Effects of Lower Extremity and Core Muscles Fatigue Protocols on Landing Mechanics and Performance in Female Athletes
,
Abstract
Fatigue decreases muscle strength and functional capacity, disrupting neuromuscular coordination by impairing load control. This negatively impacts the kinetics and kinematics of the ankle, knee, and hip joints, resulting in reduced performance and an increased risk of injury, particularly to the anterior cruciate ligament (ACL). This study aimed to compare the effects of fatigue protocols for lower extremity and core muscles on landing mechanics and performance of female athletes. This study used a cross-sectional, comparative, pretest-posttest design with a control group. A total of 105 female athletes, aged 11 to 49, were selected via convenience and purposive sampling. Participants were divided into three groups: core muscle fatigue, lower extremity muscle fatigue, and a control group. Data were gathered using the Landing Error Scoring System (LESS), Y-Balance, and 45-degree trunk flexion tests. Data were analyzed using descriptive statistics, Shapiro-Wilk test, Levene's test, one-way ANCOVA, and the Bonferroni post hoc test. A P of 0.05 or lower was considered statistically significant. ANCOVA results showed significant differences among the groups for the LESS (P=0.001) and 45 ° trunk flexion test (P=0.001). There was no significant difference between the two experimental groups regarding the LESS (P=1.00). However, a significant difference was observed between the two experimental groups in the trunk flexion test (P=0.001). Fatigue had a greater effect size on landing mechanics (ηp²=0.209) than on the trunk flexion test (ηp²=0.143). However, no significant difference was observed between the groups regarding the Y-Balance Test (P=0.996). The study revealed that fatigue protocols targeting lower extremity and core muscles had a negative impact on kinematic parameters associated with ACL injuries during jump-landing in female athletes. Additionally, core muscle fatigue significantly impacted the 45º trunk flexion test, while lower extremity muscle fatigue had no significant effect on it.
1. Arendt EA, Agel J, Dick R. Anterior cruciate ligament injury patterns among collegiate men and women. J Athl Train 1999;34:86-92.
2. Gray J, Taunton JE, McKenzie DC, Clement DB, McConkey JP, Davidson RG. A survey of injuries to the anterior cruciate ligament of the knee in female basketball players. Int J Sports Med 1985;6:314-6.
3. Qu X, Jiang J, Hu X. Effects of Subsensory Noise and Fatigue on Knee Landing and Cross-over Cutting Biomechanics in Male Athletes. J Appl Biomech 2018;34:205-10.
4. Johnson U, Ivarsson A, Karlsson J, Hägglund M, Waldén M, Börjesson M. Rehabilitation after first-time anterior cruciate ligament injury and reconstruction in female football players: a study of resilience factors. BMC Sports Sci Med Rehabil 2016;8:20.
5. Dix C, Arundale A, Silvers-Granelli H, Marmon A, Zarzycki R, Snyder-Mackler L, et al. Biomechanical measures during two sport-specific tasks differentiate between soccer players who go on to anterior cruciate ligament injury and those who do not: a prospective cohort analysis. Int J Sports Phys Ther 2020;15:928-35.
6. Lucarno S, Zago M, Buckthorpe M, Grassi A, Tosarelli F, Smith R, et al. Systematic Video Analysis of Anterior Cruciate Ligament Injuries in Professional Female Soccer Players. Am J Sports Med 2021;49:1794-802.
7. Mehl J, Diermeier T, Herbst E, Imhoff AB, Stoffels T, Zantop T, et al. Evidence-based concepts for prevention of knee and ACL injuries. 2017 guidelines of the ligament committee of the German Knee Society (DKG). Arch Orthop Trauma Surg 2018;138:51-61.
8. Mancino F, Gabr A, Plastow R, Haddad FS. Anterior cruciate ligament injuries in female athletes. Bone Joint J 2023;105-b:1033-7.
9. Lee J, Pathak P, Panday SB, Moon J. Effect of Foot-Planting Strategy on Anterior Cruciate Ligament Loading in Women During a Direction Diversion Maneuver: A Musculoskeletal Modeling Approach. Orthop J Sports Med 2020;8:2325967120963180.
