Menstrual Cycle Phase Influences Static Postural Control Under Single-Leg and Visual Deprivation Conditions

L. Cuéllar Marín, R. Coto Martín, N. Pérez Mallada, M.J. Martínez Beltrán, E. Benito-Martínez, S. Rodríguez García

Applied Sciences Vol. 16, nº. 11, pp. 5625

Summary:

Anterior cruciate ligament (ACL) injuries are highly prevalent in sports and occur more frequently in female athletes, potentially due to hormonal influences across the menstrual cycle. This study aimed to analyze static postural control across menstrual cycle phases under varying postural and sensory demands. A longitudinal repeated-measures design was conducted in 22 healthy women (18–30 years) with regular menstrual cycles and moderate physical activity levels. Static balance was assessed using a Zebris pressure platform across three menstrual phases (follicular, ovulatory, luteal), three stance conditions (bipedal, dominant and non-dominant single-leg), and two visual conditions (eyes open and closed). Center of pressure variables included confidence area, velocity, and anteroposterior and mediolateral displacement. Differences between phases were analyzed using the Friedman test with Wilcoxon post hoc comparisons and Kendall’s W effect size. No significant differences were observed in bipedal stance or under eyes-open conditions. However, under eyes-closed single-leg conditions, significant phase-dependent differences emerged. In dominant-leg stance, greater instability during the ovulatory phase was found for mediolateral displacement (p < 0.001;W = 0.321), anteroposterior displacement (p = 0.007;W = 0.223), confidence area (p < 0.001;W= 0.378), and velocity (p = 0.048; W = 0.138). Similar results were observed in the non-dominant leg for mediolateral displacement (p = 0.03; W = 0.159) and confidence area (p = 0.002; W = 0.287). These findings indicate that menstrual cycle phase influences postural control primarily under increased sensory and postural demands. The ovulatory phase appears to be associated with reduced stability when visual input is removed, suggesting a transient decrease in sensorimotor efficiency and a potential increase in neuromuscular vulnerability related to ACL injury risk.

Spanish layman's summary:

Analizar el control postural estático en las distintas fases del ciclo menstrual bajo diversas demandas posturales y sensoriales. La fase ovulatoria parece estar asociada con menor estabilidad una disminución de la eficiencia sensoriomotora relacionada con mayor riesgo de lesión.

English layman's summary:

To analyze static postural control in the different phases of the menstrual cycle under various postural and sensory demands. The ovulatory phase appears to be associated with less stability and a decrease in sensorimotor efficiency related to a higher risk of injury.

Keywords: menstrual cycle; postural control; anterior cruciate ligament; injury risk

JCR-JIF Impact Factor and WoS quartile: 2,900 - Q2 (2025)

DOI reference: https://doi.org/10.3390/app16115625

Published on paper: June 2026.

Published on-line: June 2026.

Citation:
L. Cuéllar Marín, R. Coto Martín, N. Pérez Mallada, M.J. Martínez Beltrán, E. Benito-Martínez, S. Rodríguez García, "Menstrual Cycle Phase Influences Static Postural Control Under Single-Leg and Visual Deprivation Conditions", Applied Sciences, Vol. 16, nº. 11, pp. 5625, June 2026. [Online: June 2026] doi: 10.3390/app16115625