ArticleBMC musculoskeletal disorders2025
The effect of functional fatigue on lower-limb kinematics, balance, and proprioception in individuals with ACL-reconstruction and dynamic knee valgus.
Article in BMC musculoskeletal disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Core stability versus postural control training for pain, disability, and sensorimotor function in chronic non-specific low back pain.Scientific reports · 2026Trial
- Graft-Specific Neuromuscular Responses and EMG Activities During Running Before and After Running-Induced Fatigue in Individuals with ACL Reconstruction.Sensors (Basel, Switzerland) · 2026Article
- Effects of accelerated rehabilitation after ACL reconstruction on clinical and functional outcomes: A systematic review and meta-analysis evaluating clinical meaningfulness.Journal of experimental orthopaedics · 2026Review
- Strengthening exercises improve knee muscle strength and performance but not pain in ACL-reconstructed individuals: A systematic review and meta-analysis of randomised controlled trials.Journal of experimental orthopaedics · 2025Review
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Authors and funding
3 authors.
Funding
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Abstract
objectiveIndividuals with a history of anterior cruciate ligament reconstruction (ACLR) often experience altered biomechanics, such as dynamic knee valgus (DKV), which increases the risk of re-injury. Functional fatigue, resulting from prolonged physical exertion, can further compromise neuromuscular control, balance, and proprioception, exacerbating biomechanical risk factors. This study investigates the impact of functional fatigue on kinematics, balance, and proprioception in individuals with ACLR and DKV.
methodsThis experimental study used a mixed-model design with a between-group factor (fatigue vs. no-fatigue) and a within-subject factor (pre- vs. post-fatigue). Forty-four male participants with ACLR and DKV underwent a Shortened Cycle Fatigue Protocol. Assessments included lower-limb kinematics (LESS), dynamic balance (Y-Balance Test), and knee proprioception (joint repositioning error at 30° and 60°).
resultsFunctional fatigue led to significant worsening in lower-limb kinematics, dynamic balance, and knee proprioception in the experimental group. Specifically, post-fatigue assessments showed higher LESS scores (p < 0.001), decreased Y-Balance performance (p < 0.001), and increased joint repositioning error at 30° (p < 0.001) and 60° (p < 0.001) compared to their baseline. In contrast, the control group maintained stable performance across all measures, highlighting the impact of functional fatigue on biomechanical risk factors.
conclusionFunctional fatigue significantly impairs proprioception, alters lower extremity kinematics, and decreases dynamic balance in individuals with ACLR and DKV. These findings underscore the importance of incorporating fatigue management strategies into rehabilitation and training protocols to mitigate the risk of re-injury. Clinicians should consider incorporating proprioception training, dynamic balance exercises, and muscular endurance conditioning to mitigate fatigue-induced biomechanical impairments and promote safe return-to-sport practices.
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