10. Smith HC, Vacek P, Johnson RJ, Slauterbeck JR, Hashemi J, Shultz S, et al. Risk factors for anterior cruciate ligament injury: a review of the literature - part 1: neuromuscular and anatomic risk. Sports Health 2012;4:69-78.
11. Stijak L, Kadija M, Djulejić V, Aksić M, Petronijević N, Marković B, et al. The influence of sex hormones on anterior cruciate ligament rupture: female study. Knee Surg Sports Traumatol Arthrosc 2015;23:2742-9.
12. Zago M, David S, Bertozzi F, Brunetti C, Gatti A, Salaorni F, et al. Fatigue Induced by Repeated Changes of Direction in Élite Female Football (Soccer) Players: Impact on Lower Limb Biomechanics and Implications for ACL Injury Prevention. Front Bioeng Biotechnol 2021;9:666841.
13. Tran AA, Gatewood C, Harris AH, Thompson JA, Dragoo JL. The effect of foot landing position on biomechanical risk factors associated with anterior cruciate ligament injury. J Exp Orthop 2016;3:13.
14. Yu B, Herman D, Preston J, Lu W, Kirkendall DT, Garrett WE. Immediate effects of a knee brace with a constraint to knee extension on knee kinematics and ground reaction forces in a stop-jump task. Am J Sports Med 2004;32:1136-43.
15. Hewett TE, Myer GD, Ford KR, Heidt RS Jr, Colosimo AJ, McLean SG, et al. Biomechanical measures of neuromuscular control and valgus loading of the knee predict anterior cruciate ligament injury risk in female athletes: a prospective study. Am J Sports Med 2005;33:492-501.
16. Willson JD, Davis IS. Utility of the frontal plane projection angle in females with patellofemoral pain. J Orthop Sports Phys Ther 2008;38:606-15.
17. De Blaiser C, Roosen P, Willems T, Danneels L, Bossche LV, De Ridder R. Is core stability a risk factor for lower extremity injuries in an athletic population? A systematic review. Phys Ther Sport 2018;30:48-56.
18. Sharrock C, Cropper J, Mostad J, Johnson M, Malone T. A pilot study of core stability and athletic performance: is there a relationship? Int J Sports Phys Ther 2011;6:63-74.
19. Wilkerson GB, Colston MA. A Refined Prediction Model for Core and Lower Extremity Sprains and Strains Among Collegiate Football Players. J Athl Train 2015;50:643-50.
20. Heil J, Loffing F, Büsch D. The Influence of Exercise-Induced Fatigue on Inter-Limb Asymmetries: a Systematic Review. Sports Med Open 2020;6:39.
21. McLean SG, Fellin RE, Suedekum N, Calabrese G, Passerallo A, Joy S. Impact of fatigue on gender-based high-risk landing strategies. Med Sci Sports Exerc 2007;39:502-14.
22. Weeks BK, Carty CP, Horan SA. Effect of sex and fatigue on single leg squat kinematics in healthy young adults. BMC Musculoskelet Disord 2015;16:271.
23. Khosravi S, Shirzad Eraghi E, Seydi F. Effect of core muscle functional fatigue on some of kinematics parameters related to ACL injury during single-leg stop-jump task in female athletes. Sci J Rehabil Med 2018;7:10-21.
24. Sebyani M, Shirzad E, Minoo Nejad H. Effect of Core Muscles Functional Fatigue on Some Kinematics Parameters Related to Anterior Cruciate Ligament (ACL) Injury During Cutting Maneuver in Mollegiate Male Athletes. Stud Sport Med 2018;10:61-80.
25. Seyedi M, Torkaman M, Soleiman-fallah M, Khezri D, Ashroshtaghi M. The Effect of Core Fatigue on Lower Extremity Kinematic Variables During Squats in Female Body Builders. Phys Treat Spec Phys Ther J 2022;12:261-8.
26. Aliabadi M, Daneshmandi H, Norasteh A. Study of upper extremity injuries in Iranian clubs handball and volleyball players and its relationship with some physical features. J Pract Stud Biosci Sport 2017;5:85-95.
