Effects of two neuromuscular fatigue protocols on landing performance

Tactile stimulation restores inhibited stretch reflex attributable to attenuation of Ia afferents during surprise landing

Arthrogenic muscle inhibition (AMI) is induced by pathological knee conditions. The present study aimed to investigate the effect of tactile stimulation on reflex changes induced by simulated AMI during unpredictable landing performances. Twenty participants performed six unilateral landing tasks: 15 cm normal landing (15NL), 30 cm normal landing (30NL), surprise landing (SL), 30 cm normal landing following vibration (30NLV), SL following vibration (SLV), and SL following vibration with Kinesiology tape (SLK). For SL, the solid landing platform (15 cm) was removed and replaced by a false floor. Since the false floor dislodged easily under load, participants unpredictably fell through the platform to the actual landing surface 15 cm below. After completing 15NL, 30NL, and SL, vibration was applied to participants' knees to induce neurological changes similar to AMI. After vibration, participants performed 30NLV, SLV, and SLK in a random order. EMG signals in the post-landing short latency (31-60 ms) and medium latency (61-90 ms) periods were examined. EMG signals from the vastus lateralis (VL), vastus medialis (VM), and biceps femoris (BF) were recorded and compared between tasks. EMG signals of all muscles in SL were significantly enhanced in the medium latency period as compared with 30NL. Enhanced EMG signals in SL were suppressed by vibration stimulation in the VL, but the suppressed EMG signals were restored after cutaneous stimulation with Kinesiology tape (p < 0.01). Our findings suggest that AMI could alter motor control patterns during unpredictable landing and that tactile stimulation could restore the altered motor control to a normal state.

Preparing to Land: Hamstring Preactivation Is Higher in Females and Is Inhibited by Fatigue

The hamstring plays an important role in reducing loads born by the anterior cruciate ligament. As anterior cruciate ligament injuries occur rapidly after ground contact, how the hamstring is activated prior to landing can influence injury risk. The purpose was to determine sex-related differences in hamstring activation immediately before landing and the effect of fatigue on "preactivation." Twenty-four participants (13 males and 11 females, age = 24.3 [6.5] y, mass = 72.2 [19.3] kg, height = 169 [9.7] cm) participated in this study. Participants completed a drop-vertical jump protocol before and after a lower body fatigue protocol. Hamstring electromyography (EMG) amplitude at 5 periods prior to landing, peak vertical ground reactions forces (in newtons/body weight), rate of loading (in body weight/second), and landing error scoring system were measured. Females had higher EMG amplitude before and after fatigue (P < .024), with decreased EMG amplitude for both sexes after fatigue (P = .025). There was no change on vertical ground reaction force, rate of loading, or landing error scoring system. Males and females demonstrated similar landing performance before and after fatigue but have different hamstring neuromuscular coordination strategies. The acute reduction in hamstring EMG amplitude following fatigue may increase loading on the anterior cruciate ligament.

Gait analysis of leprosy patients with foot drop using principal component analysis

BACKGROUND

Peripheral nerve injury caused by leprosy can lead to foot drop, resulting in an altered gait pattern that has not been previously described using 3D gait analysis.

METHODS

Gait kinematics and dynamics were analyzed in 12 patients with unilateral foot drop caused by leprosy and in 15 healthy controls. Biomechanical data from patients' affected and unaffected limbs were compared with controls using inferential statistics and a standard distance, based on principal components analysis (PCA).

FINDINGS

Patients walked slower than controls (0.8 ± 0.2 vs. 1.1 ± 0.2 m/s, p = 0.003), with a reduced stance and increased swing percentage. The affected limb increased (p < 0.05) plantar flexion at the initial contact (-16.8^o ± 8.3), terminal stance (-29.1^o ± 11.5), and swing (-12.4^o ± 6.2) in the affected limb compared to unaffected (-6.6^o ± 10.3; -14.6^o ± 11.6; 2.4^o ± 7.6) and controls (-5.4^o ± 2.5; -18.8^o ± 5.8; -1.4^o ± 3.9). Increased pelvic tilt and knee adduction/abduction range, with lower hip adduction, were observed. The second peak of ground reaction force (98.6 ± 5.2 %BW), ankle torque (0.99 ± 0.33 Nm/kg), and net ankle work in stance (-0.03 ± 5.4 J/Kg) decreased in the affected limb compared to controls (104.1 ± 5.5 %BW; 1.24 ± 0.4 Nm/kg; -4.58 ± 5.19 J/kg; p < 0.05). There were decreasing multivariate standard distances in the affected limb compared with the unaffected and controls. PCA loading factors highlighted the major differences between groups.

INTERPRETATION

Leprosy patients with foot drop presented altered gait patterns in affected and unaffected limbs. There were remarkable differences in ankle kinematics and dynamics. Rehabilitation devices, such as ankle foot orthosis or tendon transfer surgeries to increase ankle dorsiflexion, could benefit these patients and reduce deviations from normal gait.

Effects of Kinesio taping on calf muscle fatigue in college female athletes: A randomized controlled trial

BACKGROUND

Fatigue is a common phenomenon encountered by athletes in ordinary life and sports. Fatigue results in decreased muscle strength, balance, agility, and an increased risk of injury, which together results in hampered sports performance. Several studies have examined the effects of Kinesio Tape (KT) application on muscle fatigue however, contradictory findings are reported. This study aimed to examine the effects of the application of KT on calf muscle fatigability.

METHODS

A three-arm parallel pretest-post-test experimental design was used. Forty-five collegiate female athletes (mean age of 20.57 years) were randomly assigned to three groups. For the experimental group, KT with 50% tension; for the sham group, KT without any tension; and for the placebo group, rigid tape without any tension was applied. The number of heel rises (HRn) was measured before and after taping in the three groups, using Haberometer and Metronome. The tapes were applied in the Y shape to the calf muscle region.

RESULTS

In the experimental group: The HRn significantly increased by 18.76 % (P = .000) after applying KT. In the sham and placebo groups: There was no change in HRn before and after Taping (P > .05).

