{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T16:12:03Z","timestamp":1791303123435,"version":"4.1.0"},"reference-count":90,"publisher":"Journal of Orthopaedic & Sports Physical Therapy (JOSPT)","issue":"1","content-domain":{"domain":["www.jospt.org"],"crossmark-restriction":true},"short-container-title":["JOSPT Open"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>OBJECTIVES: (1) To summarize the literature, (2) determine sex differences, and (3) determine the changes under exercise-induced fatigue, in biomechanical lower-limb interlimb asymmetries in healthy adult male and female athletes, including those with a history of injuries.<\/jats:p>\n                  <jats:p>LITERATURE SEARCH: We searched MEDLINE, Web of Science, EMBASE, and CINAHL databases from inception to March 7, 2025 (PROSPERO; registration number: CRD42023417697).<\/jats:p>\n                  <jats:p>STUDY SELECTION: Studies were included if they assessed lower-limb interlimb biomechanical asymmetry, or compared or reported biomechanical values for both lower limbs in adult male and female athletes.<\/jats:p>\n                  <jats:p>RESULTS: Sixty-four studies (5837 athletes) were included. Forty studies compared sex-specific asymmetries. Fourteen studies reported significant sex differences in healthy athletes in asymmetry in hip abductor strength, explosive power, and kinetic measures commonly in females, as well as in quadriceps and hamstring strength in both males and females, while 11 studies found no sex differences. Five studies investigated asymmetries in healthy athletes with a history of injuries and reported sex differences in explosive power, and no sex differences for balance and knee muscle strength. Asymmetry in explosive power was more commonly noted in female healthy athletes (peak power [Females: 17.21 (0.07) &gt; males: 12.81 (0.06)], P&lt;.05, effect size = 0.33) and healthy athletes with a history of injury (asymmetry (%) [males: 95.4%, P = .003; females: 96.5%, P = .049]). A meta-analysis was not performed due to study heterogeneity. No studies assessed sex-specific asymmetry under exercise-induced fatigue.<\/jats:p>\n                  <jats:p>CONCLUSION: Sex-specific biomechanical lower-limb asymmetry remained inconsistent, with generally no sex differences except asymmetry in explosive power, which was more commonly reported in female athletes. High-quality studies are needed to address these gaps. JOSPT Open 2026;4(1):36-60. Epub 3 December 2025. doi:10.2519\/josptopen.2025.0137<\/jats:p>","DOI":"10.2519\/josptopen.2025.0137","type":"journal-article","created":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T15:17:51Z","timestamp":1764775071000},"page":"36-60","update-policy":"https:\/\/doi.org\/10.2519\/jospt.crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Interlimb Symmetry Characteristics Among Male and Female Athletes: A Systematic Review"],"prefix":"10.2519","volume":"4","author":[{"given":"Cinthuja","family":"Pathmanathan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Herrera","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie N.","family":"C\u00f4t\u00e9","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shawn","family":"Robbins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1394","reference":[{"key":"bib1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-018-5192-z"},{"key":"bib2","doi-asserted-by":"publisher","DOI":"10.1123\/jsr.2022-0052"},{"key":"bib3","doi-asserted-by":"publisher","DOI":"10.1080\/15438627.2021.1943389"},{"key":"bib4","doi-asserted-by":"publisher","DOI":"10.1519\/JSC.0000000000003837"},{"key":"bib5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2024.112291"},{"key":"bib6","doi-asserted-by":"publisher","DOI":"10.1177\/0363546520980079"},{"key":"bib7","volume":"10","author":"Arslan F","year":"2010","journal-title":"Movement and Health."},{"key":"bib8","doi-asserted-by":"publisher","DOI":"10.1123\/ijspp.2014-0379"},{"key":"bib9","doi-asserted-by":"publisher","DOI":"10.1177\/0363546517693846"},{"key":"bib10","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbmt.2023.04.023"},{"key":"bib11","first-page":"72","volume":"1","author":"Barfield WR","year":"2002","journal-title":"J Sports Sci Med."