Background Attention has turned into the role of proximal risk factors in the development of lower extremity (LE) injury.

Objective To prospectively identify hip strength associated risk factors contributing to the development of LE injury.

Design Prospective cohort design.

Setting Department of Physical Education at the University of Ghent, Belgium.

Participants Ninety-four healthy, female physical education students aged 19.53±1.07 years were tested.

Assessment of Risk Factors Testing included isokinetic hip strength measurements of abductors, adductors, internal rotators and external rotators.

Main Outcome Measurements The LE injury follow-up of the subjects was assessed using a weekly online questionnaire and a three-monthly retrospective control questionnaire. Lower extremity injury was diagnosed by an experienced M.D. (Doctor of Medicine). Cox regression analysis was used to identify the potential risk factors for the development of LE injury.

Results Thirty-four subjects were diagnosed with LE injury during follow-up. The results of this study identified that decreased average power (AVP) (P=0.031) for concentric external rotation strength was found to be a significant risk factor for LE injury. No other hip strength parameters were found to be significant contributors to the development of LE injury.

Conclusions Decreased AVP of the hip external muscles was identified as a significant predictor for LE injury in females, whereas no peak torque parameters were found to be of predictive value. A stabilizing muscle group such as the gluteal muscle group might be more challenged in a functional outcome measure then in a peak outcome measure. AVP might be therefore be considered as a more accurate parameter to evaluate strength of stabilizing muscles.