CONCLUSION

Y-shaped application of KT with 50% tension over the calf muscle region is effective in reducing its fatigability.

The Impact of COVID-19 and Muscle Fatigue on Cardiorespiratory Fitness and Running Kinetics in Female Recreational Runners

Background: There is evidence that fully recovered COVID-19 patients usually resume physical exercise, but do not perform at the same intensity level performed prior to infection. The aim of this study was to evaluate the impact of COVID-19 infection and recovery as well as muscle fatigue on cardiorespiratory fitness and running biomechanics in female recreational runners.

Methods: Twenty-eight females were divided into a group of hospitalized and recovered COVID-19 patients (COV, n = 14, at least 14 days following recovery) and a group of healthy age-matched controls (CTR, n = 14). Ground reaction forces from stepping on a force plate while barefoot overground running at 3.3 m/s was measured before and after a fatiguing protocol. The fatigue protocol consisted of incrementally increasing running speed until reaching a score of 13 on the 6–20 Borg scale, followed by steady-state running until exhaustion. The effects of group and fatigue were assessed for steady-state running duration, steady-state running speed, ground contact time, vertical instantaneous loading rate and peak propulsion force.

Results: COV runners completed only 56% of the running time achieved by the CTR (p < 0.0001), and at a 26% slower steady-state running speed (p < 0.0001). There were fatigue-related reductions in loading rate (p = 0.004) without group differences. Increased ground contact time (p = 0.002) and reduced peak propulsion force (p = 0.005) were found for COV when compared to CTR.

Conclusion: Our results suggest that female runners who recovered from COVID-19 showed compromised running endurance and altered running kinetics in the form of longer stance periods and weaker propulsion forces. More research is needed in this area using larger sample sizes to confirm our study findings.

Dynamic postural control and physical stress: an approach to determining injury risk in real sporting conditions

Dynamic postural control is one of the essential factors in situations where non-contact injuries mainly occur, i.e., landing, cutting, or stopping. Therefore, testing of dynamic postural control should be implemented in injury risk assessment. Moreover, non-contact injuries mainly occur under loaded conditions when the athlete is physically stressed. Therefore, risk factors and mechanisms of these injuries should also be regarded under loading conditions and not only when the athlete is recovered. Current studies examining the influence of physical load on risk factors, such as dynamic postural control, often use cycling protocols to stress the participants. Nevertheless, most types of sports require running as a central element and the induced internal load after cycling might not be the same after running. Therefore, the current study aimed to examine the influence of a running and a cycling protocol on dynamic postural control and to determine the potential injury risk under representative conditions. In total, 128 sport students (64 males and 64 females, age: 23.64 ± 2.44, height: 176.54 ± 8.96 cm, weight: 68.85 ± 10.98 kg) participated in the study. They were tested with the Y Balance Test before and after one loading protocol. A total of 64 participants completed a protocol on a cycle ergometer and the other 64 on a treadmill. A mixed ANOVA showed significant interactions of time and load type. Dynamic postural control was reduced immediately after cycling but did not change after running. These findings indicate a load type dependence of dynamic postural control that must be considered while assessing an athlete’s potential injury risk and they support the need for more representative designs.

Heavy-intensity cycling and running work-rate associated to VO2max affects isokinetic strength, the dynamic control ratio but not the conventional H:Q ratio

BACKGROUND: Bilateral strength asymmetry and fatigue predispose athletes to various injuries and conventional methods appear to be poor predictors of lower extremity muscular performance under NF conditions. OBJECTIVE: The purpose of the study was to compare the conventional Hcon/Qcon (HQR) ratio and the dynamic control ratio (DCR: Hecc/Qcon) under non-fatiguing (NF) and fatiguing (F) conditions and verify the effects of heavy-intensity constant running and cycling exercise on the isokinetic performance. METHODS: Twenty healthy male participants performed running and cycling VO2max at work-rate associated with the achievement of VO2max (TTE). Isokinetic muscle strength performance was tested at 60 and 180∘/s before and after these sessions with 48-hour intervals. Quadriceps (QFR) and hamstring (HFR) muscle fatigue rates were also calculated during these sessions. Blood lactate concentration was measured before and two-minutes after running and cycling TTE. RESULTS: No between-condition differences were found for the HQR while the DCR decreased significantly at 180∘/s following cycling and running sessions (p< 0.05). Cycling TTE was positively correlated with in dominant (r= 0.535, p= 0.015) and non-dominant (r= 0.446, p= 0.048) QFR. Positive correlations were also found between running TTE and dominant (r= 0.500, p= 0.25) and non-dominant (r= 0.465, p= 0.039) HFR. CONCLUSIONS: The DCR obtained at fast angular velocities following a strenuous exercise seems to be the best indicator of muscle performance while its assessment under F conditions reveals higher ratios compared to NF conditions and conventional methods.

Postural Control Responses to Different Acute and Chronic Training Load Profiles in Professional Rugby Union

ABSTRACT

Troester, JC and Duffield, R. Postural control responses to different acute and chronic training load profiles in professional rugby union. J Strength Cond Res 36(1): 220-225, 2022-The current investigation identified the response of postural control (PC) measures of single-leg balance and landing to different accumulated training load profiles representing normal, higher, and spiked loads. Twenty-two professional rugby union players performed single-leg balance and landing tests on a 1,000-Hz force plate on the first training day of 24 weeks across the season after 36 hours of recovery. Internal (session rating of perceived exertion training load) and external (total and high-speed running distance) load measures were monitored during all training sessions and matches. Calculations of acute (7-day rolling average), chronic (28-day rolling average), and acute-to-chronic workload ratio were determined. Three-week load profiles were identified that represented normal, spike, and higher load profiles to determine the effect on PC, which were analyzed using 2-way repeated-measures analysis of variance. A significant effect of load profile on landing impulse on the dominant (p = 0.005) and nondominant legs (p = 0.001) was identified, with significantly greater impulse measures in the spike and higher load profiles (p = 0.001-0.041) compared with the normal load profile. Significant load profile × week interactions (p < 0.05) were identified for landing peak force on the dominant leg and impulse on both legs suggesting a decrement during the spike load profile and increased impulse in the higher load profile. No effects (p > 0.05) were identified for load profile changes in single-leg balance sway velocity or single-leg landing time to stabilization. The respective landing responses may indicate altered movement strategies under spike and higher load profiles resulting from neuromuscular fatigue in response to the accumulated load.