27. De Blaiser C, De Ridder R, Willems T, Danneels L, Vanden Bossche L, Palmans T, et al. Evaluating abdominal core muscle fatigue: Assessment of the validity and reliability of the prone bridging test. Scand J Med Sci Sports 2018;28:391-9.
28. Borg G. Psychophysical scaling with applications in physical work and the perception of exertion. Scand J Work Environ Health 1990;16:55-8.
29. Borg G. Borg's perceived exertion and pain scales: Human kinetics; 1998.
30. Frasie A, Bertrand-Charette M, Compagnat M, Bouyer LJ, Roy JS. Validation of the Borg CR10 Scale for the evaluation of shoulder perceived fatigue during work-related tasks. Appl Ergon 2024;116:104200.
31. Lessi GC, Dos Santos AF, Batista LF, de Oliveira GC, Serrão FV. Effects of fatigue on lower limb, pelvis and trunk kinematics and muscle activation: Gender differences. J Electromyogr Kinesiol 2017;32:9-14.
32. Orishimo KF, Kremenic IJ. Effect of fatigue on single-leg hop landing biomechanics. J Appl Biomech 2006;22:245-54.
33. Padua DA, DiStefano LJ, Beutler AI, de la Motte SJ, DiStefano MJ, Marshall SW. The Landing Error Scoring System as a Screening Tool for an Anterior Cruciate Ligament Injury-Prevention Program in Elite-Youth Soccer Athletes. J Athl Train 2015;50:589-95.
34. Hanzlíková I, Hébert-Losier K. Is the Landing Error Scoring System Reliable and Valid? A Systematic Review. Sports Health 2020;12:181-8.
35. Overmoyer GV, Reiser RF 2nd. Relationships between lower-extremity flexibility, asymmetries, and the Y balance test. J Strength Cond Res 2015;29:1240-7.
36. Shaffer SW, Teyhen DS, Lorenson CL, Warren RL, Koreerat CM, Straseske CA, et al. Y-balance test: a reliability study involving multiple raters. Mil Med 2013;178:1264-70.
37. Benis R, Bonato M, La Torre A. Elite Female Basketball Players' Body-Weight Neuromuscular Training and Performance on the Y-Balance Test. J Athl Train 2016;51:688-95.
38. López-Valenciano A, Ayala F, De Ste Croix M, Barbado D, Vera-Garcia FJ. Different neuromuscular parameters influence dynamic balance in male and female football players. Knee Surg Sports Traumatol Arthrosc 2019;27:962-70.
39. Myers H, Christopherson Z, Butler RJ. Relationship between the lower quarter Y-balance test scores and isokinetic strength testing in patients status post ACL reconstruction. Int J Sports Phys Ther 2018;13:152-9.
40. Hallagin C, Garrison JC, Creed K, Bothwell JM, Goto S, Hannon J. The relationship between pre-operative and twelve-week post-operative Y-balance and quadriceps strength in athletes with an anterior cruciate ligament tear. Int J Sports Phys Ther 2017;12:986-93.
41. Plisky PJ, Gorman PP, Butler RJ, Kiesel KB, Underwood FB, Elkins B. The reliability of an instrumented device for measuring components of the star excursion balance test. N Am J Sports Phys Ther 2009;4:92-9.
42. Ehsani F, Mohseni-Bandpei MA, Shanbeh-Zadeh S. The Effect of Stabilization Exercises on Objective Outcome Measures in Patients with Chronic Non-Specific Low Back Pain: A Systematic Review with Particular Emphasis On Randomized Controlled Clinical Trial. Arch Rehabil 2013;14:8-21.
43. Bell DR, Smith MD, Pennuto AP, Stiffler MR, Olson ME. Jump-landing mechanics after anterior cruciate ligament reconstruction: a landing error scoring system study. J Athl Train 2014;49:435-41.
44. Gandomi F, Najafi M. Effect of core muscles fatigue on landing mechanic and lower extremity function. Sci J Rehabil Med 2018;7:30-40.
