Determining Sex-specific Differences in Gait Symmetry during Walking and Running in Participants who Have Undergone Anterior Cruciate Ligament Reconstruction at the Time of Release to Sport using a Wearable In-Shoe Sensor

Anterior cruciate ligament reconstruction (ACLR) is something many athletes may experience during their career due to a torn ACL. This study included ACLR athletes after their rehabilitation process, before returning to their sport to assess gait symmetry during walking and running trials using wearable in-shoe sensors to specifically measure average loading rate (ALR), peak impact force (PIF), and impulse symmetry (IMP). This study utilized 40 athletes (20 males and 20 females) from various sports, ages ranging from 14 to 21 years of age with females having 7 right limb and 13 left limb ACLRs, and males having 9 right limb and 11 left limb ACLRs. Females showed higher levels of asymmetry in their limbs that underwent ACLR during both walking and running trials compared to males. Additionally, females showed a tendency to spend less time on their surgical leg when assessing PIF during walking. Conversely, during walking and running trials assessing left limb ACLRs only, females showed higher levels of asymmetry in offloading their weight from their non-surgical limb when assessing PIF and IMP. In addition, females showed higher levels of asymmetry during average loading rates (ALRs) in both walking and running compared to males when assessing right limb ACLRs only. More research into right ACLR to left ACLR differential outcomes between males and females should be conducted in order to validate these findings, since leg dominance can play a role in the initial injury. The use of wearable technology for gait assessment should be implemented in other laboratory settings as it is a valuable and accessible tool for measuring gait symmetry. This data is valuable for any clinician involved in the rehabilitation process for the athlete. In conclusion, females tend to show higher levels of asymmetry in comparison to males after ACLR.