Fatigue and recovery have different effects on knee biomechanics of drop vertical jump between female collegiate and recreational athletes

Background

Although fatigue is known as one of the risk factors for noncontact anterior cruciate ligament injury, the effects of fatigue and recovery can be different based on the level of competition. However, it is unknown whether female recreational athletes are susceptible to fatigue or not, compared to female collegiate athletes with greater physical activity. The purpose of the present study was to examine and clarify the effects of fatigue and recovery on knee biomechanics of the drop vertical jump (DVJ) in female recreational athletes compared to female collegiate athletes.

Methods

Fifteen female collegiate athletes and ten female recreational athletes were enrolled in the current study. All subjects were basketball players and Tegner activity scales were level 9 and 7, respectively. They performed DVJ before and after the fatigue protocol. Three-dimensional knee kinematics and kinetics were collected during landing phase of DVJ. The data after the fatigue protocol (first, second, and third DVJs) were compared with those before the protocol using one-way repeated measures of analysis of variance in each group.

Results

Fatigue caused significant increase of knee abduction angle at initial contact (IC) and peak abduction moments within 40 ms from IC in female recreational athletes, whereas no increases of these parameters were observed in female collegiate athletes. Moreover, recovery from fatigue seemed to be more slowly in female recreational athletes than in female collegiate athletes as smaller knee flexion moment was observed even in post-fatigue third DVJ only for female recreational athletes.

Conclusions

Effects of fatigue on DVJ were significantly greater and continued for a longer duration in female recreational athletes compared to female collegiate athletes.

The effect of fatigue on jump height and the risk of knee injury after a volleyball training game: A pilot study

Study aim: To investigate the effect of fatigue, induced by a volleyball training game on the risk of Anterior Cruciate Ligament (ACL) injury.

Material and methods: Thirteen female volleyball college athletes, ages 18 to 21 years old, completed jump landings from a box 30 cm height, prior and post a 60-minute volleyball training game. The clinical tool Landing Error Scoring System (LESS) was employed in order to evaluate the technique of landing prior and post the game. The level of fatigue induced by the volleyball game was assessed by vertical jump test and Borg Rating of Perceived Exertion (RPE) Scale pre and post-game. In order to compare measurements pre and post-game t-tests for dependent samples were used.

Results: Participants performed lower vertical jumps post-game with a Confidence Interval of 26.2 ± 2.3 cm (pre-game) and 24.9 ± 2.2 cm (post game). The difference between pre and post-game was found to be statistically significant with a t12 = 2.55 and a p-value of 0.026. In the case of assessing fatigue, the Borg RPE scale scores were found to be statistically significant (t12 = 14.05, p < 0.001) higher post-game (10.2 ± 0.6), as compared to pre-game (6.5 ± 0.4). Similarly, LESS scores increased significantly (t12 = 2.21, p = 0.047), post-game (6.3 ± 1.1) compared to pre-game (5.8 ± 1.0) that prove poorer landing ability.

Conclusion: It seems that a short duration volleyball training game induces fatigue and negatively affects the jumping and landing ability.

Progression of Fatigue Modifies Primary Contributors to Ground Reaction Forces During Drop Landing

Few studies have focused on the effect of fatigue severity on landing strategy. This study aimed to investigate the effect of fatigue progression on ground reaction force during landing. Eighteen participants performed a fatigue exercise protocol. Then participants performed drop landings at three levels of fatigue: no fatigue, medium fatigue, and severe fatigue. Multiple linear regression was conducted to identify the predictors of the peak vertical ground reaction force at each level of fatigue. Two-way ANOVAs were conducted to test the effect of fatigue on the vertical ground reaction force and the predictors. For the vertical ground reaction force, the knee joint stiffness and the knee angle at initial contact were the main predictors at no fatigue. The peak knee flexion angle and knee power were the main predictors at medium fatigue. However, the peak ankle plantarflexion moments became the main predictor at severe fatigue. The vertical ground reaction force decreased from no to medium fatigue (p = 0.001), and then increased from medium to severe fatigue (p = 0.034). The knee joint stiffness decreased from no to medium fatigue (p = 0.049), and then remained unchanged from medium to severe fatigue. The peak knee flexion angle increased from no to medium fatigue (p = 0.001), and then slightly decreased from medium to severe fatigue (p = 0.051). The results indicate that fatigue progression causes a transition from stiff to soft landing, and then to stiff landing. Participants used ankle joints more to control the landing intensity at severe fatigue.

Muscle Tone and Body Weight Predict Uphill Race Time in Amateur Trail Runners

Background: Vertical kilometer is an emerging sport where athletes continuously run uphill. The aims of this study were to assess changes in vertical impacts caused by uphill running (UR) and the relation between the anthropometric and lower limb muscular characteristics with speed. Methods: Ten male experienced runners (35 ± 7 years old) participated in this study. In the racetrack (4.2 km long, 565 m high), seven sections were stablished. Mean speed and impact value of sections with similar slope (≈21%) were calculated. The gastrocnemius stiffness (GS) and tone (GT); and the vastus lateralis stiffness (VS) and tone (VT) were assessed before the race. Results: Pearson’s correlation showed a linear relationship between vs. and VT (r = 0.829; p = 0.000), GT and GS (r = 0.792; p = 0.001). Mean speed is correlated with weight (r = −0.619; p = 0.024) and GT (r = 0.739; p = 0.004). Multiple linear regressions showed a model with weight and GT as dependent variables of mean speed. Mean impacts decreased significantly between sections along the race. Conclusions: The vertical impacts during UR were attenuated during the race. Moreover, body weight and GT were associated with the time-to-finish, which supports that low weight alone could not be enough to be faster, and strength training of plantar flexors may be a determinant in UR.

