Sex Dominates Task Anticipation in Shaping 90° Sidestep Cutting Biomechanics: Evidence for a Proximal-to-Distal Cascade
Soran AminiAghdam, Eline Nijmeijer, Julia Scharbert, Simon Woergoetter, Alli Gokeler, Anne Benjaminse, Philipp Baumert, Christian FinkBackground:
Sidestep cutting (SSC) is used widely to examine surrogate markers of anterior cruciate ligament (ACL) loading, but the combined influence of sex and task anticipation (anticipated vs unanticipated) on whole-body biomechanics during 90° cutting remains unclear.
Hypothesis:
It was hypothesized that sex and task anticipation would exert distinct and interactive effects on trunk, pelvic, and lower-limb biomechanics during 90° cutting, with sex exerting the dominant influence.
Study Design:
Controlled laboratory study.
Level of Evidence:
Level 3.
Methods:
A total of 44 competitive amateur athletes (20 women, 24 men) performed anticipated and unanticipated 90° sidestep cuts. Whole-body 3-dimensional kinematics and lower-limb kinetics were captured. Statistical parametric mapping tested main and interactive effects of sex and task anticipation across stance (
Results:
No sex × task anticipation interactions emerged. Sex main effects spanned all variables and longer stance periods, whereas task anticipation main effects involved fewer variables and shorter intervals. Men demonstrated greater trunk and knee flexion and larger early-stance net knee flexion, varus, and external-rotation knee moments, whereas women showed a more upright trunk and pelvis with less hip and knee flexion and greater knee abduction (valgus) angles. Unanticipated cuts elicited short, phase-specific changes, including early trunk lean and reduced pelvic mobility, mid-stance hip and knee moment modulation, and late-stance ankle inversion and internal rotation changes, and attenuated braking forces.
Conclusion:
Sex was the dominant determinant of 90° SSC kinematics, joint moments, and ground-reaction forces, with effects spanning longer stance intervals than the phase-ordered proximal-to-distal differences between anticipated and unanticipated cuts, reinforcing the value of whole-body, multiplanar whole-stance interpretation.
Clinical Relevance:
Given larger and more sustained sex effects, sex-specific benchmarking may aid interpretation and individualization. Progressive exposure to unanticipated 90° cutting - building from planned, lower-demand conditions - may emphasize coordinated, multiplanar control across stance.