Evidence map›Paper›PMID 41794818›Full record

ArticleBMC sports science, medicine & rehabilitation2026

The effect of mixed fatigue on knee biomechanics and muscle activation during sidestep cutting in elite soccer players.

Kuiyu Chen, Dong Sun, Diwei Chen, Bojie Xuan, Dongxu Wang, Yang Song, Xuanzhen Cen, Monem Jemni, Gusztav Fekete, Yaodong Gu

Abstract read
In one paragraph

Article in BMC sports science, medicine & rehabilitation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Kuiyu ChenFaculty of Sports Science, Ningbo University, No. 818, Fenghua Road, Jiangbei District, Ningbo, Zhejiang, 315211, China.
Dong SunFaculty of Sports Science, Ningbo University, No. 818, Fenghua Road, Jiangbei District, Ningbo, Zhejiang, 315211, China. sundong@nbu.edu.cn.
Diwei ChenFaculty of Sports Science, Ningbo University, No. 818, Fenghua Road, Jiangbei District, Ningbo, Zhejiang, 315211, China.
Bojie XuanFaculty of Sports Science, Ningbo University, No. 818, Fenghua Road, Jiangbei District, Ningbo, Zhejiang, 315211, China.
Dongxu WangFaculty of Sports Science, Ningbo University, No. 818, Fenghua Road, Jiangbei District, Ningbo, Zhejiang, 315211, China.
Yang SongFaculty of Sports Science, Ningbo University, No. 818, Fenghua Road, Jiangbei District, Ningbo, Zhejiang, 315211, China.
Xuanzhen CenFaculty of Sports Science, Ningbo University, No. 818, Fenghua Road, Jiangbei District, Ningbo, Zhejiang, 315211, China.
Monem JemniFaculty of Sports Science, Ningbo University, No. 818, Fenghua Road, Jiangbei District, Ningbo, Zhejiang, 315211, China.
Gusztav FeketeDepartment of Materials Science and Mechanical Engineering, AUDI Hungaria Faculty of Engineering, Széchenyi István University, Győr, Hungary.
Yaodong GuFaculty of Sports Science, Ningbo University, No. 818, Fenghua Road, Jiangbei District, Ningbo, Zhejiang, 315211, China. guyaodong@hotmail.com.

Funding

National Social Science Fund of China 25BTY103
6 · The paper itself

Abstract

backgroundFootball is one of the most popular sports in the world, and it is also a sport with a high rate of injury. The study aims to investigate the effects of physical and mental mixed fatigue (PMF) on knee biomechanics during sidestep cutting maneuvers in elite male soccer players, thereby assessing the potential mechanisms underlying non-contact knee injuries.

methodsThirty-six elite male soccer players were recruited (age: 21.61 ± 1.22 years; body mass: 75.16 ± 6.34 kg; height: 175.8 ± 3.53 cm; shoe size: 41–44 EUR). Following a targeted fatigue induction protocol, key lower limb biomechanical data were acquired during anticipated sidestep cutting maneuvers both pre- and post-PMF. Statistical analyses were performed utilizing paired sample t-tests and one-dimensional Statistical Parametric Mapping (SPM1d).

resultsFollowing PMF, knee valgus increased at initial contact (P = 0.022). Kinetic analysis, supported by SPM1d, revealed a marked transition from an extensor-dominant to a flexor-dominant pattern in sagittal knee moments (P = 0.007), alongside elevated knee valgus moments (P = 0.039). Neuromuscularly, quadriceps and lateral gastrocnemius activation (iEMG/RMS) significantly decreased, whereas compensatory increases were observed in the hamstrings and medial gastrocnemius (all P < 0.001).

conclusionWhile PMF preserved most kinematics, the statistically significant increase in knee valgus, though small in magnitude, suggests an impaired frontal-plane control that may elevate Anterior Cruciate Ligament (ACL) strain. The shift from quadriceps to hamstring dominance reflects a compensatory neuromuscular strategy. These findings emphasize the importance of incorporating cognitive load into injury-prevention programs and monitoring mental fatigue to reduce non-contact knee injury risks.

Indexed as

Anterior cruciate ligament (ACL)Dual-taskKnee injuryMix fatigueMuscle fatigueNeuromuscular controlNon-contact injuriesSidestep cuttingSoccer

Identifiers

PMID41794818
PMCPMC13081324

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.