45. Riemann BL, Myers JB, Lephart SM. Sensorimotor system measurement techniques. J Athl Train 2002;37:85-98.
46. Salci Y, Kentel BB, Heycan C, Akin S, Korkusuz F. Comparison of landing maneuvers between male and female college volleyball players. Clin Biomech (Bristol) 2004;19:622-8.
47. Khayambashi K, Ghoddosi N, Straub RK, Powers CM. Hip Muscle Strength Predicts Non-contact Anterior Cruciate Ligament Injury in Male and Female Athletes: A Prospective Study. Am J Sports Med 2016;44:355-61.
48. Munro A, Herrington L, Carolan M. Reliability of 2-dimensional video assessment of frontal-plane dynamic knee valgus during common athletic screening tasks. J Sport Rehabil 2012;21:7-11.
49. Pappas E, Sheikhzadeh A, Hagins M, Nordin M. The effect of gender and fatigue on the biomechanics of bilateral landings from a jump: peak values. J Sports Sci Med 2007;6:77-84.
50. Yu B, Garrett WE. Mechanisms of non-contact ACL injuries. Br J Sports Med 2007;41:i47-51.
51. Wetters N, Weber AE, Wuerz TH, Schub DL, Mandelbaum BR. Mechanism of injury and risk factors for anterior cruciate ligament injury. Oper Technol Sports Med 2016;24:2-6.
52. Jackson ND, Gutierrez GM, Kaminski T. The effect of fatigue and habituation on the stretch reflex of the ankle musculature. J Electromyogr Kinesiol 2009;19:75-84.
53. Vermeulen S, Bleecker C, Blaiser C, Kilinç Ö O, Willems T, Vanrenterghem J, et al. The Effect of Fatigue on Trunk and Pelvic Jump-Landing Biomechanics in View of Lower Extremity Loading: A Systematic Review. J Hum Kinet 2023;86:73-95.
54. Bergmark A. Stability of the lumbar spine. A study in mechanical engineering. Acta Orthop Scand Suppl 1989;230:1-54.
55. Hodges PW. Is there a role for transversus abdominis in lumbo-pelvic stability? Man Ther 1999;4:74-86.
56. Larwa J, Stoy C, Chafetz RS, Boniello M, Franklin C. Stiff Landings, Core Stability, and Dynamic Knee Valgus: A Systematic Review on Documented Anterior Cruciate Ligament Ruptures in Male and Female Athletes. Int J Environ Res Public Health 2021;18:3826.
57. Abyar S, Fatahi A, Yousefian Molla R. The Effect of Local Fatigue in Core Stability Muscles on Selected Biomechanical Variables of Upper Limb in Professional Women Rowers. J Physiol Mov Health 2022;2.
58. Sheikhhassani S, Rajabi R, Minoonejad H. Effect of core muscle fatigue on measurements of lower extremity functional performance in male athletes. J Res Rehabil Sci 2013;9.
59. Augustsson J, Thomeé R, Lindén C, Folkesson M, Tranberg R, Karlsson J. Single-leg hop testing following fatiguing exercise: reliability and biomechanical analysis. Scand J Med Sci Sports 2006;16:111-20.
60. Chappell JD, Herman DC, Knight BS, Kirkendall DT, Garrett WE, Yu B. Effect of fatigue on knee kinetics and kinematics in stop-jump tasks. Am J Sports Med 2005;33:1022-9.
61. Kofotolis ND, Kellis E, Vlachopoulos SP. Ankle sprain injuries and risk factors in amateur soccer players during a 2-year period. Am J Sports Med 2007;35:458-66.
62. Verschueren J, Tassignon B, De Pauw K, Proost M, Teugels A, Van Cutsem J, et al. Does Acute Fatigue Negatively Affect Intrinsic Risk Factors of the Lower Extremity Injury Risk Profile? A Systematic and Critical Review. Sports Med 2020;50:767-84.
63. Bourne MN, Webster KE, Hewett TE. Is Fatigue a Risk Factor for Anterior Cruciate Ligament Rupture? Sports Med 2019;49:1629-35.
