Combined effects of fatigue and decision making on female lower limb landing postures: central and peripheral contributions to ACL injury risk

摘要: Abstract Background In spite of ongoing prevention developments, anterior cruciate ligament injury rates and the associated sex-disparity have remained, suggesting an incomplete understanding mechanism. While both fatigue decision making are known in isolation to directly impact risk, their combined manifestations remain unknown. We thus examined effects on lower limb kinematics during sports relevant landings. Methods Twenty five female National College Athletic Association athletes had initial contact peak stance phase 3D joint quantified anticipated unanticipated single (left right) leg landings, before accumulation fatigue. Jump direction was governed by light stimuli activated prior pre-land respective trials. To induce fatigue, subjects performed repetitive squat (n = 5) randomly ordered jump sequences, until squats were no longer possible. Subject-based measures each dependent factor then calculated across pre-fatigue trials, for those denoting 100% 50% submitted a 3-way mixed design analysis covariance test main time, leg. Findings Fatigue caused significant increases hip extension internal rotation, knee abduction rotation ankle supination angles. Fatigue-induced rotations angle also significantly more pronounced compared Interpretation The integrative may represent worst case scenario terms risk dynamic perpetuating substantial degradation overload central control mechanisms.