Effects of unilateral leg muscle fatigue on balance control in perturbed and unperturbed gait in healthy elderly.

This study assessed effects of unilateral leg muscle fatigue (ULMF) on balance control in gait during the stance and swing phases of the fatigued leg in healthy elderly, to test the assumption that leg muscle strength limits balance control during the stance-phase. Ten subjects (aged 63.4, SD 5.5 years) walked on a treadmill in 4 conditions: unperturbed unfatigued, unperturbed fatigued, perturbed unfatigued, and perturbed fatigued. The perturbations were lateral trunk pulls just before contralateral heel contact. ULMF was evoked by unilateral squat exercise until task failure. Isometric knee extension strength was measured to verify the presence of muscle fatigue. Between-stride standard deviations and Lyapunov exponents of trunk kinematics were used as indicators of balance control. Required perturbation force and the deviation of trunk kinematics from unperturbed gait were used to assess perturbation responses. Knee extension strength decreased considerably (17.3% SD 8.6%) as a result ULMF. ULMF did not affect steady-state gait balance. Less force was required to perturb subjects when the fatigued leg was in the stance-phase compared to the swing-phase. Subjects showed a faster return to the unperturbed gait pattern in the fatigued than in the unfatigued condition, after perturbations in swing and stance of the fatigued leg. The results of this study are not in line with the hypothesized effects of leg muscle fatigue on balance in gait. The healthy elderly subjects were able to cope with substantial ULMF during steady-state gait and demonstrated faster balance recovery after laterally directed mechanical perturbations in the fatigued than in the unfatigued condition.