Restrictions in Ankle Dorsiflexion Range of Motion Alter Landing Kinematics But Not Movement Strategy When Fatigued

CONTEXT

Ankle dorsiflexion range of motion (DF ROM) has been associated with a number of kinematic and kinetic variables associated with landing performance that increase injury risk. However, whether exercise-induced fatigue exacerbates compensatory strategies has not yet been established.

OBJECTIVES

(1) Explore differences in landing performance between individuals with restricted and normal ankle DF ROM and (2) identify the effect of fatigue on compensations in landing strategies for individuals with restricted and normal ankle DF ROM.

DESIGN

Cross-sectional.

SETTING

University research laboratory.

PATIENTS OR OTHER PARTICIPANTS

Twelve recreational athletes with restricted ankle DF ROM (restricted group) and 12 recreational athletes with normal ankle DF ROM (normal group).

MAIN OUTCOME MEASURE(S)

The participants performed 5 bilateral drop-landings, before and following a fatiguing protocol. Normalized peak vertical ground reaction force, time to peak vertical ground reaction force, and loading rate were calculated, alongside sagittal plane initial contact angles, peak angles, and joint displacement for the ankle, knee, and hip. Frontal plane projection angles were also calculated.

RESULTS

At the baseline, the restricted group landed with significantly less knee flexion (P = .005, effect size [ES] = 1.27) at initial contact and reduced peak ankle dorsiflexion (P < .001, ES = 1.67), knee flexion (P < .001, ES = 2.18), and hip-flexion (P = .033, ES = 0.93) angles. Sagittal plane joint displacement was also significantly less for the restricted group for the ankle (P < .001, ES = 1.78), knee (P < .001, ES = 1.78), and hip (P = .028, ES = 0.96) joints.

CONCLUSIONS

These findings suggest that individuals with restricted ankle DF ROM should adopt different landing strategies than those with normal ankle DF ROM. This is exacerbated when fatigued, although the functional consequences of fatigue on landing mechanics in individuals with ankle DF ROM restriction are unclear.

Stretch reflex changes in ACL-deficient individuals and healthy controls during normal and surprise landings

No studies in ACL-D individuals have examined neuromuscular adaptations during landing from a jump where an unexpected mechanical event changes the pre-programmed course of movement. The purpose of this study was to compare pre- and post-landing muscle activation in ACL-D individuals and uninjured controls during normal and surprise landings. Nineteen ACL-D and 17 uninjured volunteered. Participants performed repeated single leg landings from 30 and 15 cm heights. During 15 cm landings, a single surprise landing was performed where participants unexpectedly fell through a false surface at 15 cm to the solid floor a further 15 cm below. Electromyography (EMG) amplitude from vastus lateralis (VL), lateral hamstrings (LH), and soleus (Sol) was recorded. Pre-landing (-60 to 0 ms), post-landing short latency (31-60 ms), and post-landing medium latency (61-90 ms) periods were examined. Comparisons in EMG amplitudes were made across limbs (ACL-D, ACL intact, and control) in 30 cm landings. Additionally, the ratio of EMG amplitude in surprise:30 cm normal landings was analyzed. Post-landing LH EMG was reduced in the ACL-D compared to control limbs at short latencies (P < 0.05). Post-landing VL EMG was reduced in the ACL-D and ACL intact compared to the control limb at both latencies (P < 0.05). Surprise landings notably increased post-landing EMG in all muscles, across all limbs (P < 0.001). However, the gain in VL EMG was significantly greater in ACL-D and ACL intact limbs (P < 0.05). These changes in neuromuscular control of ACL-D individuals during expected and surprise landings may have important implications for rehabilitation, instability, and the risk of secondary injury.

Motion-control shoes help maintaining low loading rate levels during fatiguing running in pronated female runners

BACKGROUND

The use of motion-control shoes may assist pronated runners to maintain their stability throughout a fatiguing running. However, there are no studies describing the effects of fatigue on running biomechanics of runners with pronated feet.

RESEARCH QUESTION

Whether motion-control shoes can assist pronated recreational female runners to maintain impact loading patterns following a fatiguing protocol?

METHODS

Twenty-two female rearfoot runners with foot pronation were asked to perform a fatiguing treadmill running protocol using a neutral shoe or a motion-control shoe in two separate occasions. Before (Pre-fatigue) and after the fatiguing protocol (Post-fatigue), participants were asked to run overground on a track that contained two force platforms to record ground reaction forces and moments. Running speed were 3.3 m s^-1 (±2.5% variability). The effects of shoe type and fatigue were investigated on the peak vertical impact ground reaction force (pvIGRF), time to reach pvIGRF, vertical loading rate (LR) and peak negative foot free moments (FM).

RESULTS

Pronated runners presented lower LR with motion-control shoes compared to neutral shoes Pre- (p < 0.005; -18 ± 25%) and Post-fatigue (p < 0.001; -27 ± 15%). This change in LR was predominantly driven by a longer time to reach pvIGRF with motion-control shoes (p < 0.001, 39%). The pvIGRF and LR increased after fatiguing running with neutral shoes (pvIGRF: p < 0.05; 18 ± 28%; LR: p < 0.05; 15 ± 22%), but not with motion-control shoes. Furthermore, there were strong correlations between FM and LR for both Pre-fatigue (r=-0.61, p < 0.005) and Post-fatigue measurements (r=-0.66, p < 0.01), but only for the motion-control shoes.

SIGNIFICANCE

These results suggest that motion-control shoes prevent exacerbated fatigue-related increases in mechanical loading following initial contact in pronated female runners.

Monitoring residual 36 h post-match neuromuscular fatigue in rugby union; a role for postural control?

