The effect of limb dominance on change of direction biomechanics : a systematic review of its importance for injury risk

Objective:To critically evaluate the effect of limb dominance on change of direction (COD) biomechanicsassociated with increased ACL injury-risk.Methods:A systematic review of the literature was conducted using Medline and Sport DISCUS data-bases. Studies that compared COD biomechanics (lower-limb/whole-body kinetics/kinematics) betweenlimbs, contained an approach run, and included physically active participants were included.Results:Of the 456 articles identified, six were included. All studies investigated a cutting action, whilethe majority defined limb dominance as the preferred kicking limb, whereas one study defined limbdominance as preferred push-off cutting limb. Conflicting observations were found, with one studyindicating the non-dominant and one study indicating the dominant limb displayed biomechanicaldeficits associated with increased non-contact ACL injury-risk during COD. Conversely, the remainingstudies demonstrated no significant or substantial differences in COD biomechanics between limbs.Conclusions:Female soccer players, male rugby players, and female handball players exhibit subtle side-to-side differences when performing cutting manoeuvres. However, the limb displaying high-risk me-chanics is inconsistent within and between studies and populations. Thus, it remains inconclusive forCOD that limb dominance is an ACL injury-risk factor and whether a particular limb is of heightenedinjury-risk.Level of evidence:Level 2, Systematic revie