Effect of lower extremity muscular fatigue on motor control performance.

PURPOSE The purpose of this study was to determine whether lower extremity fatigue affects the ability of an individual to balance on an unstable platform. METHODS Twenty healthy subjects (average age, 29 yr, range, 20 to 39 yr) were tested on an instrumented balance assessment system. Static tests were done on the limbs unilaterally and then bilaterally, and finally a dynamic test was performed in which the subject moved the platform in a circular manner to chase a moving object on a computer screen. After testing, subjects were fatigued using an isokinetic dynamometer, which imposes closed kinetic chain antagonistic exercise on the ankle, knee, and hip, similar to a stair stepper. No rest was allowed, and subjects were fatigued to less than 50% of their initial tested force. Subjects were then immediately retested on the unstable platform using the same testing protocol. All subjects completed the testing. RESULTS Analysis of pre- and post-fatigue balance results demonstrated significant decreases in motor control performance on the three static tests following exercise to fatigue in all subjects (P < 0.001). CONCLUSIONS Our findings support anecdotal evidence that fatigued individuals are at increased risk of injury because of loss of balance. Avoidance of fatigue and preconditioning may prevent injury.

[1]  B. Andrew The sensory innervation of the medial ligament of the knee joint , 1954, The Journal of physiology.

[2]  P. Roland,et al.  A quantitative analysis of sensations of tension and of kinaesthesia in man. Evidence for a peripherally originating muscular sense and for a sense of effort. , 1977, Brain : a journal of neurology.

[3]  J. Kennedy,et al.  Nerve supply of the human knee and its functional importance , 1982, The American journal of sports medicine.

[4]  H. Skinner,et al.  Exercise-related knee joint laxity , 1986, The American journal of sports medicine.

[5]  R. D'ambrosia,et al.  The synergistic action of the anterior cruciate ligament and thigh muscles in maintaining joint stability , 1987, The American journal of sports medicine.

[6]  R. D'ambrosia,et al.  Muscular coactivation , 1988, The American journal of sports medicine.

[7]  H. Skinner,et al.  Proprioception in the anterior cruciate deficient knee , 1989, The American journal of sports medicine.

[8]  A. Lindstrand,et al.  Disability in anterior cruciate ligament insufficiency. An analysis of 19 untreated patients. , 1990, Acta orthopaedica Scandinavica.

[9]  D. Halliday,et al.  Fourier analysis of the relation between the discharge of quadriceps motor units and periodic mechanical stimulation of cat knee joint receptors , 1990, Experimental physiology.

[10]  H. Tropp,et al.  Function Testing in Patients with Old Rupture of the Anterior Cruciate Ligament , 1990, International journal of sports medicine.

[11]  H. Johansson,et al.  Receptors in the knee joint ligaments and their role in the biomechanics of the joint. , 1991, Critical reviews in biomedical engineering.

[12]  J. Polak,et al.  The distribution of peptide-containing nerves in the synovia of the cat knee joint. , 1991, Histology and histopathology.

[13]  P. Katonis,et al.  The innervation of the human meniscus. , 1992, Clinical orthopaedics and related research.

[14]  M. Pitman,et al.  The intraoperative evaluation of the neurosensory function of the anterior cruciate ligament in humans using somatosensory evoked potentials. , 1992, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[15]  J. Ralphs,et al.  The joint capsule: structure, composition, ageing and disease. , 1994, Journal of anatomy.

[16]  A. Lindstrand,et al.  The Effect of Physiotherapy on Standing Balance in Chronic Anterior Cruciate Ligament Insufficiency , 1994, The American journal of sports medicine.

[17]  S. Lephart,et al.  Functional rehabilitation for the upper and lower extremity. , 1995, The Orthopedic clinics of North America.

[18]  A. K. Aune,et al.  Hamstrings and gastrocnemius co‐contraction protects the anterior cruciate ligament against failure: An in vivo study in the rat , 1995, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[19]  W. Tatton,et al.  Joint receptors modulate short and long latency muscle responses in the awake cat , 2004, Experimental Brain Research.