64. Barber-Westin SD, Noyes FR. Effect of Fatigue Protocols on Lower Limb Neuromuscular Function and Implications for Anterior Cruciate Ligament Injury Prevention Training: A Systematic Review. Am J Sports Med 2017;45:3388-96.
65. Madigan ML, Pidcoe PE. Changes in landing biomechanics during a fatiguing landing activity. J Electromyogr Kinesiol 2003;13:491-8.
66. Navacchia A, Ueno R, Ford KR, DiCesare CA, Myer GD, Hewett TE. EMG-Informed Musculoskeletal Modeling to Estimate Realistic Knee Anterior Shear Force During Drop Vertical Jump in Female Athletes. Ann Biomed Eng 2019;47:2416-30.
2. Gray J, Taunton JE, McKenzie DC, Clement DB, McConkey JP, Davidson RG. A survey of injuries to the anterior cruciate ligament of the knee in female basketball players. Int J Sports Med 1985;6:314-6.
3. Qu X, Jiang J, Hu X. Effects of Subsensory Noise and Fatigue on Knee Landing and Cross-over Cutting Biomechanics in Male Athletes. J Appl Biomech 2018;34:205-10.
4. Johnson U, Ivarsson A, Karlsson J, Hägglund M, Waldén M, Börjesson M. Rehabilitation after first-time anterior cruciate ligament injury and reconstruction in female football players: a study of resilience factors. BMC Sports Sci Med Rehabil 2016;8:20.
5. Dix C, Arundale A, Silvers-Granelli H, Marmon A, Zarzycki R, Snyder-Mackler L, et al. Biomechanical measures during two sport-specific tasks differentiate between soccer players who go on to anterior cruciate ligament injury and those who do not: a prospective cohort analysis. Int J Sports Phys Ther 2020;15:928-35.
6. Lucarno S, Zago M, Buckthorpe M, Grassi A, Tosarelli F, Smith R, et al. Systematic Video Analysis of Anterior Cruciate Ligament Injuries in Professional Female Soccer Players. Am J Sports Med 2021;49:1794-802.
7. Mehl J, Diermeier T, Herbst E, Imhoff AB, Stoffels T, Zantop T, et al. Evidence-based concepts for prevention of knee and ACL injuries. 2017 guidelines of the ligament committee of the German Knee Society (DKG). Arch Orthop Trauma Surg 2018;138:51-61.
8. Mancino F, Gabr A, Plastow R, Haddad FS. Anterior cruciate ligament injuries in female athletes. Bone Joint J 2023;105-b:1033-7.
9. Lee J, Pathak P, Panday SB, Moon J. Effect of Foot-Planting Strategy on Anterior Cruciate Ligament Loading in Women During a Direction Diversion Maneuver: A Musculoskeletal Modeling Approach. Orthop J Sports Med 2020;8:2325967120963180.
10. Smith HC, Vacek P, Johnson RJ, Slauterbeck JR, Hashemi J, Shultz S, et al. Risk factors for anterior cruciate ligament injury: a review of the literature - part 1: neuromuscular and anatomic risk. Sports Health 2012;4:69-78.
11. Stijak L, Kadija M, Djulejić V, Aksić M, Petronijević N, Marković B, et al. The influence of sex hormones on anterior cruciate ligament rupture: female study. Knee Surg Sports Traumatol Arthrosc 2015;23:2742-9.
12. Zago M, David S, Bertozzi F, Brunetti C, Gatti A, Salaorni F, et al. Fatigue Induced by Repeated Changes of Direction in Élite Female Football (Soccer) Players: Impact on Lower Limb Biomechanics and Implications for ACL Injury Prevention. Front Bioeng Biotechnol 2021;9:666841.
13. Tran AA, Gatewood C, Harris AH, Thompson JA, Dragoo JL. The effect of foot landing position on biomechanical risk factors associated with anterior cruciate ligament injury. J Exp Orthop 2016;3:13.