The present study investigated single-leg balance and landing measures, respectively, at the beginning of a weekly micro-cycle 36 h after a match compared to 48 h rest without any match load. Twenty-seven professional rugby union players performed balance and landing tests on a 1000 Hz force plate across three in-season micro-cycles either with or without match loads in the prior 36 h. Participants were further sub-divided into higher and lower match load groups to investigate changes in balance and landing variables. Differences between rested and 36 h post-match single-leg balance sway velocity were trivial in all cases, except for the higher-load group on the dominant leg, which were possibly impaired 36 h post-match (ES ± 90% CL = 0.68 ± 0.66). Differences between rested and 36 h post-match single-leg landing measures of relative impulse on the non-dominant leg were possibly lower (0.36 ± 0.34), with possible impairment observed on both legs in the higher load group 36 h post-match (0.39 ± 0.33; 0.49 ± 0.42). Differences in landing measures of peak force and time to stabilisation were mainly trivial (ES < 0.20). Postural control measures at 36 h post-match are comparable to a rested state; though impairment of sway velocity on the dominant leg and landing impulse may indicate residual neuromuscular fatigue resulting from increased match exposure.

The combined impact of a perceptual-cognitive task and neuromuscular fatigue on knee biomechanics during landing

BACKGROUND

A large majority of anterior cruciate ligament (ACL) injuries are non-contact, most often occurring during a landing or change of direction. Recent research indicates that cognitive factors may be involved in non-contact ACL injuries. The aim of this study was to determine if a game-situation perceptual-cognitive load leads to altered landing kinematics in physically fatigued female athletes.

METHODS

Nineteen female recreational athletes were recruited to perform a series of jumping and landing trials. In a first phase, eight trials were performed in an isolated condition and eight were performed while participants performed a perceptual-cognitive task. Before a second identical phase, participants underwent a muscular fatigue protocol. Knee-joint kinematics were recorded and compared between conditions using paired t-tests.

RESULTS

Muscle fatigue led to statistically significant increases in peak knee abduction and peak internal knee rotation as well as a decrease in maximum knee flexion, when comparing conditions without the perceptual-cognitive task. The perceptual-cognitive task had no statistically significant effect on any knee rotations, either pre- or post-fatigue. However, a subgroup of 12 athletes showed a significant increase in knee abduction in the presence of the perceptual-cognitive task, only in the fatigued condition.

CONCLUSION

A perceptual-cognitive task combined with muscle fatigue alters knee kinematics of landing for a subset of recreational athletes, potentially increasing the risk of ACL rupture. Further studies are necessary to confirm this finding and to identify characteristics of at-risk individuals to target them for injury prevention protocols.

The effect of knee flexor and extensor fatigue on shock absorption during cutting movements after a jump landing

BACKGROUND

Sporting situations include instances of continuous and/or integrated movements. However, the effect of fatigue on the performance of these movements remains unclear.

PURPOSE

To investigate the effect of knee flexor and extensor fatigue on the shock absorption strategy of the lower limb during cutting movements performed after jump landings.

METHODS

Twenty-four healthy participants performed cutting movements following jump landings from two heights - 30cm and 40cm - and under three levels of lower limb fatigue: pre-fatigue (100% peak knee extension torque), and post-fatigue 50% (post-50%) and 30% (post-30%) peak knee extension torque. Fatigue was induced by repeated isokinetic flexion/extension of the knee (60°/s).

RESULTS

Compared to the pre-fatigue condition, power and work at the knee joint decreased under both post-50% and post-30% conditions (P<0.001), while the work performed by the ankle (P<0.001) increased significantly. An increase in height from 30cm to 40cm was associated with an increase in the range of motion of the ankle (P<0.001) and knee (P=0.022), peak vertical ground reaction force (P<0.001), rate of loading (P<0.001), knee stiffness (P=0.026) and peak power of the knee (P<0.001), as well as the work performed by the knee (P<0.001) and hip (P<0.001) joints.

CONCLUSIONS

Under substantial muscle fatigue the proportion of shock absorption contributed by the knee for cutting movements performed after jump landings from a height of 40cm decreased; there was an adaptive increase in the contribution by the ankle.

Effects of Two Fatigue Protocols on Impact Forces and Lower Extremity Kinematics during Drop Landings: Implications for Noncontact Anterior Cruciate Ligament Injury

The purpose of the study was to determine the effects of fatigue on the impact forces and sagittal plane kinematics of the lower extremities in a drop landing task. 15 male collegiate athletes were recruited. Five successful trials of a drop landing task were obtained during prefatigue and postfatigue in two fatigue protocols (constant speed running fatigue protocol [R-FP] and shuttle running + vertical jumping fatigue protocol [SV-FP]). Duration time, maximal heart rate, and RPE of each protocol were measured separately. Kinematic measures of the hip, knee, and ankle joints at different times coupled with peak impact force and loading rate were acquired. Our results showed a more flexed landing posture due to an increase in hip and knee flexion angles in the postfatigue condition. However, no differences in peak impact force and loading rate were found between pre- and postfatigue conditions. The changes were similar between protocols, but the SV-FP showed a significantly shorter exercise duration time than the R-FP. Fatigued athletes in this study demonstrated altered motor control strategies during a drop landing task, which may be an intentional or unintentional protective strategy for preventing themselves from potential ACL injury.

Effects of Kinesio® Taping on Dynamic Balance Following Fatigue: a Randomized Controlled Trial

The objective of the study was to determine the effects of Kinesio taping (KT) in inhibiting fatigue and preserving dynamic balance. Male recreational athletes were recruited to participate in this study. Participants were blinded from the group assignment and divided into four groups (Group A; KT and fatigue, Group B; no tape and fatigue, Group C; KT and no fatigue and Group D; no tape and no fatigue) using sequentially opaque, sealed envelopes. Pre and post measurements of Modified Star Excursion Balance Test (SEBT) composite score and normalized reach distance were used to measure dynamic balance. Adapted Functional Agility Short Term Fatigue Protocol (FAST-FP) was used to induce fatigue. KT was applied to rectus femoris, biceps femoris and medial gastrocnemius of the dominant leg. There was a significant change in the SEBT composite score between groups over time (p<0.05) and in time effect (p<0.05). The main effect comparing the SEBT composite score between the group was not significant (p=0.16). Group A (90.10±9.40) and Group B (86.14±10.50) attained lower mean for SEBT composite score compared to Group C (97.30±10.83) and Group D (98.13±9.47) suggests that fatigue have a diminishing effect on dynamic balance. KT application inhibit the effects of fatigue and preserved lateral and posterior direction of SEBT. KT application may lower the risk for injuries in the lateral and posterior directions following fatigue induction.