},{"key":"bib12","doi-asserted-by":"publisher","DOI":"10.1080\/02640414.2017.1361894"},{"key":"bib13","doi-asserted-by":"publisher","DOI":"10.1016\/j.ptsp.2023.03.010"},{"key":"bib14","doi-asserted-by":"publisher","DOI":"10.1016\/j.gaitpost.2013.04.014"},{"key":"bib15","doi-asserted-by":"publisher","DOI":"10.1055\/s-0029-1225328"},{"key":"bib16","first-page":"216","volume":"8","author":"Brumitt J","year":"2013","journal-title":"Int J Sports Phys Ther."},{"key":"bib17","doi-asserted-by":"publisher","DOI":"10.1080\/14763141.2013.861013"},{"key":"bib18","doi-asserted-by":"publisher","DOI":"10.3233\/IES-2012-0449"},{"key":"bib19","doi-asserted-by":"publisher","DOI":"10.2478\/v10131-011-0001-9"},{"key":"bib20","doi-asserted-by":"publisher","DOI":"10.3390\/sports12120339"},{"key":"bib21","doi-asserted-by":"publisher","DOI":"10.26603\/001c.117775"},{"key":"bib22","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2021.814572"},{"key":"bib23","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17093295"},{"key":"bib24","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0305141","volume":"19","author":"Chen G","year":"2024","journal-title":"PLOS ONE."},{"key":"bib25","doi-asserted-by":"publisher","DOI":"10.1123\/jsr.2014-0250"},{"key":"bib26","doi-asserted-by":"publisher","DOI":"10.1519\/JSC.0000000000002687"},{"key":"bib27","doi-asserted-by":"publisher","DOI":"10.23736\/S0022-4707.16.06290-3"},{"key":"bib28","doi-asserted-by":"publisher","DOI":"10.1080\/24733938.2019.1628351"},{"key":"bib29","doi-asserted-by":"publisher","DOI":"10.1515\/hukin-2015-0150"},{"key":"bib30","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0286942"},{"key":"bib31","doi-asserted-by":"publisher","DOI":"10.1007\/s42978-022-00192-y"},{"key":"bib32","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph19084672"},{"key":"bib33","doi-asserted-by":"publisher","DOI":"10.1016\/j.ptsp.2020.03.008"},{"key":"bib34","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2017.02.015"},{"key":"bib35","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11020360"},{"key":"bib36","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2023.104602"},{"key":"bib37","first-page":"859","volume":"37","author":"Hadzic V","year":"2013","journal-title":"Coll Antropol."},{"key":"bib38","doi-asserted-by":"publisher","DOI":"10.1519\/JSC.0000000000003003"},{"key":"bib39","doi-asserted-by":"publisher","DOI":"10.1186\/s40798-020-00270-x"},{"key":"bib40","doi-asserted-by":"publisher","DOI":"10.1016\/j.ptsp.2021.03.001"},{"key":"bib41","unstructured":"Higgins JPT Savovi\u0107 J Page MJ Elbers RG Sterne JAC. Assessing risk of bias in a randomized trial. In: Higgins JPT Thomas J Chandler J et al, eds. in Cochrane Handbook for Systematic Reviews of Interventions. 2nd ed.  Cochrane; 2024."},{"key":"bib42","doi-asserted-by":"publisher","DOI":"10.1519\/JSC.0b013e318212de7b"},{"key":"bib43","first-page":"75","volume":"26","author":"Kayhan RF","year":"2024","journal-title":"Res Sport Educ Sci."},{"key":"bib44","first-page":"203","volume":"12","author":"Kotrljanovic A","year":"2016","journal-title":"Arch Budo Sci Martial Arts Extreme Sports."},{"key":"bib45","first-page":"729","volume":"41","author":"Lambert C","year":"2020","journal-title":"Int J Sports Med."},{"key":"bib46","doi-asserted-by":"publisher","DOI":"10.1080\/14763141.2020.1839124"},{"key":"bib47","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-018-5088-y"},{"key":"bib48","first-page":"356","volume":"7","author":"Loudon JK","year":"2012","journal-title":"Int J Sports Phys Ther."},{"key":"bib49","first-page":"7","volume":"7","author":"Ma L-L","year":"2020","journal-title":"Mil Med Res."},{"key":"bib50","doi-asserted-by":"publisher","DOI":"10.3389\/fspor.2021.715833"},{"key":"bib51","doi-asserted-by":"publisher","DOI":"10.1097\/JSM.0b013e3180592a48"},{"key":"bib52","doi-asserted-by":"publisher","DOI":"10.23736\/S0022-4707.20.11178-2"},{"key":"bib53","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmrj.2018.08.380"},{"key":"bib54","first-page":"118","volume":"33","author":"Moul JL","year":"1998","journal-title":"J Athl Train."},{"key":"bib55","doi-asserted-by":"publisher","DOI":"10.1097\/00005768-200201000-00003"},{"key":"bib56","doi-asserted-by":"publisher","DOI":"10.1097\/00002060-200108000-00005"},{"key":"bib57","doi-asserted-by":"publisher","DOI":"10.1097\/00005768-200201000-00003"},{"key":"bib58","unstructured":"National Heart, Lung, and Blood Institute. Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Study Quality Assessment Tools. 2021."},{"key":"bib59","doi-asserted-by":"publisher","DOI":"10.23736\/S0022-4707.18.07852-0"},{"key":"bib60","doi-asserted-by":"publisher","DOI":"10.47197\/retos.v0i41.85934"},{"key":"bib61","doi-asserted-by":"publisher","DOI":"10.53646\/jwsm.v1i1.8"},{"key":"bib62","doi-asserted-by":"publisher","DOI":"10.3390\/medicina58081080"},{"key":"bib63","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2020-103173"},{"key":"bib64","doi-asserted-by":"publisher","DOI":"10.1519\/JSC.0b013e3181a2d7b3"},{"key":"bib65","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2006.2244"},{"key":"bib66","doi-asserted-by":"publisher","DOI":"10.29333\/ejgm\/14285"},{"key":"bib67","doi-asserted-by":"publisher","DOI":"10.1136\/jisakos-2019-000288"},{"key":"bib68","doi-asserted-by":"publisher","DOI":"10.1016\/j.gaitpost.2016.11.005"},{"key":"bib69","doi-asserted-by":"crossref","DOI":"10.1590\/1516-3180.2022.0578.r1.06032023","volume":"142","author":"Romero-Morales C","year":"2023","journal-title":"Sao Paulo Med J."},{"key":"bib70","first-page":"378","volume":"36","author":"Rosene JM","year":"2001","journal-title":"J Athl Train."},{"key":"bib71","doi-asserted-by":"publisher","DOI":"10.3389\/fspor.2025.1510803"},{"key":"bib72","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.g7647","volume":"350","author":"Shamseer L","year":"2015","journal-title":"BMJ."},{"key":"bib73","volume":"15","author":"Sharma R","year":"2023","journal-title":"Cureus."},{"key":"bib74","doi-asserted-by":"publisher","DOI":"10.1016\/j.adolescence.2010.06.007"},{"key":"bib75","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0000000000000380"},{"key":"bib76","doi-asserted-by":"publisher","DOI":"10.1123\/jab.23.3.190"},{"key":"bib77","first-page":"i4919","volume":"355","author":"Sterne JAC","year":"2011","journal-title":"BMJ."},{"key":"bib78","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2015.5777"},{"key":"bib79","doi-asserted-by":"publisher","DOI":"10.2147\/OAJSM.S315162"},{"key":"bib80","doi-asserted-by":"publisher","DOI":"10.1055\/a-1870-4041"},{"key":"bib81","doi-asserted-by":"publisher","DOI":"10.1007\/s40279-019-01071-3"},{"key":"bib82","doi-asserted-by":"publisher","DOI":"10.3233\/IES-194201"},{"key":"bib83","doi-asserted-by":"publisher","DOI":"10.1080\/14763141.2020.1830160"},{"key":"bib84","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2022-105695"},{"key":"bib85","doi-asserted-by":"publisher","DOI":"10.1007\/s40279-019-01235-1"},{"key":"bib86","first-page":"87","volume":"45","author":"Vieira A","year":"2017","journal-title":"Physician Sportsmed."},{"key":"bib87","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.1993.17.2.102"},{"key":"bib88","doi-asserted-by":"crossref","unstructured":"Webb B Kenning JH Guzman A Slater L Mangum LC.  The lumbopelvic-hip complex contribution during lower extremity screening tests in elite figure skaters. J Athl Train. 2022;57:581\u2013585. https:\/\/doi.org\/10.4085\/1062-6050-0373.21","DOI":"10.4085\/1062-6050-0373.21"},{"key":"bib89","unstructured":"Wells GA Shea B O'Connell D Peterson J Welch V Losos M Tugwel P. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. 2021. Available at: https:\/\/www.ohri.ca\/programs\/clinical_epidemiology\/oxford.asp"},{"key":"bib90","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0000000000002913"}],"container-title":["JOSPT Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.jospt.org\/doi\/pdf\/10.2519\/josptopen.2025.0137","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T12:02:14Z","timestamp":1768478534000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.jospt.org\/doi\/10.2519\/josptopen.2025.0137"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":90,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.2519\/josptopen.2025.0137"],"URL":"https:\/\/doi.org\/10.2519\/josptopen.2025.0137","relation":{},"ISSN":["2832-8280"],"issn-type":[{"value":"2832-8280","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2026-01-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}