14. Yu B, Herman D, Preston J, Lu W, Kirkendall DT, Garrett WE. Immediate effects of a knee brace with a constraint to knee extension on knee kinematics and ground reaction forces in a stop-jump task. Am J Sports Med 2004;32:1136-43.
15. Hewett TE, Myer GD, Ford KR, Heidt RS Jr, Colosimo AJ, McLean SG, et al. Biomechanical measures of neuromuscular control and valgus loading of the knee predict anterior cruciate ligament injury risk in female athletes: a prospective study. Am J Sports Med 2005;33:492-501.
16. Willson JD, Davis IS. Utility of the frontal plane projection angle in females with patellofemoral pain. J Orthop Sports Phys Ther 2008;38:606-15.
17. De Blaiser C, Roosen P, Willems T, Danneels L, Bossche LV, De Ridder R. Is core stability a risk factor for lower extremity injuries in an athletic population? A systematic review. Phys Ther Sport 2018;30:48-56.
18. Sharrock C, Cropper J, Mostad J, Johnson M, Malone T. A pilot study of core stability and athletic performance: is there a relationship? Int J Sports Phys Ther 2011;6:63-74.
19. Wilkerson GB, Colston MA. A Refined Prediction Model for Core and Lower Extremity Sprains and Strains Among Collegiate Football Players. J Athl Train 2015;50:643-50.
20. Heil J, Loffing F, Büsch D. The Influence of Exercise-Induced Fatigue on Inter-Limb Asymmetries: a Systematic Review. Sports Med Open 2020;6:39.
21. McLean SG, Fellin RE, Suedekum N, Calabrese G, Passerallo A, Joy S. Impact of fatigue on gender-based high-risk landing strategies. Med Sci Sports Exerc 2007;39:502-14.
22. Weeks BK, Carty CP, Horan SA. Effect of sex and fatigue on single leg squat kinematics in healthy young adults. BMC Musculoskelet Disord 2015;16:271.
23. Khosravi S, Shirzad Eraghi E, Seydi F. Effect of core muscle functional fatigue on some of kinematics parameters related to ACL injury during single-leg stop-jump task in female athletes. Sci J Rehabil Med 2018;7:10-21.
24. Sebyani M, Shirzad E, Minoo Nejad H. Effect of Core Muscles Functional Fatigue on Some Kinematics Parameters Related to Anterior Cruciate Ligament (ACL) Injury During Cutting Maneuver in Mollegiate Male Athletes. Stud Sport Med 2018;10:61-80.
25. Seyedi M, Torkaman M, Soleiman-fallah M, Khezri D, Ashroshtaghi M. The Effect of Core Fatigue on Lower Extremity Kinematic Variables During Squats in Female Body Builders. Phys Treat Spec Phys Ther J 2022;12:261-8.
26. Aliabadi M, Daneshmandi H, Norasteh A. Study of upper extremity injuries in Iranian clubs handball and volleyball players and its relationship with some physical features. J Pract Stud Biosci Sport 2017;5:85-95.
27. De Blaiser C, De Ridder R, Willems T, Danneels L, Vanden Bossche L, Palmans T, et al. Evaluating abdominal core muscle fatigue: Assessment of the validity and reliability of the prone bridging test. Scand J Med Sci Sports 2018;28:391-9.
28. Borg G. Psychophysical scaling with applications in physical work and the perception of exertion. Scand J Work Environ Health 1990;16:55-8.
29. Borg G. Borg's perceived exertion and pain scales: Human kinetics; 1998.
30. Frasie A, Bertrand-Charette M, Compagnat M, Bouyer LJ, Roy JS. Validation of the Borg CR10 Scale for the evaluation of shoulder perceived fatigue during work-related tasks. Appl Ergon 2024;116:104200.
31. Lessi GC, Dos Santos AF, Batista LF, de Oliveira GC, Serrão FV. Effects of fatigue on lower limb, pelvis and trunk kinematics and muscle activation: Gender differences. J Electromyogr Kinesiol 2017;32:9-14.