Effects of Sex and Fatigue on Biomechanical Measures During the Drop-Jump Task in Children

Background:

Female athletes have a higher rate of anterior cruciate ligament (ACL) injury than males from adolescence and into maturity, which is suggested to result from sex-specific changes in dynamic movement patterns with maturation. Few studies have studied movement strategies and response to fatigue in children.

Purpose:

To evaluate the effect of fatigue on biomechanical variables associated with increased risk for ACL injury during a drop-jump (DJ) performance in children.

Study Design:

Controlled laboratory study.

Methods:

A total of 116 children (mean age, 10.4 years) were recruited from local sports clubs and performed 5 repetitions of a DJ task before and after a fatigue protocol. Kinematic and kinetic data from initial contact (IC) to the first peak vertical ground reaction force (vGRF) were analyzed for both limbs, including limb and fatigue as within-subject factors for analyses between boys and girls. Pearson correlation coefficients were calculated to identify associations between variables of interest.

Results:

Girls demonstrated greater peak vGRF values than boys (by 8.1%; P < .05), there were greater peak vGRF values for the right limb than the left (by 6.2%; P < .001), and fatigue led to slightly greater values (P < .05). Although weak, the correlation between peak vGRF values and knee flexion excursion was stronger for girls (r = –0.20) than boys (r = –0.08) (P < .006). Fatigue resulted in greater knee flexion angles at IC and less excursion during landing, more so for girls (by 6.1° vs 1.4°; interaction, P < .001), although the knee flexion moment was generally lowered by fatigue (P < .001). Limb asymmetry in knee flexion moments was more pronounced for boys than for girls (interaction, P < .05), contrary to that seen in frontal plane knee moments, where asymmetry was much greater in girls than boys (interaction, P < .001).

Conclusion:

Even as young athletes, girls and boys seem to adopt dissimilar movement strategies and are differently affected by fatigue.

Clinical Relevance:

Injury prevention programs should be considered at an earlier age in an effort to lower the risk of ACL injury in athletes.

Effect of short-term fatigue, induced by high-intensity exercise, on the profile of the ground reaction force during single-leg anterior drop-jumps

[Purpose] Fatigue may be an important contributing factor to non-contact anterior cruciate ligament injuries in sports. The purpose of this study was to evaluate the effects of controlled lower limb fatigue, induced by a short-term, high-intensity exercise protocol, on the profile of the ground reaction force during landings from single-leg anterior drop-jumps. [Subjects and Methods] Twelve healthy males, 18 to 24 years old, performed single-leg anterior drop-jumps, from a 20 cm height, under two conditions, ‘fatigue’ and ‘non-fatigue’. Short-term fatigue was induced by high-intensity interval cycling on an ergometer. Effects of fatigue on peak vertical ground reaction force, time-to-peak of the vertical ground reaction force, and loading rate were evaluated by paired t-test. [Results] Fatigue shortened the time-to-peak duration of the vertical ground reaction force by 10% (non-fatigue, 44.0 ± 16.8 ms; fatigue, 39.6 ± 15.8 ms). Fatigue also yielded a 3.6% lowering in peak vertical ground reaction force and 9.4% increase in loading rate, although these effects were not significant. [Conclusion] The effects of fatigue in reducing time-to-peak of the vertical ground reaction force during single-leg anterior drop-jumps may increase the risk for non-contact anterior cruciate ligament injury in males.

The acute effects of an intense stretch-shortening cycle fatigue protocol on the neuromechanical parameters of lower limbs in men and prepubescent boys

The study examined the differences between boys and adults after an intense stretch-shortening cycle fatigue protocol on neuromechanical parameters of the lower limb. Thirteen boys (9-11 years old) and 13 adult men (22-28 years old) were tested for maximal isometric voluntary knee extension torque and drop jump (DJ) performance from 30 cm before and immediately after a fatigue protocol, consisted of 10 × 10 maximum effort vertical jumps. Three-dimensional kinematics, kinetics and electromyographic (EMG) parameters of the lower extremities muscles were recorded during DJs before and after the fatigue test. The results indicated that reduction in maximal isometric torque and jumping performance was significantly higher in adults compared to boys. Vertical ground reaction forces, contact time and maximum knee flexion increased in a greater extend in adults than in boys. In addition, preactivation, EMG agonist activity, knee joint stiffness and stretch reflex decreased more in adults than in boys at all the examined phases of jumping tasks. It is concluded that employed fatigue protocol induced acute reduction in performance and altered motor control during jumping in both age groups. However, the differences in the level of fatigue between the 2 groups could be attributed to neuromuscular, mechanical and kinematic parameters observed between groups.

Effects of Volitional Spine Stabilization and Lower Extremity Fatigue on Trunk Control During Landing in Individuals With Recurrent Low Back Pain

STUDY DESIGN

Controlled laboratory study.

BACKGROUND

Recurrent low back pain (LBP) and neuromuscular fatigue are independently thought to increase the risk of spine injury. Volitional preemptive abdominal contraction (VPAC) is thought to improve lumbar spine and pelvis control in individuals with recurrent LBP. The effects of VPAC on fatigued landing performance in individuals with recurrent LBP are unknown.

OBJECTIVES

To determine the effects of VPAC and lower extremity fatigue on trunk control during landing in a population of individuals with recurrent LBP.

