A systematic review of the physiological and biomechanical differences between males and females in response to load carriage during walking activities.

The purpose of this review was to systematically assess literature on differences between males and females in the physiological and biomechanical responses to load carriage during walking. PubMed, CINAHL, Scopus, Web of Science and the Cochrane library were searched. A total of 4637 records were identified and screened. Thirty-three papers were included in the review. Participant characteristics, load carriage conditions, study protocol, outcome measures and main findings were extracted and qualitatively synthesised. Absolute oxygen uptake and minute ventilation were consistently greater in males but there were limited sex-specific differences when these were expressed relative to physical characteristics. There is limited evidence of sex-specific differences in spatio-temporal variables, ground reaction forces (normalised to body mass) or sagittal plane joint angles with load. However, differences have been found in hip and pelvic motions in the frontal and horizontal planes, which might partly explain an economical advantage for females proposed by some authors.