32. Orishimo KF, Kremenic IJ. Effect of fatigue on single-leg hop landing biomechanics. J Appl Biomech 2006;22:245-54.
33. Padua DA, DiStefano LJ, Beutler AI, de la Motte SJ, DiStefano MJ, Marshall SW. The Landing Error Scoring System as a Screening Tool for an Anterior Cruciate Ligament Injury-Prevention Program in Elite-Youth Soccer Athletes. J Athl Train 2015;50:589-95.
34. Hanzlíková I, Hébert-Losier K. Is the Landing Error Scoring System Reliable and Valid? A Systematic Review. Sports Health 2020;12:181-8.
35. Overmoyer GV, Reiser RF 2nd. Relationships between lower-extremity flexibility, asymmetries, and the Y balance test. J Strength Cond Res 2015;29:1240-7.
36. Shaffer SW, Teyhen DS, Lorenson CL, Warren RL, Koreerat CM, Straseske CA, et al. Y-balance test: a reliability study involving multiple raters. Mil Med 2013;178:1264-70.
37. Benis R, Bonato M, La Torre A. Elite Female Basketball Players' Body-Weight Neuromuscular Training and Performance on the Y-Balance Test. J Athl Train 2016;51:688-95.
38. López-Valenciano A, Ayala F, De Ste Croix M, Barbado D, Vera-Garcia FJ. Different neuromuscular parameters influence dynamic balance in male and female football players. Knee Surg Sports Traumatol Arthrosc 2019;27:962-70.
39. Myers H, Christopherson Z, Butler RJ. Relationship between the lower quarter Y-balance test scores and isokinetic strength testing in patients status post ACL reconstruction. Int J Sports Phys Ther 2018;13:152-9.
40. Hallagin C, Garrison JC, Creed K, Bothwell JM, Goto S, Hannon J. The relationship between pre-operative and twelve-week post-operative Y-balance and quadriceps strength in athletes with an anterior cruciate ligament tear. Int J Sports Phys Ther 2017;12:986-93.
41. Plisky PJ, Gorman PP, Butler RJ, Kiesel KB, Underwood FB, Elkins B. The reliability of an instrumented device for measuring components of the star excursion balance test. N Am J Sports Phys Ther 2009;4:92-9.
42. Ehsani F, Mohseni-Bandpei MA, Shanbeh-Zadeh S. The Effect of Stabilization Exercises on Objective Outcome Measures in Patients with Chronic Non-Specific Low Back Pain: A Systematic Review with Particular Emphasis On Randomized Controlled Clinical Trial. Arch Rehabil 2013;14:8-21.
43. Bell DR, Smith MD, Pennuto AP, Stiffler MR, Olson ME. Jump-landing mechanics after anterior cruciate ligament reconstruction: a landing error scoring system study. J Athl Train 2014;49:435-41.
44. Gandomi F, Najafi M. Effect of core muscles fatigue on landing mechanic and lower extremity function. Sci J Rehabil Med 2018;7:30-40.
45. Riemann BL, Myers JB, Lephart SM. Sensorimotor system measurement techniques. J Athl Train 2002;37:85-98.
46. Salci Y, Kentel BB, Heycan C, Akin S, Korkusuz F. Comparison of landing maneuvers between male and female college volleyball players. Clin Biomech (Bristol) 2004;19:622-8.
47. Khayambashi K, Ghoddosi N, Straub RK, Powers CM. Hip Muscle Strength Predicts Non-contact Anterior Cruciate Ligament Injury in Male and Female Athletes: A Prospective Study. Am J Sports Med 2016;44:355-61.
48. Munro A, Herrington L, Carolan M. Reliability of 2-dimensional video assessment of frontal-plane dynamic knee valgus during common athletic screening tasks. J Sport Rehabil 2012;21:7-11.
49. Pappas E, Sheikhzadeh A, Hagins M, Nordin M. The effect of gender and fatigue on the biomechanics of bilateral landings from a jump: peak values. J Sports Sci Med 2007;6:77-84.
50. Yu B, Garrett WE. Mechanisms of non-contact ACL injuries. Br J Sports Med 2007;41:i47-51.
51. Wetters N, Weber AE, Wuerz TH, Schub DL, Mandelbaum BR. Mechanism of injury and risk factors for anterior cruciate ligament injury. Oper Technol Sports Med 2016;24:2-6.