METHODS

Thirty-two recurrent LBP (mean ± SD age, 21.2 ± 2.7 years) and 33 healthy (age, 20.9 ± 2.3 years) subjects performed 0.30-m drop-jump landings with and without VPAC and fatigue. Trunk, pelvis, and hip biomechanical and electromyographic variables were obtained using 3-D motion capture. Hypotheses were tested using analysis of variance.

RESULTS

Volitional preemptive abdominal contraction resulted in significantly earlier muscle onsets across all muscles, with and without fatigue, in both groups (mean ± SD, 0.058 ± 0.019 seconds earlier; P≤.001) and altered lumbar lateral flexion (1.4° ± 14.8° greater right lateral flexion; P = .002). Fatigue significantly delayed muscle onsets (0.040 ± 0.014 seconds later; P≤.001) and altered pelvic obliquity (1.4° ± 11.0° greater; P≤.001) and trunk side flexion (2.0° ± 14.8° less; P≤.001). The recurrent LBP group exhibited delayed muscle onsets (0.039 ± 0.031 seconds later; P≤.004) and 4.2° less hip abduction at initial contact (P≤.008) in comparison to healthy controls.

CONCLUSION

Volitional preemptive abdominal contraction decreases some of the detrimental effects of fatigue on landing biomechanics and thus may reduce spine injury risk in individuals with recurrent LBP.

Fatigue and soft tissue vibration during prolonged running

Muscle tuning paradigm proposes that the mechanical properties of soft tissues are tuned in such a way that its vibration amplitude become minimized. Therefore, the vibrations of soft tissue are heavily damped. However, it has been hypothesized that the ability of muscle tuning decreases with fatigue. This study investigated the changes in vibration characteristics of soft tissue with fatigue. Vibrations of the gastrocnemius muscle of 8 runners during a prolonged run protocol on a treadmill at constant velocity (4 ms(-1)) were measured using a tri-axial accelerometer. The vibration amplitude is calculated using the Fourier transform and a wavelet-based method was used to calculate the damping coefficient. The results showed that: (1) the vibration amplitude in longitudinal direction increased with fatigue, which may be interpreted as the decreased muscle function with fatigue. (2) The amplitude increase percent strongly depended on the vibration frequency. (3) The damping coefficient of the gastrocnemius increased with fatigue. A 1-DOF mass-spring-damper model was used in order to validate the wavelet based method and simulate the observed phenomena.

What is normal? Female lower limb kinematic profiles during athletic tasks used to examine anterior cruciate ligament injury risk: a systematic review

BACKGROUND

It has been proposed that the performance of athletic tasks where normal motion is exceeded has the potential to damage the anterior cruciate ligament (ACL). Determining the expected or 'normal' kinematic profile of athletic tasks commonly used to assess ACL injury risk can provide an evidence base for the identification of abnormal or anomalous task performances in a laboratory setting.

OBJECTIVE

The objective was to conduct a systematic review of studies examining lower limb kinematics of females during drop landing, drop vertical jump, and side-step cutting tasks, to determine 'normal' ranges for hip and knee joint kinematic variables.

DATA SOURCES

An electronic database search was conducted on the SPORTDiscus(TM), MEDLINE, AMED and CINAHL (January 1980-August 2013) databases using a combination of relevant keywords.

STUDY SELECTION

Studies identified as potentially relevant were independently examined by two reviewers for inclusion. Where consensus could not be reached, a third reviewer was consulted. Original research articles that examined three-dimensional hip and knee kinematics of female subjects during the athletic tasks of interest were included for review. Articles were excluded if subjects had a history of lower back or lower limb joint injury or isolated data from the female cohort could not be extracted.

STUDY APPRAISAL AND SYNTHESIS METHODS

Two reviewers independently assessed the quality of included studies. Data on subject characteristics, the athletic task performed, and kinematic data were extracted from included studies. Studies were categorised according to the athletic task being examined and each study allocated a weight within categories based on the number of subjects assessed. Extracted data were used to calculate the weighted means and standard deviations for hip and knee kinematics (initial contact and peak values). 'Normal' motion was classified as the weighted mean plus/minus one standard deviation.

RESULTS

Of 2,920 citations, a total of 159 articles were identified as potentially relevant, with 29 meeting all inclusion/exclusion criteria. Due to the limited number of studies available examining double-leg drop landings and single-leg drop vertical jumps, insufficient data was available to include these tasks in the review. Therefore, a total of 25 articles were included. From the included studies, 'normal' ranges were calculated for the kinematic variables of interest across the athletic tasks examined.

LIMITATIONS

Joint forces and other additional elements play a role in ACL injuries, therefore, focusing solely on lower limb kinematics in classifying injury risk may not encapsulate all relevant factors. Insufficient data resulted in no normal ranges being calculated for double-leg drop land and single-leg drop vertical jump tasks. No included study examined hip internal/external rotation during single-leg drop landings, therefore ranges for this kinematic variable could not be determined. Variation in data between studies resulted in wide normal ranges being observed across certain kinematic variables.

CONCLUSIONS

The ranges calculated in this review provide evidence-based values that can be used to identify abnormal or anomalous athletic task performances on a multi-planar scale. This may be useful in identifying neuromuscular factors or specific muscular recruitment strategies that contribute to ACL injury risk.

Neuromuscular fatigue and tibiofemoral joint biomechanics when transitioning from non-weight bearing to weight bearing

CONTEXT

Fatigue is suggested to be a risk factor for anterior cruciate ligament injury. Fatiguing exercise can affect neuromuscular control and laxity of the knee joint, which may render the knee less able to resist externally applied loads. Few authors have examined the effects of fatiguing exercise on knee biomechanics during the in vivo transition of the knee from non-weight bearing to weight bearing, the time when anterior cruciate ligament injury likely occurs.

OBJECTIVE

To investigate the effect of fatiguing exercise on tibiofemoral joint biomechanics during the transition from non-weight bearing to early weight bearing.

DESIGN

Cross-sectional study.

SETTING

Research laboratory.

