Postural stability in altered and unaltered sensory environments following fatiguing exercise of lower extremity joints

Investigations of postural recovery following controlled external perturbations have provided models for healthy and pathological balance behavior. Less work, however, has investigated postural responses related to internal perturbations of the balance system. In this study, lower extremity joint (knee, or ankle) and overall fatigue of the dominant leg provided the internal perturbations to the balance system. Postural sway was examined during unilateral dominant leg standing before and immediately following fatiguing exercise, as well as at 10, 20, and 30 min post-fatigue activity. Sway was measured in both firm and sway-referenced support surface (external perturbation) conditions. Both joint-localized fatigue and overall fatigue were found to induce impairments in postural control, which were further exacerbated by external postural perturbations. Follow-up pairwise comparisons indicated that these impairments persisted at 10 and 30 min post-fatigue. No differences in postural sway were found between fatigue locations or across any interactions between sway and fatigue location. The results indicated that muscular fatigue imposed a prolonged internal perturbation to postural control, regardless of any individual or combined joint fatigue localization. This global effect, combined with the prolonged impairment in postural response, provides support for critical contributions from a central mechanism to postural deficits due to fatigue.