Sex differences in wrist strength: a systematic review

Sex differences in strength have been attributed to differences in body anthropometrics and composition; these factors are often ignored when generating workplace guidelines. These differences directly impact the upper extremity, leaving female workers exposed to injury risk. The wide range of tools and techniques for measuring upper extremity strength presents a challenge to ergonomists and work task designers; collating outcomes to provide a clear outlook of differences between males and females is essential and the purpose of this work. Four online databases were searched (PROSPERO ID: CRD42022339023) with a focus on articles assessing sex differences in wrist strength. A total of 2,378 articles were screened for relevancy; 25 full-text articles were included in this systematic review. Articles examined movement pairs (ulnar/radial deviation, pronation/supination, and flexion/extension), as well as contraction types (isometric and isokinetic) to observe sex differences in wrist strength. Across all articles, females produced ∼60-65% of male flexion/extension strength, ∼55-60% pronation/supination strength, and ∼60-70% ulnar/radial deviation strength. Overall, females presented lower strength-producing abilities than males, but when considering strength relative to body mass, male-female differences were less pronounced and occasionally females surpassed male strength metrics; typically, this occurred during flexion/extension, particularly in isokinetic contractions. This review has identified a scarcity of articles examining ulnar/radial deviation, pronation/supination, as well as isokinetic contractions; these are needed to supplement workplace exposure guidelines.