PATIENTS OR OTHER PARTICIPANTS

Ten participants (5 men and 5 women; age = 25.3 ± 4.0 years) with no previous history of knee-ligament injury to the dominant leg.

INTERVENTION(S)

Participants were tested before (preexercise) and after (postexercise) a protocol consisting of repeated leg presses (15 repetitions from 10°-40° of knee flexion, 10 seconds' rest) against a 60% body-weight load until they were unable to complete a full bout of repetitions.

MAIN OUTCOME MEASURE(S)

Electromagnetic sensors measured anterior tibial translation and knee-flexion excursion during the application of a 40% body-weight axial compressive load to the bottom of the foot, simulating weight acceptance. A force transducer recorded axial compressive force.

RESULTS

The axial compressive force (351.8 ± 44.3 N versus 374.0 ± 47.9 N; P = .018), knee-flexion excursion (8.0° ± 4.0° versus 10.2° ± 3.7°; P = .046), and anterior tibial translation (6.7 ± 1.7 mm versus 8.2 ± 1.9 mm; P < .001) increased from preexercise to postexercise. No significant correlations were noted.

CONCLUSIONS

Neuromuscular fatigue may impair initial knee-joint stabilization during weight acceptance, leading to greater accessory motion at the knee and the potential for greater anterior cruciate ligament loading.

Lower extremity fatigue, sex, and landing performance in a population with recurrent low back pain

CONTEXT

Low back pain and lower extremity injuries affect athletes of all ages. Previous authors have linked a history of low back pain with lower extremity injuries. Fatigue is a risk factor for lower extremity injuries, some of which are known to affect female athletes more often than their male counterparts.

OBJECTIVE

To determine the effects of lower extremity fatigue and sex on knee mechanics, neuromuscular control, and ground reaction force during landing in people with recurrent low back pain (LBP).

DESIGN

Cross-sectional study.

SETTING

A clinical biomechanics laboratory.

PATIENTS OR OTHER PARTICIPANTS

Thirty-three young adults with recurrent LBP but without current symptoms.

INTERVENTION(S)

Fatigue was induced using a submaximal free-weight squat protocol with 15% body weight until task failure was achieved.

MAIN OUTCOME MEASURE(S)

Three-dimensional knee motion, knee and ankle moments, ground reaction force, and trunk and lower extremity muscle-activity measurements were collected during 0.30-m drop vertical-jump landings.

RESULTS

Fatigue altered landing mechanics, with differences in landing performance between sexes. Women tended to have greater knee-flexion angle at initial contact, greater maximum knee internal-rotation angle, greater maximum knee-flexion moment, smaller knee-adduction moment, smaller ankle-inversion moment, smaller ground reaction force impact, and earlier multifidus activation. In men and women, fatigue produced a smaller knee-abduction angle at initial contact, greater maximum knee-flexion moment, and delays in semitendinosus, multifidus, gluteus maximus, and rectus femoris activation.

CONCLUSIONS

Our results provide evidence that during a fatigued 0.30-m landing sequence, women who suffered from recurrent LBP landed differently than did men with recurrent LBP, which may increase women's exposure to biomechanical factors that can contribute to lower extremity injury.

Eletromiografia do bíceps braquial em contrações dinâmicas

INTRODUÇÃO: A reprodutibilidade da atividade eletromiográfica de superfície (EMG) é mais estudada em protocolos que envolvem contrações isométricas. Alguns fatores relacionados às contrações dinâmicas podem contribuir para a instabilidade do sinal mioelétrico e dificultar a reprodutibilidade da medida da EMG. OBJETIVO: Determinar a reprodutibilidade teste-reteste e quantificar o erro técnico da medida da frequência mediana (FM) e da amplitude (root mean square, RMS) da EMG, em contrações dinâmicas e estáticas. MÉTODOS: Dez sujeitos foram testados em dois dias, sendo a atividade EMG registrada na maior porção do bíceps braquial. No primeiro dia foi feito o teste de uma repetição máxima (1RM) e de contração voluntária máxima (CVM). No segundo dia foram realizadas duas séries de 10 contrações dos flexores do cotovelo com 75% de 1RM, entremeadas por 1 h em repouso. Antes de cada série foi realizada uma CVM. RESULTADOS: Para a FM e RMS foi observado alto coeficiente de correlação intraclasse para o sinal do bíceps braquial (CCI = 0,90-0,98 para a FM; CCI = 0,89-0,94 para o RMS) e de baixo para moderado coeficiente de variação (CV = 2,5-6,2% para a FM; CV = 14,6-16,3% para o RMS) em ambos os testes. Não foi observada diferença significativa entre teste e reteste (p > 0,05). CONCLUSÃO: A FM e o RMS apresentam alta confiabilidade e baixo a moderado erro em contrações estáticas e dinâmicas, possibilitando o uso da EMG para investigação da fadiga e de desordens neuromusculares.

The effects of lower extremity muscle fatigue on the vertical ground reaction force: a meta-analysis

There is currently no consensus in the literature on whether the magnitude of the ground reaction force or loading rate decreases or increases with muscle fatigue. In this article, the effects of lower extremity muscle fatigue on the magnitude of the ground reaction force and loading rate during running and drop landing are examined. Through a systematic search of the literature, 24 articles are identified that satisfy the inclusion criteria and study the relationship between fatigue and the ground reaction force variables during running, single-leg drop landing, and bilateral drop landing. The articles are categorized based on the type of locomotion they study. To determine whether or not the ground reaction force peaks/loading rate are markedly affected by fatigue, meta-analyses are conducted both separately for each type of locomotion and for an aggregate of all studies. The results of the meta-analyses show that the ground reaction force active peak significantly decreases for the following study groups: aggregate of all included studies, studies of drop landing (both single-leg and bilateral), and studies of bilateral landing only. The ground reaction force active peak did not significantly change in running and single-leg drop landing. The effects of muscle fatigue on the magnitude of the ground reaction force impact peak and loading rate was always insignificant.