The effects of muscle fatigue of knee muscles on balance ability in healthy adults

무릎 근육의 근피로가 정상 성인의 균형에 미치는 영향

  • Lim, Garin (Department of Physical Therapy, Haengbokhan Hospital) ;
  • Chang, Jongsung (Department of Physical Therapy, Yeungnam University College)
  • 임가린 (행복한 재활요양병원 물리치료실) ;
  • 장종성 (영남이공대학교 물리치료과)
  • Received : 2018.03.18
  • Accepted : 2018.03.29
  • Published : 2018.04.30


Objectives The purpose of this study was to examine the effects muscle fatigue at the knee muscles on balance during standing in healthy adults. Methods Thirty healthy adults were recruited along with their written informed consent. Subjects were randomly assigned to knee extensor group (fatigue on knee extensor, KE), and knee flexor group (fatigue on knee flexor, KF). And subjects performed exercise with each muscle group until muscle fatigue was induced. They were assessed balance ability by functional reaching test (FRT), limit of stability (LOS), and postural sway (one leg standing, normal eye open (NO), normal eye close (NC), pillow with eye open (FO), and pillow with eye close (FC)) before and after fatigue. Results There were significant group differences balance performances in FRT, anterior of limit of stability, one leg standing, and the muscle fatigue of knee muscles were decreased balance performances. The balance performance was affected by visual sense and proprioception. Conclusions These results show that the muscle fatigue of knee muscles decreased balance performance. Therefore, balance exercise program should be trained without muscle fatigue.


  1. Egerton T, Brauer SG, Cresswell AG. The immediate effect of physical activity on standing balance in healthy and balance-impaired older people. Australas J Ageing. 2009;28(2):93-6.
  2. Wojcik LA, Nussbaum MA, Lin D, Shibata PA, Madigan ML. Age and gender moderate the effects of localized muscle fatigue on lower extremity joint torques used during quiet stance. Hum Mov Sci. 2011;30(3):574-83.
  3. Paillard T, Lafont C, Costes-Salon MC, Riviere D, Dupui P. Effects of brisk walking on static and dynamic balance, locomotion, body composition, and aerobic capacity in ageing healthy active men. Int J Sports Med. 2004;25(7):539-46.
  4. Reimer RC 3rd, Wikstrom EA. Functional fatigue of the hip and ankle musculature cause similar alterations in single leg stance postural control. J Sci Med Sport. 2010;13(1):161-6.
  5. Clifford AM, Holder-Powell H. Postural control in healthy individuals. Clin Biomech (Bristol, Avon). 2010;25(6):546-51.
  6. D'Hondt E, Deforche B, De Bourdeaudhuij I, Gentier I, Tanghe A, Shultz S, Lenoir M. Postural balance under normal and altered sensory conditions in normal-weight and overweight children. Clin Biomech (Bristol, Avon). 2011;26(1):84-9.
  7. Murphy DF, Connolly DAJ, Beynnon BD. Risk factors for lower extremity injury: a review of the literature. Br J Sports Med. 2003;37(1):13-29.
  8. Maki BE, Cheng KC, Mansfield A, Scovil CY, Perry SD, Peters AL, McKay S, Lee T, Marquis A, Corbeil P, Fernie GR, Liu B, McIlroy WE. Preventing falls in older adults: new interventions to promote more effective change-in-support balance reactions. J Electromyogr Kinesiol. 2008;18(2):243-54.
  9. Kim HS. The effect of the plantar pressure on dynamic balance by fatigue of leg in the subjects with functional ankle instability. J Digital Contents Society. 2016;16(1):734-42.
  10. Springer BK, Pincivero DM. The effects of localized muscle and whole-body fatigue on single-leg balance between healthy men and women. Gait Posture. 2009;30(1):50-4.
  11. Jeon HS, Hwang S, Woo YK. The effect of ankle and knee immobilization on postural control during standing. Knee. 2013;20(6):600-4.
  12. Duncan PW, Weiner DK, Chandler J, Studenski S. Functional reach: a new clinical measure of balance. J Gerontol. 1990;45(6):M192-7.
  13. Winter DA. Human balance and posture control during standing and walking. Gait Posture. 1995;3(4):193-214.
  14. Gribble PA, Hertel J. Effect of lower-extremity muscle fatigue on postural control. Arch Phys Med Rehabil. 2004;85(4):589-92.
  15. Kim YW, Choi HS, Kim TH. Availability of functional reach test for balance evaluation of the elderly through sensory organization test. J Korean Soc Phys Med. 2011;6(3):293-301.
  16. Kanekar N, Santos MJ, Aruin AS. Anticipatory postural control following fatigue of postural and focal muscles. Clin Neurophysiol. 2008;119(10):2304-13.
  17. Riemann BL, Myers JB, Lephart SM. Comparison of the ankle, knee, hip, and trunk corrective action shown during single-leg stance on firm, foam, and multiaxial surfaces. Arch Phys Med Rehabil. 2003;84(1):90-5.
  18. An JH, Hwang JH, Woo YK, Kim YH, Lee KW, Kim NG. Static posturographic characteristics during balance control under virtual moving surround in patients with chronic ankle sprain. Ann Rehabil Med. 2005;29(3):297-302.
  19. Lee HM, Cheng CK, Liau JJ. Correlation between proprioception, muscle strength, knee laxity, and dynamic standing balance in patients with chronic anterior cruciate ligament deficiency. Knee. 2009;16(5):387-91.
  20. Karamanidis K, Arampatzis A, Mademli L. Age-related deficit in dynamic stability control after forward falls is affected by muscle strength and tendon stiffness. J Electromyogr Kinesiol. 2008;18(6):980-9.
  21. Mademli L, Arampatzis A, Karamanidis K. Dynamic stability control in forward falls: postural corrections after muscle fatigue in young and older adults. Eur J Appl Physiol. 2008;103(3):295-306.