52. Jackson ND, Gutierrez GM, Kaminski T. The effect of fatigue and habituation on the stretch reflex of the ankle musculature. J Electromyogr Kinesiol 2009;19:75-84.
53. Vermeulen S, Bleecker C, Blaiser C, Kilinç Ö O, Willems T, Vanrenterghem J, et al. The Effect of Fatigue on Trunk and Pelvic Jump-Landing Biomechanics in View of Lower Extremity Loading: A Systematic Review. J Hum Kinet 2023;86:73-95.
54. Bergmark A. Stability of the lumbar spine. A study in mechanical engineering. Acta Orthop Scand Suppl 1989;230:1-54.
55. Hodges PW. Is there a role for transversus abdominis in lumbo-pelvic stability? Man Ther 1999;4:74-86.
56. Larwa J, Stoy C, Chafetz RS, Boniello M, Franklin C. Stiff Landings, Core Stability, and Dynamic Knee Valgus: A Systematic Review on Documented Anterior Cruciate Ligament Ruptures in Male and Female Athletes. Int J Environ Res Public Health 2021;18:3826.
57. Abyar S, Fatahi A, Yousefian Molla R. The Effect of Local Fatigue in Core Stability Muscles on Selected Biomechanical Variables of Upper Limb in Professional Women Rowers. J Physiol Mov Health 2022;2.
58. Sheikhhassani S, Rajabi R, Minoonejad H. Effect of core muscle fatigue on measurements of lower extremity functional performance in male athletes. J Res Rehabil Sci 2013;9.
59. Augustsson J, Thomeé R, Lindén C, Folkesson M, Tranberg R, Karlsson J. Single-leg hop testing following fatiguing exercise: reliability and biomechanical analysis. Scand J Med Sci Sports 2006;16:111-20.
60. Chappell JD, Herman DC, Knight BS, Kirkendall DT, Garrett WE, Yu B. Effect of fatigue on knee kinetics and kinematics in stop-jump tasks. Am J Sports Med 2005;33:1022-9.
61. Kofotolis ND, Kellis E, Vlachopoulos SP. Ankle sprain injuries and risk factors in amateur soccer players during a 2-year period. Am J Sports Med 2007;35:458-66.
62. Verschueren J, Tassignon B, De Pauw K, Proost M, Teugels A, Van Cutsem J, et al. Does Acute Fatigue Negatively Affect Intrinsic Risk Factors of the Lower Extremity Injury Risk Profile? A Systematic and Critical Review. Sports Med 2020;50:767-84.
63. Bourne MN, Webster KE, Hewett TE. Is Fatigue a Risk Factor for Anterior Cruciate Ligament Rupture? Sports Med 2019;49:1629-35.
64. Barber-Westin SD, Noyes FR. Effect of Fatigue Protocols on Lower Limb Neuromuscular Function and Implications for Anterior Cruciate Ligament Injury Prevention Training: A Systematic Review. Am J Sports Med 2017;45:3388-96.
65. Madigan ML, Pidcoe PE. Changes in landing biomechanics during a fatiguing landing activity. J Electromyogr Kinesiol 2003;13:491-8.
66. Navacchia A, Ueno R, Ford KR, DiCesare CA, Myer GD, Hewett TE. EMG-Informed Musculoskeletal Modeling to Estimate Realistic Knee Anterior Shear Force During Drop Vertical Jump in Female Athletes. Ann Biomed Eng 2019;47:2416-30.
| Files | ||
| Issue | Vol 63 No 4 (2025) | |
| Section | Original Articles | |
| Keywords | ||
| Neuromuscular fatigue Core stability Kinematic parameters Anterior cruciate ligament (ACL) injuries Landing error | ||
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1.
Hajizadeh R, Piri H, Naserpour N, Mozafari S. Effects of Lower Extremity and Core Muscles Fatigue Protocols on Landing Mechanics and Performance in Female Athletes. Acta Med Iran. 2025;63(4):237-246.
