extremity and trunk. The current study is part of my PhD thesis, “Is seeing just believing? Measurement properties of visual assessment of Postural Orientation Errors (POEs) in people with anterior cruciate ligament injury”. In this study, we validate that test battery against other common measures of muscle function and investigate whether there are any sex differences in POE scores in patients with an ACL injury.


In your own words, what did you find?

We found that women with ACL injury have worse postural orientation than men with an ACL injury, evaluated with visual assessment. This is consistent with studies evaluating postural orientation using 3D kinematics. We also found that worse POE scores were associated with shorter hop distance and fewer side-hops in women but not in men. However, no associations were found between POE scores and PROMS.


What was the main challenge you faced in your study?

The analyses were performed separately for men and women, so the main challenge in this study was the limited sample size.


If there is one take-home message from your study, what would that be?

That visual assessment of POEs could be used during rehabilitation to evaluate postural orientation and help decide when a patient has good enough postural orientation to progress to more sport-specific tasks. For example, based on data from our study, when patients can perform the ADL tasks with good postural orientation, they are more likely to perform better on jumping tasks.

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